Iranian Journal of Neurosurgery最新文献

{"title":"A Case Report of Early Surgical Intervention for Diffuse Idiopathic Skeletal Hyperostosis of the Cervical Spine: Challenges in Management","authors":"M. Shafizad, Pooria Sobhanian, E. Ghadirzadeh, Rostam Poormousa, G. Godazandeh","doi":"10.32598/irjns.9.14","DOIUrl":"https://doi.org/10.32598/irjns.9.14","url":null,"abstract":"Background and Importance: Diffuse idiopathic skeletal hyperostosis (DISH) can compress the trachea and esophagus when located in the cervical spine. In this report, we investigated whether it is preferable to perform the early surgical intervention in symptomatic patients or to wait and administer supportive care and perform late surgical intervention regardless of whether symptoms progress or not. Case Presentation: We present the case of a 70-year-old patient with diffuse idiopathic skeletal hyperostosis (DISH) causing significant dysphagia and unilateral vocal cord paresis, resulting in dyspnea and stridor. Imaging diagnostics revealed large osteophytes anterior to the cervical spine from C3 to C6 compressing the cervical spine. Significant clinical improvement was observed following the anterior resection of the patient's osteophytes. Conclusion: In order to achieve higher success and less recurrence, it is preferable to perform surgical intervention earlier in the disease's progression. However, more studies are necessary to confirm this because most of the present results are from case report articles and have less evidence.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48082415","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":"Single Surgeon Experience of Adjacent Segment Disease and Related Risk Factors Following Posterior Decompression and Fusion in Lumbar Degenerative Disorders","authors":"Kaveh Haddadi, Abdolrasool Alaee, Anoushe Ghafari, M. Khademloo","doi":"10.32598/irjns.9.10","DOIUrl":"https://doi.org/10.32598/irjns.9.10","url":null,"abstract":"Background and Aim: This study aims to evaluate the frequency of adjacent segment disease (ASD) and its risk factors following posterior decompression and fusion in lumbar degenerative disorders. Methods and Materials/Patients: This retrospective cohort study was performed by reviewing the records of patients with spinal degeneration disorders who underwent lumbar fusion surgery and needed reoperation from 2013 to 2019. The participants were divided into two groups, including patients with ASD and non-ASD patients, and were compared in terms of age, sex, BMI, smoking, fusion level, surgical indications, follow-up times, laminectomy, cross-link device usage, imaging findings, fusion terminating in L1, L5 and S1, and reoperation. Results: Out of a total of 277 candidates, 181 met the inclusion criteria. In terms of gender distribution, 43.3% of the participants were male and 56.7% were female. The median age was 54 years in the ASD group and 48 years in the non-ASD group. The median follow-up of the patients was six years in the ASD group and five years in the non-ASD group. Forty patients (22.1%) developed ASD during this period. The final analysis showed a significant relationship between age, sex, indication for reoperation, repeated surgery, laminectomy, cross-link device use, imaging findings, and fusion terminating in L1. Conclusion: High body mass index, aging, lumbar spinal canal stenosis, reoperation, laminectomy at the upper fusion unit, cross-link device use, lumbar canal stenosis in imaging, and fusion to L1 vertebrae are considered risk factors for ASD.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42809644","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 Effect of Curcumin on the Recovery of Severe Traumatic Brain Injury: A Double-blind Randomized Controlled Trial","authors":"M. Saatian, Masoome Rostayi, E. Jalili, Sara Ataei, A. Poormohammadi, M. Farhadian, A. Abdoli","doi":"10.32598/irjns.9.3","DOIUrl":"https://doi.org/10.32598/irjns.9.3","url":null,"abstract":"Background and Aim: Traumatic brain injury (TBI) is one of the critical causes of death in trauma patients. In this study, the effect of nanocurcumin on the outcome of severe TBI was investigated for the first time in humans. Methods and Materials/Patients: This randomized, double-blind, and paralleled controlled study included 128 patients aged from 18 to 70 years with severe brain trauma. Patients were randomly assigned to control group (standard care treatment+placebo) and intervention group (standard care treatment+oral nanocurcumin). Changes in the level of consciousness, cerebral edema, kidney function, liver enzymes, sodium and potassium electrolytes, and brain function were followed up and compared until 6 months after discharge. Results: The Mean±SD in the intervention (14.44±31.86 years) and control patients (14.86±33.34 years) had no significant difference (P=0.543). Both groups