@article{ author = {Kato, Yoko and Nouri, Mohse}, title = {Training the Next Generation of Neurosurgeons in Developing Countries – Mission Possible}, abstract ={One of the main concerns in different countries is training young neurosurgeons to treat patients. Each country is dealing with this issue with a certain strategy considering its goals. Training physicians is far different from many other fields, as it cannot be accomplished in the library or by reading books. This fact becomes even more notable when it comes to the neurosurgery which requires meticulous surgical skills and knowledge. Training a capable neurosurgeon starts with the process of accepting, develops with residency education, and is solidified by a post-graduation training (e.g. fellowships) which will be reviewed briefly here}, Keywords = {Training, Neurosurgeon, Developing Countries}, volume = {3}, Number = {1}, pages = {6-7}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.1.6}, url = {http://irjns.org/article-1-83-en.html}, eprint = {http://irjns.org/article-1-83-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Layegh, Mahsa and Hejazian, Ebrahim}, title = {Prevalence of Spondylolysis and Spondylolisthesis in Patients Afflicted with Chronic Back Pain in Babol City, Iran, during 2012 and 2013}, abstract ={Background and Aim: Chronic back pain is one of the most important reasons of individuals’ referring to clinic, so that no determined  recognition is posed in considerable number of such individuals. Spondylolysis and spondylolisthesis are two important pathologies that people might be afflicted with for years but they might be unaware of it. Therefore, such diseases may account for chronic back pain. This study aims at analyzing prevalence of these two injuries in individuals afflicted with chronic back pain. Methods and Materials/Patients: This has been a cross-sectional study for two years on individuals who referred to our clinic with complaining about chronic back pain with taken MRI and radiography of spine for diagnosis of their problem. Information related to current pathologies in imaging was extracted and registered from an interpretation of physician and radiologist report.  Results: In this study, 289 out of 692 studied individuals were male. Spondylolysis and spondylolisthesis were observed in 8.6% and 13% of them, respectively. Prevalence of spondylolisthesis in women (18%) was significantly more than that in men especially by aging. There was no statistically significant relationship between spondyloysis and spondylolisthesis. Conclusion: Spondylolisthesis and spondylolysis are seen among the main reasons of chronic back pain in aged women with prevalence of 13% and 8.6%, respectively.}, Keywords = { Chronic Back Pain, Spondylolysis, Spondylolisthesis, Prevalence}, volume = {3}, Number = {1}, pages = {8-14}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.1.8}, url = {http://irjns.org/article-1-84-en.html}, eprint = {http://irjns.org/article-1-84-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Atlasi, Mohammad Ali and Montazeri, Maryam and Fakharian, Esmaeil and Akbari, Hossein and Talari, Hamid Rez}, title = {Morphology of Human Insula in Iranian Population and its Relationship with Sex, Age, and Handedness: an Imaging Anatomical Study}, abstract ={Background and Aim: Topography of the human insula has occasionally been studied in different populations. The purpose of this study was to evaluate the morphology of human insula in Iranian population and its relationship with sex, age, and handedness via magnetic resonance imaging. Methods and Materials/Patients: In our study, 380 normal magnetic resonance imaging were enrolled. The number of short and long insular gyri, as well as their relationship with sex, age, hemispheres and handedness were assessed. Results: No significant differences were seen in number of insular gyri among right and left hemispheres, and males and females, but gyri number of left insula in right handers were significantly more than that in left handers. Maximum anterior – posterior distance of base of insula was longer in male and left insula compared to female and right insula, respectively. Younger individuals had more gyri than the older ones. The middle short insular gyrus can be absent more frequently than anterior and posterior short gyri. Conclusion: The sagittal magnetic resonance imagings in our study can be appropriate for numbering the insular gyri and help to understand the complicated anatomical structures of insula. The findings of this study demonstrate an insular gyri pattern of handedness and age-related morphology in Iranian population, with similar gyri pattern in both males and females.  }, Keywords = { Insular Cortex, Human, MRI, Morphology }, volume = {3}, Number = {1}, pages = {15-20}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.1.15}, url = {http://irjns.org/article-1-85-en.html}, eprint = {http://irjns.org/article-1-85-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Bagheri, Seyed reza and Alimohammadi, Ehsan and Saeedi, Hamidreza and Sepehri, Parandoosh and Soleimani, Pezhman and Fatahian, Reza and Abdi, Alireza and Beiki, Omi}, title = {Decompressive Craniectomy in Traumatic Brain Injury:Factors Influencing Prognosis and Outcome}, abstract ={Background and Aim: Decompressive craniectomy can be life-saving for patients with severe traumatic brain injury, but many questions about its ideal application, indications, timing, technique, and even the definition of success of decompressive craniectomy remains unclear. The aim of this study was to assess the factors associated with prognosis and outcome of patients with traumatic brain injury who had undergone a rapid decompressive craniectomy. Methods and Materials/Patients: We investigated 61 patients, who had undergone rapid decompressive craniectomy. The effect of variables including demographic features of patients, primary level of consciousness, pupil size and reactivity, and midline shift in patients' brain CT scan on outcome of patients were assessed. Results: 61 patients (36 males and 25 females) underwent rapid surgical decompressive craniectomy within 4.5±2 hours after trauma. Mean age of patients was 36.09±15.89 years old (range: 16 to 68 years). Of 61 patients, 33 (54.1%) had favorable and 28 (45.9%) had unfavorable outcome. Patients with following conditions had significantly worse outcome; age older than 60 years, bilateral non-reactive mydriasis, critical head injury (GCS<5), midline shift more than 10 millimeters in their brain CT scan. GCS and age could predict the outcome of surgery more significantly than other variables, so that higher age predicted unfavorable outcome with 1.13 times, and in GCS<5 the probability of unfavorable outcome is about 192 times. Patients with midline shift more than 10 mm are 6.15 times more likely to have risk of unfavorable outcome than those with midline shift less than 10 mm. Conclusion: In this study, we found that age more than 60 years and GCS less than five were associated with poor outcome. Patients with these conditions could not benefit much from early decompressive craniectomy.}, Keywords = {Decompressive Craniectomy, Glasgow Outcome Scale, Glasgow Coma Scale}, volume = {3}, Number = {1}, pages = {21-26}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.1.21}, url = {http://irjns.org/article-1-70-en.html}, eprint = {http://irjns.org/article-1-70-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Mashouf, Mehryar and Kiaee, Maryam and Bidabadi, Elham}, title = {Topography of Sylvian Fissure and Central Sulcus as Neurosurgical Landmarks: an Anatomical Study Using Cadaveric Specimens in Iran}, abstract ={Background and Aim: In the present study, the cerebral surface landmarks in human fresh autopsy specimens were investigated. Methods and Materials/Patients: Totally, 37 fresh adult autopsy human brain specimens from the Rasht Forensic Medicine Center were enrolled. Four specimens were excluded because of some traumatic injuries to cerebral cortex. Demographic information of all cases was obtained. Length of bilateral central sulcuses and posterior ramous of Sylvian fissures, thickness of superior, middle, and inferior gyri of temporal lobes, as well as the distance from frontal poles to midpoint of central sulcuses were measured and analyzed using SPSS software. Results: In total, 25 male (75.8%) and 8 female (24.2%) specimens were included. Mean (range) length of posterior ramus of right and left Sylvian fissure were 75.61 (50-95) and 74.55 (49-100) millimeter, respectively. Mean (range) length of right and left central sulcus were 94.85 (75-115) and 97.24 (65-125) millimeter, respectively. Mean (range) thickness of right and left superior temporal gyrus were 16.66 (520) and 15.33 (7-25) millimeter, respectively. Mean (range) thickness of right and left middle temporal gyrus were 16.63 (5-25) and 16.42 (8-25) millimeter, respectively. Mean (range) thickness of right and left inferior temporal gyrus were 10.30 (5-20) and 10.70 (5-22) millimeter, respectively. Mean (range) distance from right and left frontal pole to midpoint of right and left central sulcuse were 81.27 (55-105) and 82.63 (60-105) millimeter, respectively. There were no statistically significant differences between two hemisphere measurements. Conclusion: It can be said that the two hemispheres are similar in cerebral surface landmarks.  }, Keywords = {Anatomy, Autopsy, Cerebral Cortex, Surface Landmarks}, volume = {3}, Number = {1}, pages = {27-30}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.1.27}, url = {http://irjns.org/article-1-68-en.html}, eprint = {http://irjns.org/article-1-68-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Mbaye, Maguette and Thioub, Mbaye and Kessely, Yannick Canton and Tine, Ibrahima and Cisse, Mohamed El Hassimi and Thiam, Alioune Badara and Ba, Momar Code and Badiane, Seydou Boubakar}, title = {Pituitary Abscess: a Report of Two Cases}, abstract ={Background and Importance: Abscess of the hypophysis or pituitary adenoma is a very rare entity, and its preoperative diagnosis could be challenging. The clinical presentation is less specific, and despite the recent advancement in imaging, diagnosis before surgery is still difficult. Case Presentation: We reported two cases of pituitary abscesses in patients aged 38 and 42 years. The first patient was managed for maxillary sinusitis associated with pituitary adenoma whose diagnosis was made following surgery. For the second patient, the diagnosis was proposed before surgery following an MRI which showed a ring enhancement lesion of the hypophysis. Both patients benefitted from surgery where one had sub-labial rhino-septal trans-sphenoidal approach and the other through endoscopic endonasal trans-sphenoidal approach. Both received intravenous broad spectrum antibiotics.   Conclusion:  Post-operative evolution was good with control MRI showing complete disappearance of the sellar lesion. Early diagnosis and treatment improved the prognosis.}, Keywords = {Abscess, Hypophysis, Transphenoidal Approach}, volume = {3}, Number = {1}, pages = {31-35}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.1.31}, url = {http://irjns.org/article-1-86-en.html}, eprint = {http://irjns.org/article-1-86-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Goel, Atul}, title = {Chiari Formation: Atlantoaxial Instability is the Cause}, abstract ={The entity of Chiari formation was described by Hans Chiari in 1891 [1,2]. Since then the subject has been evaluated elaborately by a number of authors. However, it may only be correct to state that confusion in the understanding of pathogenesis and the nature of anomaly, significance of associated  abnormal soft tissue and bone anomalies and more importantly the treatment of the entity has not been resolved. The number of described treatment patterns are a testimony to the inadequacy of the understanding. The general consensus is that uncal herniation and tonsillar herniation are both similar in their pathogenesis wherein the part of the temporal brain or the cerebellum are pushed out of their compartment through a hiatus or hole into the other body compartment. In the process of herniation, there is congestion of space and compromise of the neural structures in the vicinity that leads to neurological symptoms or deficits. The factor that causes the push in case of Chiari malformation is unclear. However, the presence of an increased volume of cerebellar mass, a smaller volume of the posterior cranial fossa bone compartment or a combination of both these factors could be the possible cause. The general understanding is that the addition of the tonsillar volume in the foramen magnum limits the space for the neural structures that are compressed and results in related symptoms. Foramen magnum decompression is an established and a gold standard form of treatment.  }, Keywords = {Chiari, Atlantoaxial Instability, Anomaly,}, volume = {3}, Number = {2}, pages = {36-38}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.2.36}, url = {http://irjns.org/article-1-96-en.html}, eprint = {http://irjns.org/article-1-96-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Tannoury, Tony and haddadi, kaveh and Kempegowda, Harish and Kadam, Abhijeet and Tannoury, Chadi}, title = {Role of Minimally Invasive Spine Surgery in Adults with Degenerative Lumbar Scoliosis: A Narrative Review}, abstract ={Background and Aim: Degenerative lumbar scoliosis is a spinal deformity resulting from advanced disc degeneration and facet arthropathy. Given the inconclusive available literature and lack of high-quality data supporting the role of minimally invasive surgical management of degenerative lumbar scoliosis, this review intends to highlight and compare the various viable minimally invasive surgical methods for adult degenerative deformity correction. Methods and Materials/Patients: Online databases search including Medline, PubMed and Ovid was preformed using the keywords: adult, degenerative, lumbar scoliosis, etiology, clinical issues, diagnostic imaging, spinopelvic alignment, non-operative and surgical treatment options, minimally invasive, interbody fusion, and percutaneous pedicle screw fixation. Eighty-three studies, published after 2000, on degenerative lumbar scoliosis epidemiology, classification and management were identified and reviewed. Results: Minimally invasive surgical techniques available for interbody fusion include posterior lumbar interbody fusion, transformational lumbar interbody fusion, oblique lumbar interbody fusion, anterior lumbar interbody fusion, and extreme lateral interbody fusion. Each surgical option warrants technical considerations, indication, complications awareness, and functional and radiological outcomes assessment. Sound patients’ selection is key for improved outcomes, and therefore the following factors should be well examined prior to surgical intervention: the patient’s medical condition and underlying morbidities, the extent of the involved disc spaces, imaging characteristics, and surgeon skills. Conclusion: The superiority of one surgical technique over the others, was not proven due to lack of strong and supportive data. However, a comprehensive review of indications, benefits, and disadvantages of the minimally invasive surgical procedures is presented. There is an interest in minimally invasive surgery of the spine owing to lower complication rates and morbidity, with limited soft tissue disturbance, decreased blood loss, improved cosmesis, shorter hospital stay, earlier return to work, and therefore decreased general health care costs.}, Keywords = {Lumbar, Degenerative, Scoliosis, Minimally Invasive, Surgical Procedures}, volume = {3}, Number = {2}, pages = {39-50}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.2.39}, url = {http://irjns.org/article-1-105-en.html}, eprint = {http://irjns.org/article-1-105-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Zareian, Leila and Azarhomayoun, Amir and Alimohamadi, Maysam and Khajavi, Mohammadreza and Razeghi-Jahromi, Soodeh}, title = {Impact of Acute Phase Epigallocatechin-3-gallate Supplementation on Consciousness and S100B Serum Levels in TBI Patients: A Double Blind Randomized Clinical Trial}, abstract ={Background and Aim: Traumatic brain injury is one of the leading causes of mortality and disability in young adults. Epigallocatechin-3-gallate, the antioxidant compound of green tea, has been proposed to have antioxidant and anti-inflammatory properties. This study evaluates the potential effects of epigallocatechin-3-gallate on the early clinical outcome and serum S100B levels (biomarker for brain tissue damage severity) in patients with moderate to severe traumatic brain injury. Methods and Materials/Patients: Thirty patients with moderate to severe traumatic brain injury admitted to the intensive care unit were enrolled. The patients were randomly allocated to treatment with either a daily oral dose of 400 mg epigallocatechin-3-gallate or placebo (distilled water) for seven days. The main outcome measures were duration of mechanical ventilation and ICU stay, Glasgow Coma Scale, and S100B protein level. Results: The results revealed a significant improvement in consciousness level after seven days in the epigallocatechin-3-gallate group (2.93±3.9 unit improvement in GCS versus 0.14±3.05 reduction in GCS, p-value:0.033). There was also a significantly shorter duration of mechanical ventilation in the epigallocatechin-3-gallate compared to the control group (5.1 days versus 9.8 days, p-value:0.02). Reduction of the serum S100B level was slightly higher in the epigallocatechin-3-gallate group (23.96 versus 18.6 pg/ml) but the difference was not statistically significant. Conclusion: Epigallocatechin-3-gallate supplementation had beneficial effects on consciousness level of the patients with moderate to severe traumatic brain injury in the acute phase.  }, Keywords = {Epigallocatechin-3-gallate, Head Trauma, Neuroprotection, S100B Protein, Traumatic Brain Injury}, volume = {3}, Number = {2}, pages = {51-57}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.2.51}, url = {http://irjns.org/article-1-87-en.html}, eprint = {http://irjns.org/article-1-87-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Kpélao*, Essossinam and AnthonyBékéti, Katanga and Moumouni, Abdel Kader and Hobli-Ahanogbé, Kodjo Mensah and Doléagbenou, Agbéko Komlan and Egu, Komi and Alihonou, Thierry and Bakondé, Essosolim Hodabalo and Egbohou, Pilakimwé and Dossim, Assang}, title = {A Technique for Treatment of Overdrainage in Ventriculoperitoneal Shunt}, abstract ={Background and Importance: Overdrainage is a complication of ventriculoperitoneal shunt but adjustable valves and anti-siphon devices can prevent it. These very expensive valves are most often inaccessible, so that the majority of the valves available in Togo are fixed differential pressure valves. Although overdrainage is a widely-known issue, we aimed to introduce a new risk factor and the way we manage this complication. Case Presentation: This case series study included all patients who had overdrainage or a high potential risk of overdrainage (hydranencephaly). Our technique consisted of partial ligation of the peritoneal catheter at the level of the thorax by non-resorbable wire while controlling the drainage rate at the slots. The goal was to transform this fixed differential pressure valve into a pressure-controlled and flow-regulated one. Patients were followed for 1, 3 and 6 months, postoperatively.                                    Conclusion: Hydranencephaly predisposes patients to overdrainage. The partial ligature of the catheter is an effective technique for treating or preventing overdrainage.  }, Keywords = {Overdrainage, Ligation, Catheter}, volume = {3}, Number = {2}, pages = {58-62}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.2.58}, url = {http://irjns.org/article-1-108-en.html}, eprint = {http://irjns.org/article-1-108-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Valderrama, Jorge and Garcia, Ricardo and Satyarthee, Guru and Calderon, Willem and Hoz, Samer and Narvaez-Rojas, Alexis and Moscote, Luis}, title = {Intracranial Pial Arteriovenous Fistula Mimicking a Vein of Galen Aneurysm with Hydrocephalus Managed with Endovascular Method: Case Report}, abstract ={Background and Importance: Intracranial pial arteriovenous fistula is a recently described matter as a rare vascular malformation occurring in children. It is usually located in the subpial space in the intracranial cavity with a high-flow shunt. Case Presentation: Authors report on a 2-year-old child with intracranial pial arteriovenous fistula and progressive enlargement of head and seizures mimicking progressive obstructive hydrocephalus for eight months. Cranial computed tomography showed a hyperdense midline vein of Galen and enlarged straight sinus associated with obstructive hydrocephalus. Presence of an aneurysm of the vein of Galen was suspected. Conclusion: Authors believe that cranial screening with computed tomography for suspected early diagnosis is of high importance.}, Keywords = {Pial, Arteriovenous, Fistula, Galen, Aneurysm, Pediatric, Embolization, Hydrocephalus}, volume = {3}, Number = {2}, pages = {67-63}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.2.67}, url = {http://irjns.org/article-1-76-en.html}, eprint = {http://irjns.org/article-1-76-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Alimohammadi, Ehsan and Sharifi, Guive and Samadian, Mohammad and Ebrahimzadeh, Kaveh and Rezaei, Omidvar}, title = {Normal Pressure Hydrocephalus Presentation with a Large Pseudomeningocele}, abstract ={Background and Importance: This interesting case is about the presence of normal pressure hydrocephalus and a large pseudomeningocele at the same time after 13 months of posterior fossa surgery. Although the occurrence of a pseudomeningocele following posterior fossa surgery is not so rare, such a late large pseudomeningocele development with signs and symptoms of NPH after 13 months of surgery is rather peculiar.   