The Iranian Journal of Neurosurgery最新文献

{"title":"Sensitivity, Specificity, and Cut-off Point of the Mini-Mental State Examination in Patients With Mild Traumatic Brain Injury","authors":"Maryam Jafroudi, Sajjad Rezaei, Z. Reihanian, S. Yousefzadeh-Chabok","doi":"10.32598/irjns.8.25","DOIUrl":"https://doi.org/10.32598/irjns.8.25","url":null,"abstract":"Background and Aim: Most patients suffering from traumatic brain injury (TBI) are those with mild injuries (mTBI). However, due to the absence of symptoms in brain imaging until long after the injury, the manifestations of cognitive impairments remain undiagnosed. Therefore, cognitive screening is considered a key measure in these patients. One of the common screening tools for evaluating cognitive impairments is the mini-mental state examination (MMSE) test. The present study aimed to determine the cut-off point, sensitivity, and specificity of the MMSE test in mTBI patients. Methods and Materials/Patients: In this observational and cross-sectional-analytical study, the statistical population included all patients with mTBI who were injured in the 1st half of 2022. The case group included 79 mTBI patients admitted to the trauma, neurosurgery, and intensive care unit (ICU) departments of Poursina Hospital in Rasht City, Iran, in the 1st half of 2022, who had been referred to the same hospital and Velayat specialized clinic for rehabilitation and re-visit, and the control group included 79 normal healthy individuals. Both groups were cognitively evaluated by the MMSE test on two occasions with an average time interval of 2-3 weeks. Results: The results of the discriminant analysis showed a cut-off point of 27 to 28 as the probable point of cognitive impairment. Also, to identify the cognitive impairment in mTBI patients, this test reported low sensitivity of 0.43-0.58 and a moderate specificity of 0.69-0.80 in two tests. Conclusion: In screening for possible mild cognitive impairment in mTBI patients, the MMSE is relatively useful and should not be used solely to replace a comprehensive neuropsychological evaluation with diagnostic purposes.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129676682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Revise the Medical Students’ Educational Curriculum: Focus on New Therapeutic Strategies as Regenerative Medicine in Neurological Disorders","authors":"Chia Bamshad, A. Saberi, E. Nasiri, Sajjad Rezaei, Amirmahmoud Hashemi Tabalvandani, Zahra Golipour Soleimani, Mehryar Habibi Roudkenar, Farnaz Salahizadeh, Amaneh Mohammadi Roushandeh","doi":"10.32598/irjns.8.14","DOIUrl":"https://doi.org/10.32598/irjns.8.14","url":null,"abstract":"Background and Aim: Healthcare students highly affect the general public regarding transferring knowledge about novel therapeutic approaches. Therefore, assessing and updating their knowledge about the application of new strategies in the treatment of different diseases is very important. The present study was designed to evaluate the level of the students’ knowledge about stem cells and their application in neurological disorders at the Guilan University of Medical Sciences (GUMS). Methods and Materials/Patients: In this cross-sectional study, a questionnaire was designed in three sections. Exclusion criteria were reluctance to participate in the project or answer to less than 20% of the questions. Inclusion criteria included studying at GUMS and willingness to participate in the project and answer the questionnaire. The questionnaire was distributed in all GUMS faculties, including medicine, paramedicine, nursing and midwifery, dentistry, health, and pharmacy. The data were analyzed by SPSS v. 16 through Pearson correlation coefficient, independent t-test, oneway analysis of variance (ANOVA), and Cronbach’s alpha. Results: According to the total awareness score, 51.2% of students showed very poor and 39.7% showed poor knowledge about stem cells and their application in neurological diseases. The knowledge score of the students in the medical faculty was higher than non-medical and was dependent on their educational year. In addition, medical students showed no significant difference in neither knowledge (F=1.406, P=0.221) nor attitude (F=0.603, P=0.697) scores. Fortunately, 72.2% of students had moderate and 20.6% had a strong attitude toward stem cell applications. A moderate correlation was observed between attitude toward stem cells and knowledge about the application of stem cells (r=0.325, P=0.000). Conclusion: GUMS students’ knowledge level was poor toward stem cells and their application in neurological diseases. It is suggested to include some courses about stem cells in the educational curriculum. However, the student’s attitude toward the use of stem cells was encouraging.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115714828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Selenium in Oral Nutritional Therapy for Patients With Subarachnoid Hemorrhage","authors":"S. Z. Faritous, Zohre Hashemi, M. Hajiesmaeili, Zohreh Morshedizad, H. Bakhshandeh, Soha Mehrabimahani","doi":"10.32598/irjns.8.13","DOIUrl":"https://doi.org/10.32598/irjns.8.13","url":null,"abstract":"Background and Aim: Every year, traumatic brain injuries lead to more than one million admissions to emergency rooms and more than 50,000 deaths, and millions of disabilities worldwide, among all ages and genders. This study aimed to examine the effects of selenium added to oral nutritional therapy on the mortality rate and length of hospital stay in patients with subarachnoid hemorrhage admitted to the intensive care unit (ICU) for six months. Methods and Materials/Patients: This clinical trial included 100 patients admitted to the ICU of Loghman Hakim