The Iranian Journal of Neurosurgery最新文献

{"title":"Spinal Giant Cell Tumor in Neurospine Surgery: A Narrative Study","authors":"S. M. Mousavi, N. Kalani, A. Kazeminezhad","doi":"10.32598/irjns.8.10","DOIUrl":"https://doi.org/10.32598/irjns.8.10","url":null,"abstract":"Background and Aim: Spinal Giant Cell Tumor (GCT) is a primary low-grade malignant aggressive tumor of the spine and is more prevalent in the third and fourth decades of life. Spinal GCT frequently occurs in the sacrum. The most common presentation of spinal GCT is pain. Spinal GCT is seldom observed as an asymptomatic, incidental radiological occurrence. Based on the clinic-radiological findings, differential diagnoses of spinal GCT are Aneurismal Bone Cyst (ABC), plasmacytoma, symptomatic hemangioma, and Tuberculosis (TB). A biopsy is crucial for a definitive diagnosis. Because of the rich vascular supply about 24 hours prior to operation, Digital Subtraction Angiography (DSA) with tumor embolization is recommended. The treatment of choice for these tumors is complete, extralesional surgical resection which is not usually possible. General treatment is resorted as incomplete partial resection following local radiotherapy. The method of choice for reconstruction is cement or metallic cages and because of the high recurrence rate, bone graft is avoided. The local recurrence rate in the spinal column is lower than in other areas. Methods and Materials/Patients: The spinal GCT incidence, manifestations, diagnosis, and management were concisely reviewed. Using the keywords of GCT, GCT manifestations, GCT complications, GCT management, and GCT incidence, all the relevant articles were retrieved from Google Scholar, Medline, and PubMed, reviewed critically, and analyzed. Results: Spinal GCT rarely presents as an incidental finding in radiologic studies. Because of the high vascular supply of GCTs, preoperative embolization must be performed. The ideal treatment of spinal GCT is complete surgical tumor excision and when not possible, intralesional resection is an alternative treatment. The prognosis of spinal GCT is not good as other primary spinal tumors because of incomplete excision of the tumor and following high recurrence rate. Conclusion: Spinal GCTs are complex clinical entities. Operation is obligatory, and postoperative close follow-up is mandatory to stop recurrences early","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"5 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":"122961541","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":"Anal Protrusion of Peritoneal End of Ventriculoperitoneal Shunt and Multiple Brain Abscesses: A Case Report With Review of Literature","authors":"Ahtesham Khizar, Soha Zahid","doi":"10.32598/irjns.8.5","DOIUrl":"https://doi.org/10.32598/irjns.8.5","url":null,"abstract":"Background and Importance: Ventriculoperitoneal shunt surgery is a widely accepted treatment for hydrocephalus, but it is not free from complications. Of all the complications, bowel perforation represents only 0.01-0.07% and it often presents with asymptomatic anal protrusion of the distal end of the ventriculoperitoneal shunt. The mechanism causing shunt ejection is unknown, but the most widely accepted theory is that after intestinal perforation, the tubing of the shunt is propelled out by the peristaltic movements in the gut. Case Presantation: A case of a 3.5-year-old boy with anal protrusion of the peritoneal end of ventriculoperitoneal shunt and multiple brain abscesses is reported. In surgery, the ventriculoperitoneal shunt was divided at the clavicular region, and the peritoneal end was gently pulled out of the anus while the ventricular end was exteriorized. Empirical antibiotics, antiepileptics, and steroids were given. The culture and sensitivity report revealed no microorganisms. The child improved over a period of two weeks and then a new ventriculoperitoneal shunt was inserted on the opposite side. Conclusion: Suspicion for bowel perforation must be kept high in symptomatic ventriculoperitoneal shunt patients even though most of the patients present with asymptomatic anal protrusion of the peritoneal end of ventriculoperitoneal shunt. In order to avoid infectious and neurological consequences, early identification and then subsequent treatment are crucial. The extruded end can easily be removed from the migrated orifice without the need for extensive surgery.