Case Presentation: A 59-year-old man referred to our clinic for a cerebellopontine angle tumor. The patient presented with right hearing loss and mild facial palsy. We operated the patient with retrosigmoid approach, and we discharged him after five days. After about 13 months, the patient referred to our center again with complaint of progressive bulging of previous surgical region and gait apraxia, urinary incontinence and dementia. A large pseudomeningocele in the site of previous surgery was seen. Conclusion: The authors presented a case report on late development (13 months) of a huge pseudomeningocele following vestibular schwannoma surgery with signs and symptoms of normal pressure hydrocephalus. Such a late big pseudomeningocele presentation with signs and symptoms of normal pressure hydrocephalus after posterior fossa surgery is peculiar.  }, Keywords = {Hydrocephalus, Pseudomeningocele, Intracranial, Pressure }, volume = {3}, Number = {2}, pages = {73-77}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.2.73}, url = {http://irjns.org/article-1-102-en.html}, eprint = {http://irjns.org/article-1-102-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Farrokhi, Majid Reza and Yadollahikhales, Golnaz and Gholami, Mehrnaz}, title = {Treatment of 44 Cases With Lumbar Spine Stenosis and Degenerative Instability: Outcomes of Surgical Intervention}, abstract ={Background and Aim: Degenerative lumbar spine disease can lead to lumbar spine instability. The patients can present with Low Back Pain (LBP), radicular pain, and motor and sensory dysfunction. Age >50, female sex and pregnancies are among prevalent risk factors. The degeneration process usually starts from the intervertebral discs progressing to involve facet joints, ligaments, and vertebral bodies leading to spinal instability and deformity. This study aims to evaluate the effect of lumbar decompression and Posterolateral Fusion (PLF) on the short- and long-term outcomes of these patients.  Methods and Materials/Patients: This prospective study assessed the effect of lumbar decompression and PLF in patients with lumbar instability  referred to the Neurosurgery Clinic of Chamran hospital between March 2011 and March 2013. Forty-four patients with degenerative lumbar spine instability and stenosis were eligible for participation to undergo lumbar decompression and PLF. Its clinical effect was evaluated using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). The change in sagittal and coronal planes was also assessed according to pre- and post-operative findings at 2-year follow-up. The statistical method of assessment was repeated using paired t-test. P<0.05 was considered statistically significant. Results: The mean preoperative VAS score decreased significantly at 2 years after the surgery (6.87±1.07 vs. 2.20±1.15; P<0.001). The comparison between preoperative ODI and its 6-month, 1 and 2-year counterparts showed a significant improvement (P<0.001). Moreover, 82.7% of the patients showed a good fusion rate. The sagittal and coronal angles were reduced significantly after the surgery (P<0.05). Short vs. long segment fusion and inclusion of sacral body did not significantly affect the VAS, ODI scores and the deformity angles.  Conclusion: Lumbar decompression and PLF is a safe and effective method for patients suffering from degenerative lumbar instability.}, Keywords = {Lumbar spine stenosis, Degenerative instability, Posterior lumbar fusion, Visual Analogue Scale, Oswestry Disability Index}, volume = {3}, Number = {3}, pages = {79-88}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.3.79}, url = {http://irjns.org/article-1-91-en.html}, eprint = {http://irjns.org/article-1-91-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Tabesh, Homayoun and Kamangar, Mohammad and Tabesh, Aryan and Rastgoo, Amin and Mohammadhosseini, Ehsan and Raeissi-dehkordi, Mehrnaz}, title = {The Effect of Applying Topical Vancomycin Powder on Prevention of Surgical Site Infection in Patients Undergoing Spinal Surgery Using Implants}, abstract ={Background and Aim: Surgical Site Infection (SSI) is one of the most important complications after spine surgeries. Different methods have been proposed to prevent this type of infection. The present study was performed to evaluate the effect of applying topical vancomycin powder on prevention of SSI in patients undergoing spinal surgery using implants in Al-Zahra Hospital, Isfahan, Iran from February 2015 to June 2016. Methods and Materials/Patients: In this clinical trial, 100 patients candidate for spinal surgery with implants were divided into two