were similar in terms of gender (P=0.669). The average level of consciousness in the intervention group increased by about 3 units (P=0.004) and more than 2 units (P=0.002) at discharge compared with the control group. By comparing the optimal performance of patients in the first (P=0.389) trimester and second (P=0.309) trimester after discharge, no significant difference was observed between the intervention and control groups. The amount of brain edema caused by severe brain trauma on the seventh day of treatment in the intervention group was lower than that in the control group (P=0.038). Conclusion: Administrating oral nanocurcumin supplement in patients with severe brain trauma along with their routine treatment is effective in improving brain edema and their level of consciousness without causing coagulation, and liver and kidney complications. These findings are not only statistically significant but also clinically vital.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48503548","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":"Estimating Hemodynamic Significant Deformations of Brachiocephalic Arteries Using CT Perfusion","authors":"V. Krylov, E. Grigorieva, Natalia P. Polunina, V.V. Lukyanchikov, V. Dalibaldyan","doi":"10.32598/irjns.9.7","DOIUrl":"https://doi.org/10.32598/irjns.9.7","url":null,"abstract":"Background and Aim: The cause of most strokes is associated with the pathology of the carotid arteries. Many modern researchers suggest preventive surgery in the presence of arterial deformity to prevent strokes. The hemodynamic significance of carotid deformities is determined by morphological and functional disorders at the level of tortuosity, the reaction of cerebral blood flow is not often considered. Here, we assume that cerebral autoregulation in tortuosity can be different. Methods and Materials/Patients: A total of 64 patients (31-75 years old) with 110 carotid deformities were analyzed. Duplex color mapping, computed tomography angiography of carotid arteries, and computed tomography perfusion were performed by estimating the absolute and average values of cerebral blood flow (mL/100 g/min), cerebral blood volume (mL/100 g), Mean transit time (MTT) (s) in similar areas of the cortex. In 6 patients, the acetazolamide challenge test was used to evaluate the autoregulatory disturbances. Results: According to computed tomography angiography and duplex color mapping, 18(28.1%) patients had unilateral tortuosity, and 46(71.9%) patients had bilateral tortuo s ity. Hemodynamically significant deformities were detected in 33 cases (30% of tortuosity). In 54 cases (49% of tortuosity), the deformities were accompanied by carotid stenosis. Perfusion disorders were detected in 23 of 64 patients (35.9%). In the majority of cases (75% of all perfusion disorders), hypoperfusion was diagnosed on the side corresponding to the maximum degree of stenosis, regardless of the location of the tortuosity. Neurologically significant hypoperfusion, compensated by collateral blood flow revealed only in 7.8% of cases of hemodynamic significant internal carotid artery deformity without concomitant atherosclerosis. Conclusion: The decision on surgical correction of carotid artery tortuosity should be made while considering both local changes in hemodynamics and proven violations of autoregulation of cerebral blood flow, especially in patients with concomitant carotid stenosis.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49155559","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 Attitude of Neurosurgeons Toward Telemedicine During COVID-19 Pandemic","authors":"H. Ebrahimi, Hesam Azimi, Z. Kolahchi, Z. Gholami, Shahin Nasseri, Maryam Adib, A. Amirjamshidi, M. Shirani Bidabadi, A. Pour-Rashidi","doi":"10.32598/irjns.9.5","DOIUrl":"https://doi.org/10.32598/irjns.9.5","url":null,"abstract":"Background and Aim: Telemedicine can be considered a primary modality of patient care for non-emergent conditions in the COVID-19 era. The usage and expansion of telemedicine are important and inevitable issues. We decided to investigate the neurosurgeons’ perspective on telemedicine in the treatment and follow-up of neurosurgical patients during the COVID-19 period. Methods and Materials/Patients: This cross-sectional study was carried out in the Department of Neurosurgery, Tehran, from June 2021 to July 2021. An internet-based questionnaire was distributed among all postgraduate and assistant neurosurgeons at the Tehran University of Medical Sciences. Statistical analysis was performed using SPPS (IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp; 2016). Results: This study was performed among 74 neurosurgeons who were mainly male (89.2%). Their mean age was 33.16±5.69 years (ranging from 27 to 62 years), and telemedicine has not been used previously in 37 precipitants (50%). Most precipitants preferred