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122227863","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":"Hemichorea-Hemiballismus in a Patient With a Large Right Cerebellopontine Angle Meningioma: A Case Report","authors":"G. Vadiee, Zahra Eghlidos, S. Hosseini, Amir Rezakhah","doi":"10.32598/irjns.8.6","DOIUrl":"https://doi.org/10.32598/irjns.8.6","url":null,"abstract":"Background and Importance: Movement disorders caused by meningiomas in the Cerebellopontine Angle (CPA) region are yet to be reported. This case report emphasizes the importance of careful imaging studies and examinations for patients presenting with movement disorders, even for benign tumors and less common etiologies. Case Presentation: A 45-year-old woman presented with irregular, involuntary, shortterm, transient, and unpredictable movements in the right upper and lower limbs since several months before, which conformed to the hemispheric pattern of the hemichoreahemiballismus type. Despite these issues, the main complaints of the patient were severe headaches, convulsions, blurred vision, and intermittent altered consciousness. Upon physical examination, abnormal movements of the right face and right upper and lower limbs were apparent. Dystonia was noted in the patient’s upper limbs. On brain MRI, a homogeneous mass 3.5 cm in diameter was found in the patient's right CPA, with compressive effects on the pons and medulla. The diagnosis of meningioma was made, and an excellent outcome was achieved following resection. Conclusion: Although meningiomas are usually considered benign tumors, they can, as noted in this case report, exert mechanical mass effects on adjacent structures following gradual enlargement. This can lead to various movement disorders, even in unusual locations. Hence, all patients with movement disorders must be examined thoroughly, with the neurological examination being of utmost importance. The present case itself illustrates the variety of causes and manifestations of movement disorders, particularly dystonia and hemiballismus secondary to benign meningioma, even in less common site","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127815171","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":"Evaluating the Longevity of Implantable Pulse Generator Used in Deep Brain Stimulation: A Systematic Review","authors":"S. Hannani, A. Beigi-Khoozani, Azimeh Afshar-Zarandi","doi":"10.32598/irjns.8.7","DOIUrl":"https://doi.org/10.32598/irjns.8.7","url":null,"abstract":"Background and Aim: Deep Brain Stimulation (DBS) surgery is increasingly performed to treat movement disorders. In these patients, a rechargeable or non-rechargeable battery is placed under their subcutaneous chest after implantation of an electrode in the basal ganglia of the brain, which has different battery life. Methods and Materials/Patients: In this study, three databases, including PubMed, ScienceDirect, Scopus without time limit, and Google Scholar search engine were examined by two independent researchers. Results: In the initial search, a total of 338 data were found. Then, by reviewing the title and summary of articles, 17 articles were included in the study and then 13 articles were reviewed in full text. The results of the articles were divided into two subgroups of battery life related to the types or subtypes of movement disorders indicated by DBS and battery life related to the types of IPG models. Conclusion: Battery life in Parkinson’s movement disorder and tremor is longer than in dystonia. Also, the battery life of Soletra model is longer than Kinetra and Kinetra model is longer than Activa, and any battery replacement surgery reduces battery life.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130163092","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":"Mental Health and Quality of Life in Parkinson Patients During the COVID-19 Epidemic: A Systematic Review","authors":"F. Bagheri Sheykhangafshe, Maryam Saeedi, Alireza Alesadi Sani, Arina Kiani, Vahid Savabi Niri","doi":"10.32598/irjns.8.8","DOIUrl":"https://doi.org/10.32598/irjns.8.8","url":null,"abstract":"Background and Aim: The COVID-19 has had several psychological and physical consequences, which have been more reported in people with chronic diseases, such as Parkinson’s Disease (PD). In this regard, this study reviewed all articles, which evaluated the mental health and quality of life of patients with PD during the COVID-19 epidemic. Methods and Materials/Patients: In this study, the keywords Parkinson’s disease, PD, Coronavirus 2019, COVID-19, SARS-CoV-2, mental health, quality of life, depression, stress, and anxiety were searched in the abstract and title of articles published between 2020 (May) and 2022 (April) in reputable international scientific databases of EMBASE, Google Scholar, ScienceDirect, Scopus, and PsycINFO, PubMed, and Clarivate Analytics. The PRISMA checklist was used to review and control the quality of articles. Of the total 369 articles found, 21 articles were selected for review. Results: According to the studies, patients with PD had anxiety, depression, stress, poor sleep quality, death-related thoughts, fear, and cognitive, behavioral, and motor problems during the pandemic. Femininity, low level of education, and poverty were also among the factors exacerbating psychological disorders in PD patients. Decreased physical and social activity also reduced the quality of life in patients with PD. During home quarantine, many patients became concerned about access to medication and physicians, which exacerbated PD. Conclusion: According to studies, the outbreak of COVID-19 reduced the mental health and quality of life of patients with PD. Since having high mental health has an important role in increasing the immune system against various diseases, identifying and treating vulnerable groups can increase life expectancy in patients.