Hospital, Tehran, Iran. These patients were then randomly assigned to intervention or control groups. Standard oral solutions were administered to both groups according to recommended guidelines. Along with the standard nutritional intake, the participants in the intervention group were given 1000 μg of selenium (Selenase-Biosyn, Germany) on the first day of feeding, dissolved in 100 mL of normal saline for 30 minutes, followed by 500μg of selenium daily for 10 days. We screened patients for GCS, and APACHE-II scores, as well as cortisol levels on days 1 and 10. Results: The APACHE-II mean score on the 10th day was significantly different between the two groups, and this was also true before the intervention. In terms of mortality rates, there was no significant difference between the control group and the intervention group. Neither the control group nor the intervention group spent significantly more time in ICU. Conclusion: The effects of selenium on other variables were unclear, although mortality rates did not differ significantly between the two groups. Considering the confounding variables through regression analysis, the APACHE-II variable was negatively impacted by selenium, but taking into account the significant effect of age, a definitive conclusion cannot be made.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129860750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Scenario of Acute Traumatic Thoracic Disc Herniation and Review of the Literature","authors":"A. Rahimizadeh, Zahed Malekmohammadi, W. Williamson, Mahan Amizadeh","doi":"10.32598/irjns.8.12","DOIUrl":"https://doi.org/10.32598/irjns.8.12","url":null,"abstract":"Background and Importance: Sequestrated thoracic disc herniation after a traumatic event without an apparent spinal fracture or dislocation is an extremely rare scenario. Case Presentation: Evaluation of an elderly female with acute paraparesis secondary to a fall down to the ground revealed a right-sided extruded disc at the level of T10-T11. At 6-month follow-up, she made a dramatic recovery following an appropriate surgical intervention. Conclusion: With occurrence of acute paraparesis following a traumatic event, MRI of the vertebral column is necessary, even in the absence of tomographic evidence of fracture-dislocation.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"254 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115848201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Combination of Harrington and Pedicular Screw Fixation in Traumatic Fracture-dislocation of Thoracic Spine: A Case Report and Literature Review","authors":"M. Ehsaei, S. Mohazzab-Torabi, A. Haghir, Bahador Maleki-Pour, Mohammad Ali Abouei Mehriz","doi":"10.32598/irjns.8.21","DOIUrl":"https://doi.org/10.32598/irjns.8.21","url":null,"abstract":"Background and Importance: Fracture-dislocation of the thoracic or lumbar spine (traumatic spondyloptosis) occurs in less than 5% of all spinal injuries mainly affecting the ventral direction. Case Presentation: A paraplegic young man was admitted to Shahid Kamyab Hospital in Mashhad City, Iran due to a motor vehicle accident. Computerized tomography (CT) showed a complete posterior dislocation of the T10 vertebral body on T9, with the superior articular processes of T9 bilaterally locked in the inferior endplate of T10 and complete fractures of the posterior elements. Conclusion: The spinal dislocation was re-aligned by a combination of Harrington fixation and pedicular screws leading to spinal fusion. Six months after surgery, the patient was still paraplegic but the sensory symptoms in the lower extremities and clean intermittent catheterization improved.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123798869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paroxysmal Sympathetic Hyperactivity in Acquired Brain Injury: A Case Series","authors":"Jayaprakash Duraisamy, Rajkumar P.R, Thirumurthy K.S, Akshay Rajkumar, Saju Denishya","doi":"10.32598/irjns.8.19","DOIUrl":"https://doi.org/10.32598/irjns.8.19","url":null,"abstract":"Background and Aim: Paroxysmal sympathetic hyperactivity (PSH) is a clinical syndrome characterized by paroxysmal and transient episodes of fever, tachypnea, tachycardia, hypertension, diaphoresis, and dystonia following non-noxious stimuli. It is a rare clinical condition and is seen in patients with acquired brain injury (trauma, meningitis, encephalitis, and stroke). Paroxysmal sympathetic hyperactivity-assessment measure (PSH-AM) is a clinical tool for diagnosing PSH. This study aims to describe the clinical characteristics and the outcomes of PSH. Case Presentation: Of the 412 patients admitted to the neurosurgery intensive care unit at PSGIMSR, Coimbatore, India, 11 (2.6%) patients were diagnosed to have PSH according to the PSH-AM scale. Trauma (72%) was the leading cause of the development of PSH. All patients (100%) had developed at least two PSH episodes per day that persisted for at least 3 consecutive days. Tachycardia and tachypnea were the most common symptoms noted in all PSH patients. The Glasgow Outcome Score (GOS) was less than 3 in 72% of PSH cases at the time of discharge, indicating a poor outcome. Conclusion: Traumatic brain injury remained the leading cause of PSH. The duration of hospitalization was increased in patients with PSH. Along with the prompt treatment of the primary disease, appropriate medications to overcome sympathetic hyperactivity ensure better recovery for these patients. Patients with PSH had relatively poor GOS at the time of discharge.