groups using randomization technique including 50 patients in each group. Vancomycin powder solved in 20cc N/S serum was flushed over all layers of the surgical wound in the case group and in the control group sterile normal saline solution was used. Patients were examined at discharge and three months after surgery for ruling out surgical site infection. SSIs following spine surgery can be superficial, characterized by obvious wound drainage and erythema or it can be deep infections disseminating under the fascia which may lead to discitis, epidural abscess, and spondylitis. Results: One case of SSI was observed in the control group who was 83 years old. The mean age of all patients was 51.9±14.5 years old. The duration of surgery in this patient was 5 hours. The mean duration of surgery was 3.41±0.73 hours. The length of implant, BMI, sex, underlying diseases and other risk factors (diabetes and hypertension) did not affect the rate of infection. Conclusion: Even though topical antibiotics seem to be effective on controlling SSI but our finding did not support this hypothesis. The authors would like to suggest that keeping routine strict sterility strategies during spine operations is effective enough in preventing surgical site infection.}, Keywords = {Surgical, Site, Wound, Infection, Spinal surgery, Vancomycin}, volume = {3}, Number = {3}, pages = {89-94}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.3.89}, url = {http://irjns.org/article-1-90-en.html}, eprint = {http://irjns.org/article-1-90-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Gharib-Salehi, Mohammad and Alimohammadi, Ehsan and Bagheri, Seyed-Reza and Saeidi-Brojeni, Hamidreza and Abdi, Alireza and Akbary, Meisam and Nargesi, Mozhgan and Abbasi, Zahra and Khani, Ameneh and Amiri, Akram}, title = {Cerebral Angiographic Findings in Non-Traumatic Intracranial Hemorrhage: A Single Center Experience in the West of Iran}, abstract ={Background and Aim: This study aimed at analyzing the demographic characteristics of the patients with non-traumatic intracranial hemorrhage, their angiographic results and the correlation between computed tomography (CT) scan and angiography findings. Methods and Materials/Patients: In a descriptive study, we retrospectively reviewed the records of the patients with non-traumatic intracranial hemorrhage based on their brain CT or lumbar puncture findings from 2011 to 2017. For all patients, four vessel catheter angiography via the femoral approach was performed in the Medical Imaging Center of Kermanshah University of Medical Sciences, Iran. Results: We investigated 143 cases with non-traumatic intracranial hemorrhage which was indicated in CT findings (91.61%) or lumbar puncture (8.39%). Of 143 patients, 64 (44.8%) were men and 79 (55.2%) women (mean age 53.7±12.1 years old). Moreover, 104(72.7%) patients had Subarachnoid Hemorrhage (SAH), 19(13.3%) of them had Intracranial Hemorrhage (ICH), 8(5.6%) ones had Intraventricular Hemorrhage (IVH) and 12(8.4%) patients had normal brain CT. There were 100 cases of aneurysm (69.93%), 13 cases of Arteriovenous Malformations (AVM) (9.09%), 28 cases with negative angiograms (19.58%), and 2 cases with other pathologies (1.4%). Seven (4.89%) cases of multiple aneurysms were also recorded. Of 13 patients with AVM, 8(61.5%) patients had AVM in parieto-occipital region, 2(15.4%) in temporal, 1(7.7%) in frontal region and 2(15.4%) had deep AVM. Two (1.4%) patients with SAH had dural AVF. Twenty-eight (19.6%) patients had negative angiogram, 22 cases of them had second angiography after one to two weeks. The most common positive finding in the second angiogram was Acom aneurysm (18.18%). Conclusion: Aneurysms and AVMs are the most common causes of non-traumatic intracranial hemorrhage. The most common site of intracranial aneurysms is the circle of Willis. A second angiogram after one to two weeks is necessary in most patients with negative results in first angiography after non-traumatic intracranial hemorrhage.