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132928796","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":"Neurosurgery Practice During the COVID-19 Pandemic","authors":"G. Sharifi, N. Kalani, A. Kazemi, A. Kazeminezhad","doi":"10.32598/irjns.8.3","DOIUrl":"https://doi.org/10.32598/irjns.8.3","url":null,"abstract":"Background and Aim: The viral agent in severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) is the cause of the novel coronavirus disease 2019 (COVID-19). It was first identified in December 2019 in the city of Wuhan, Hubei, China, and the World Health Organization declared it as an outbreak and a Public Health Emergency of International Concern on 30 January 2020, and a pandemic on 11 March 2020. Neurosurgeons are not prime in COVID-19 management but they continue for caring, visiting, and operating neurosurgical patients. In neurosurgical cases that need non-urgent operation, systematic SARS-CoV-2 testing of low-risk patients should be considered. In cases with positive SRAS-COV-2 testing, the procedures should be delayed until they are cured. The high-risk settings in the neurosurgical operation room are endotracheal intubation and extubation, operations in the vicinity of sinuses and/or mastoids, operations with accidental injury to respiratory or digestive tracts, and usage of aerosol-generating instruments on virioncontaminated tissues. The risk of SARS-COV-2 infection is decreased by delaying all nonemergent cases, replacing general anesthesia with other anesthesia methods, replacing neurosurgical approaches with alternative approaches that bypass the respiratory tract, and decreasing the usage of aerosol-generating instruments. Methods and Materials/Patients: This is a narrative study about COVID-19 infection in neurosurgery. Using the keywords SARS-COV2, neurosurgery, and COVID-19, all the relevant articles (about 52) were retrieved from Google Scholar, Medline, and PubMed and reviewed and critically analyzed. Results: Neurosurgeons can change neurosurgical routines in COVID-19 patients such as delaying all nonemergent cases, replacing general anesthesia with other anesthesia methods, replacing neurosurgical approaches with alternative approaches that bypass the respiratory tract, decreasing the usage of aerosol-generating instruments, and doing preoperative SRAS-COV-2 testing. Conclusion: For decreasing the risk of COVID-19 transmission in neurosurgery, we can change routine neurosurgical protocols. Without the prevention of COVID-19 transmission, all neurosurgeons, personnel, and patients will contract COVID-19.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126935305","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":"Neuroprotective Effects of Vitamin D on Patients With Traumatic Brain Injury: A Clinical Trial","authors":"Sajjad Shafiei, Mohammad Sardar Zaheriani, Misagh Sahfizad, Saeid Ehteshami, Mahmoud Mosazadeh, Kaveh Haddadi","doi":"10.32598/irjns.8.4","DOIUrl":"https://doi.org/10.32598/irjns.8.4","url":null,"abstract":"Background and Aim: Traumatic brain injury (TBI) is a globally-critical socioeconomic and public health problem. Introducing medications and strategies to treat and improve the prognosis of TBI is crucial. Current literature not only supports the key role of vitamin D on normal brain function, but also helps recovering from a myriad of pathologies. The present research was conducted to evaluate the neuroprotective effects of vitamin D on patients with TBI presenting to Imam Khomeini Hospital, Sari, Iran. Methods and Materials/Patients: This randomized clinical trial assigned patients with vitamin D levels of over30 ng/ml to an intervention group (n=42) and a control group (n=42), who respectively received a single dose (150,000 units) of vitamin D and a placebo upon admission. The Glasgow Coma Score (GCS) and mortality were recorded at the beginning of the study and three months after the final prescription. Results: The mean GCS score upon admission was obtained as 8.64±2.29 in the vitamin D group and 8.42±2.93 in the placebo group. This score was respectively obtained as 13.50±1.85 and 10.97±2.37 upon discharge, suggesting a significant difference