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"63 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126623050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Series of Spinal Epidural Hematoma: A Single Center Experience","authors":"Jayaprakash Duraisamy, P. R. Rajkumar, K. S. Thirumurthy, Akshay Rajkumar","doi":"10.32598/irjns.8.17","DOIUrl":"https://doi.org/10.32598/irjns.8.17","url":null,"abstract":"Background and Importance: Spinal epidural hematoma (EDH) is a rare clinical condition that occurs spontaneously in patients with a spine injury. Most patients require laminectomy and evacuation of spinal EDH. Magnetic resonance imaging (MRI) of the spine with magnetic resonance angiography is the chosen radiological investigation. This study aims to review cases with spinal EDH and discuss its etiology, pathogenesis, investigations, and various management strategies. Case Presantation: This is a retrospective analysis study of five spinal EDH cases admitted at our institute from August 2020 to August 2021. Four patients underwent laminectomy and evacuation, while one was managed conservatively because of rapid clinical improvement. The patients’ functional outcomes were assessed by using American spinal cord injury association impairment scale (AIS) before and after treatment. Four of the five patients who participated in this study had significant neurological improvement. One of the patients who presented late to us had poor neurological recovery despite the surgical intervention. Conclusion: Surgical evacuation of spinal EDH within 48 hours of the onset of symptoms ensures good clinical recovery. Spontaneous resolution is possible in some cases if patients have an improvement in their neurological status early in the course of the disease. Hence, we conclude that prompt treatment in spinal EDH patients ensures maximum functional recovery. Patients with spinal EDH need close follow-up and periodical neurological examination.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"31 9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116928826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain mapping in Neurosurgical Oncology","authors":"S. Javadi","doi":"10.32598/irjns.specialissue.1","DOIUrl":"https://doi.org/10.32598/irjns.specialissue.1","url":null,"abstract":"This article has no abstract.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134427597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods to Improve Fiber Reconstruction at DTI-Based Tractography in the Area of Brain Tumor: Case Illustration and Literature Review","authors":"S. Javadi, Seyed Morsal Mosallami Aghili, Amir Mohammad Javadi, S. Raminfard","doi":"10.32598/irjns.specialissue.2","DOIUrl":"https://doi.org/10.32598/irjns.specialissue.2","url":null,"abstract":"Background and Aim: Diffusion Tensor Imaging (DTI)-based tractography can help us visualize the spatial relation of fiber tracts to brain lesions. Several factors may interfere with the procedure of diffusion-based tractography, especially in brain tumors. The current study aims to discuss several solutions to improve the procedure of fiber reconstruction adjacent to or inside brain lesions. Illustrative cases are also presented. Methods and Materials/Patients: The paper is a narrative review of methods that can improve DTI-based fiber reconstruction in the area of brain tumors. To provide up-to-date information, we briefly reviewed related articles extracted from Google Scholar, Medline, and PubMed. Results: We proposed five techniques to improve fiber reconstruction. Technique 1 is a very low Fractional Anisotropy (FA) application. Technique 2 includes resampling techniques, such as q-ball and High Angular Resolution Diffusion Imaging (HARDI). Technique 3 is the reconstruction of fiber tracts by defining the separated Region of Interest (ROIs). Technique 4 explains the selection of the ROIs according to functional Magnetic Resonance Imaging (fMRI) since the anatomical configuration is distorted by neoplasm. Technique 5 consists of using unprocessed images for preoperative planning and correlation with the clinical situation. Conclusion: DTI tractography is highly sensitive to noise and artifacts. The application of tractography techniques can improve fiber imaging in the area of brain tumors and edema.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132728679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastasis of Malignant Intracranial Meningioma to the Lung: Report of a Case and Review of the Relevant Literature","authors":"Kanisorn Sungkaro, Sakchai Sae-heng","doi":"10.32598/irjns.8.9","DOIUrl":"https://doi.org/10.32598/irjns.8.9","url":null,"abstract":"Background and Importance: Distant extracranial metastasis of meningioma is rare, and the pathophysiology of metastasis in meningioma remains a topic of debate. This study aimed to describe a patient who suffered from multiple pulmonary metastases of meningioma. Case Presentation: This report introduced a rare case of a 47-year-old female who presented with right hemiparesis. Cranial Computed Tomography (CT) demonstrated a homogeneously enhanced tumor in the left temporal lobe. The patient underwent tumor resection; the pathological result was found to be World Health Organization (WHO) grade I meningothelial meningioma. Recurrence of the tumor transpired after two years and a second operation was performed. WHO grade II atypical meningioma was diagnosed. Subsequently, the patient developed a chronic cough and her chest x-ray showed multiple lung masses. CT-guided biopsy of the right lung mass was performed. Finally, pulmonary metastatic meningioma was diagnosed. Conclusion: Distant extracranial metastasis and malignant transformation of meningioma involve the genetic alteration of a tumor, which should be studied further.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122281931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}