telemedicine for follow-up (93.24%). The common reasons for unimplemented telemedicine were determined by insurance and repayment obstacles (58.11%). Most of the participants believed that telemedicine should first be adapted to working condition and local setting, then it can be applied more in the future. Eventually, the effectiveness of telemedicine was controversial, according to most neurosurgeons’ replies. Conclusion: This study indicated neurosurgeons’ preference for telemedicine. They considered it a comfortable alternative. However, the effectiveness of telemedicine is controversial as it should be adapted first and then used extensively for future purposes. It is also suggested that future studies compare the results of this research with those of studies performed after the COVID-19 outbreak.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42025790","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":"Solitary Fibrous Tumor One Year After Posterior Cervical Laminectomy","authors":"Amirmohammad Mahabadi, Navid Askariardehjani, M. Rezvani, Mehdi Shafiei, Mehdi Mahmoodkhani","doi":"10.32598/irjns.9.9","DOIUrl":"https://doi.org/10.32598/irjns.9.9","url":null,"abstract":"Background and importance: Cervical laminectomy and fixation (PCF) is a surgery used in the treatment of symptomatic patients who are resistant to medical therapy, though it can have serious complications affecting patient outcomes. Case Presentation: This case report describes a rare occurrence of a solitary fibrous tumor (SFT) at the site of a previous cervical laminectomy in a 45-year-old female patient. Following non-surgical treatment for paresthesia and weakness in the upper limbs due to cervical stenosis, the patient underwent cervical laminectomy from C3-6 without instrumentation. Conclusion: One year after surgery, the patient presented with severe pain and swelling at the surgical site, and radiological evaluation revealed a large mass in the para-vertebral muscular layer. The mass was removed, and microscopic evaluation revealed a typical SFT. The patient underwent an extension of laminectomy and fusion with lateral mass screw, and follow-up at six months showed no recurrence of the tumor.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43497145","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":"Chronic Pain and Psychological Interventions: A Systematic Review","authors":"F. Karimian, S. Saadat, M. Hosseininezhad","doi":"10.32598/irjns.9.8","DOIUrl":"https://doi.org/10.32598/irjns.9.8","url":null,"abstract":"Background and Aim: Chronic pain is an emotional experience with unpleasant psychological consequences for individuals and society. This research aims to systematically review the psychological interventions implemented in people suffering from chronic pain. Methods and Materials/Patients: In this systematic review, the following keywords were searched in PubMed, Scopus, and Google Scholar databases: Chronic pain, psychological interventions, psychotherapy, psychology, clinical trials, and randomized clinical trials. The time span for the search was from January 2018 to December 2022. From a total of 2785 articles, 20 articles by 2078 contributors were selected for this review. Results: Cognitive behavioral therapy ranks first among psychological interventions for people with chronic pain. Also, to improve the quality of life and psychological health of these individuals from other psychological interventions, such as acceptance and commitment therapy, the mindfulness method has been used. This treatment has been effective in relieving pain, controlling pain, reducing stress and depression, and improving the quality of life. Using a randomized controlled trial design and follow-up were the strengths of these studies. Conclusion: The findings suggest that psychological interventions had the greatest impact on pain relief, quality of life, depression, and stress, respectively. Accordingly, it is proposed to use psychological interventions in addition to medical treatment.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43166531","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":"Optic Pathway Glioma Treatment: A Mini-review of the Current Literature","authors":"A. Iranmehr","doi":"10.32598/irjns.9.4","DOIUrl":"https://doi.org/10.32598/irjns.9.4","url":null,"abstract":"Background and Aim: Optic pathway glioma (OPG) is a chronic condition that needs a multidisciplinary management strategy. Most of these tumors are observed in the pediatric population and the tumor tends to stabilize after the child’s growth. This benign course can be observed mostly in neurofibromatosis 1 (NF1) patients, which are about half of the pediatric patients. Methods and Materials/Patients: The current literature in PubMed and Scopus databases was searched. The recent data regarding OPG and treatment options were reviewed to