as per the t-test (P=0.04).The mean Glasgow Outcome Score (GOS) upon discharge was obtained as 4.24±1.51 in the intervention group and 4.10±1.40in the controls. The t-test suggested insignificant differences in the GOS between the two groups upon admission (P=0.823). After three months, the GOS respectively reaching desirable levels in 49.7% and 62.8% of cases in the placebo and intervention groups revealed statistically significant differences among the two groups (P=0.03). Conclusion: The present results showed the improving effects of vitamin D on level of consciousness and outcomes in patients with acute TBI. More studies are suggested to be performed to investigate the effects of other medications, including amantadine and methylphenidate with a larger sample size.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131050245","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 New Modified Video Solution System for Neuroendoscopic Procedures","authors":"A. Seddighi, A. Nikouei, A. Seddighi, M. Hosseini, M. Hosseini, A. Zali","doi":"10.32598/irjns.8.2","DOIUrl":"https://doi.org/10.32598/irjns.8.2","url":null,"abstract":"Background and Aim: Today, neuroendoscopic surgery is gaining popularity because of its minimal damage to normal structures, fewer complications, and excellent clinical results. Using an endoscope and related instruments, surgeons can perform complex surgeries through small incisions, especially for minimally invasive spinal and brain surgeries. Neuroendoscopic systems are currently costly and not portable. Our new video solution is portable at a lower cost and can display and record images in 4K resolution. Methods and Materials/Patients: We modified the GoPro Hero 6 camera to serve our purpose. By detaching the original camera lens and its front part and replacing the removed parts with a new design, we made a C-mount camera that can connect to a standard C-mount coupler and various common scopes. For color correction, we used an IR-cut filter in front of the camera sensor. Results: By changing some parts of the camera and connecting it to a C-mount coupler and a scope lens, we made a small, portable neuroendoscope that displays and records images in clear, sharp, high resolution, with a high frame rate. Conclusion: The modified GoPro camera can be used as an alternative and unexpansive neuroendoscope system for education or treatment in medical centers in developing countries.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114906523","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":"Coronavirus Transmission during Mastoidectomy after Craniotomy to Remove Schwannoma Tumor: Danger to Surgical Team Members","authors":"A. Merajikhah, A. Beigi-Khoozani","doi":"10.32598/irjns.8.1","DOIUrl":"https://doi.org/10.32598/irjns.8.1","url":null,"abstract":"NOT APPLICABLE","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131008212","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":"Evaluation of Pain Tolerance Threshold Following Administration of Anti-TNF-α in REM Sleep-deprived Male Wistar Rats","authors":"M. Hosseinpourfard, M. Nasehi, M. Zarrindast, M. Izadi, M. Nami","doi":"10.32598/irjns.7.4.3","DOIUrl":"https://doi.org/10.32598/irjns.7.4.3","url":null,"abstract":"Background and Aim: The level of Tumor Necrosis Factor-alpha (TNF-α) changes by Rapid Eye Movement (REM) sleep deprivation. TNF-α is a known biomarker of REM Sleep Deprivation (RSD). Prior studies have shown that any alteration in REM sleep can increase the amount of TNF-α. Accordingly, the Pain Tolerance Threshold (PTT) is believed to be increased in patients with insomnia after using anti-TNF-α or Infliximab (IFX). The present study aims to demonstrate the effect of IFX and its importance in the pain management of hospital inpatients. Methods and Materials/Patients: Seventy-two male Wistar rats in 9 groups were studied after obtaining the approval of the ethics committee of Tehran University of Medical Sciences (CNS. Protocol-ICSS-940816). Remicade was used for inducing the anti-TNF-α. Multiple platform water-tank was used for REM sleep deprivation induction. Pain tolerance was measured on a hot plate apparatus. Results: There was a significant increase in the duration of the rats’ tolerance on the hot plate between the saline group and the group that received IFX (0.2 mg/kg) (F2=8.363) (P<0.001). Conclusion: Chronic SD can cause neuronal damage due to neuroinflammatory insults. REM sleep deprivation, in the long run, sensitizes the brain to neurodegenerative insults via the inflammatory mechanism, to some extent through the TNFα-associated pathways.","PeriodicalId":143032,"journal":{"name":"The Iranian Journal of Neurosurgery","volume":"47 1-2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123462749","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}