design this narrative mini-review. Results: The brief data extracted from 17 articles, cited in the reference list, were included in the study. Conclusion: Chemotherapy is the first and best treatment modality for patients with OPG. It is more useful at younger ages because it has lower rates of complications and cancer in the future compared with radiotherapy, the treatment of choice in previous decades for these patients. However, in recent practice, it has been substituted by chemotherapy because of its serious adverse effects on the pediatric population. Neurosurgical treatments for OPG are used for three main purposes, third ventricle obstruction-related hydrocephalus, biopsy, and tissue diagnosis for cases with an uncertain diagnosis, and tumor decompression due to mass effect on vital structures. Surgical decompression is not considered the first-line treatment in OPG. It can be used for patients with progressive exophthalmos with ipsilateral blindness or patients with refractory pain after adjuvant treatment. This short review discusses the main aspects of OPG treatment modalities.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46906005","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":"Intradural Extramedullary Capillary Hemangioma of Spinal Cord: A Case Report and an Updated Review","authors":"S. Pandey, N. Chore, Pankaj Kumar, Achal Saxena","doi":"10.32598/irjns.9.6","DOIUrl":"https://doi.org/10.32598/irjns.9.6","url":null,"abstract":"Background and Importance: Capillary hemangiomas are benign tumors found on the skin and soft tissues. They rarely present as an intradural spinal tumor. Common differential diagnosis methods are schwannoma, hemangioblastoma, metastasis, and paragangliomas. Case Presentation: We report a case of a 38-year-old female with complaints of lower backache with radiation to lower limbs, in which the magnetic resonance imaging revealed an intradural tumor compressing the cauda equina nerve roots, arising from the L3 level. The patient underwent L2-L3 laminectomy with tumor excision with the preservation of nerve roots. Conclusion: Histopathology suggested capillary hemangioma and the patient improved symptomatically and no recurrence has been reported to date.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45315664","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 Neurosurgery","authors":"","doi":"10.32598/irjns.specialissue.e4","DOIUrl":"https://doi.org/10.32598/irjns.specialissue.e4","url":null,"abstract":"Background and Aim: Brain mapping is the study of the anatomy and function of the Central Nervous System (CNS). Brain mapping has many techniques and these techniques are permanently changing and updating. From the beginning, brain mapping was invasive and for brain mapping, electrical stimulation of the exposed brain was needed. However, nowadays brain mapping does not require electrical stimulation and often does not require any complex involvement of patients. To perform brain mapping, functional and structural neuroimaging has an essential role. The techniques for brain mapping include noninvasive techniques (structural and functional magnetic resonance imaging [fMRI], diffusion MRI [dMRI], magnetoencephalography [MEG], electroencephalography [EEG], positron emission tomography [PET], near-infrared spectroscopy [NIRS] and other non-invasive scanning techniques) and invasive techniques (direct cortical stimulation [DCS] and intracarotid amytal test [IAT] or wada test). Methods and Materials/Patients: This is a narrative study on brain mapping in neurosurgery. To provide up-to-date information on brain mapping in neurosurgery, we precisely reviewed brain mapping and neurosurgery articles. Using the keywords “brain mapping”, “neurosurgery”, “brain mapping techniques”, and “benefits of brain mapping”, all of the related articles were obtained from Google Scholar, PubMed, and Medline and were precisely studied. Results: To perform an effective and safe neurosurgical intervention, precise information about the structural and functional anatomy of the brain is obligatory. Based on the information on brain mapping, the selection of suitable patients for the operation, the plan of appropriate operative approach, and good surgical results can be acquired. To provide this information, we can use brain mapping techniques that were formerly applied in neuroscientific brain mapping efforts with noninvasive techniques, such as fMRI, MEG, dMRI, PET, etc and invasive techniques, such as DCS, IAT, etc. Conclusion: Functional brain mapping is a constantly evolving fact in neurosurgery. All stages in obtaining a functional image are complex and need knowledge of the basic physiologic and imaging features.","PeriodicalId":53336,"journal":{"name":"Iranian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45073313","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}