}, Keywords = {Cerebral, Angiography, Intracranial, Hemorrhage, Arteriovenous, Malformation}, volume = {3}, Number = {3}, pages = {95-102}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.3.95}, url = {http://irjns.org/article-1-88-en.html}, eprint = {http://irjns.org/article-1-88-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Yousefzadeh-Chabok, Shahrokh and Kazemnejad-Leili, Ehsan and Kouchakinejad-Eramsadati, Leila and Moghtader, Maria and Abolfathi, Nasim and Reihanian, Zoheir and Hosseinpour, Marieh}, title = {Hydrocephalus in Patients With Head Trauma: A Series of 14 Patients}, abstract ={Background and Aim: Hydrocephalus can cause ventricular expansion, which if not treated promptly, can result in brain damage. The hydrocephalus-induced damage is not fully improved, even by means of surgical procedures, leading to permanent damages to the brain. Methods and Materials/Patients: The aim of this study was to evaluate the demographic characteristics as well as hydrocephalus in patients with head trauma in Poursina Hospital, Rasht. The information including age, sex, Glasgow Coma Scale (GCS), trauma mechanism and accompanying brain injuries on admission were recorded. Patients with hydrocephalus diagnosed by CT scan underwent further investigation and therapeutic approaches. The treatment-related results were collected based on the GOS scale. Finally, the data were entered into SPSS version 18, and the results were analyzed by Fisher’s exact test, and Independent t-test. Results: Of the 548 patients, hydrocephalus was observed in 14 patients (2.6%). The mean age of the patients was 44.07±24.48 years old. 31.1% of men (14 cases) had hydrocephalus, while none of women suffered from this complication. Car accidents (12 people) and fall (2 people) were identified as causes of incident in hydrocephalus patients. Head injury severity in most patients with hydrocephalus was mild (n=7, GCS=13-15) and moderate (n=6, GCS=9-12), and severe (n=1, GCS=3-8). Subarachnoid hemorrhage (n=5) and then epidural hematoma (n=4) and intracerebral hemorrhage (n=4) had the most severe damage to the skull. Most patients (n=11) were treated by surgery. Three patients recovered completely. Moderate disability, severe disability, vegetative state, and death occurred in 3, 2, 1, and 5 Patients, respectively. According to independent t-test, there is a statistically significant relationship between Glasgow Coma Scale and hydrocephalus (P=0.03). Fisher’s exact test also showed a statistically significant relationship between intracerebral hemorrhage (P=0.045) and intraventricular hemorrhage (P=0.013) on admission with hydrocephalic incidence. Conclusion: This complication was mostly observed in young traumatic patients (younger than 40 years of age) and in patients with mild head injury. Therefore, it is necessary to pay attention to these people in order to detect hydrocephalus, if any, as soon as possible, and these patients be treated appropriately.}, Keywords = {Hydrocephalus, Head Injury, Trauma}, volume = {3}, Number = {3}, pages = {103-108}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.3.103}, url = {http://irjns.org/article-1-113-en.html}, eprint = {http://irjns.org/article-1-113-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Ouladsaiad, Mohamed and Hokoumi, Hamza and Aballa, Najou}, title = {A Giant Abdominal Cerebrospinal Fluid Pseudocyst}, abstract ={Background and Aim: Ventriculoperitoneal shunt (VPS) is the most commonly used procedure for treatment of hydrocephalus in children. Abdominal cerebrospinal fluid pseudocyst is a rare complication but potentially fatal. The pathogenesis of this complication remains unclear. This complication should be considered during differential diagnosis of an abdominal mass. Our aim is to report how large and giant an abdominal cerebrospinal fluid pseudocyst can develop, and how severe the neurological damage can be.  Case Presentation: A 6 year-old girl known to have a ventriculoperitoneal shunt presented with abdominal distension and signs of increased Intracranial Pressure (ICP). Ultrasonography revealed a hypoechoic intraperitoneal fluid containing cyst with a well-defined margin and septations. Abdominal computerized tomography revealed a huge cyst in the abdomen and the distal part of the peritoneal shunt tube located within the cyst. Laparotomy revealed a huge cyst extending from the upper right side of the abdomen to the pelvis. The whole cyst was excised and the catheter repositioned.   Conclusion: Early diagnosis of abdominal Cerebrospinal Fluid (CSF) pseudocyst is only possible through close and periodic examination of patients after the procedure.}, Keywords = {Ventriculoperitoneal shunt, Abdominal, Pseudocyst, Cerebrospinal fluid, Hydrocephalus, Encephalocele}, volume = {3}, Number = {3}, pages = {109-114}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.3.109}, url = {http://irjns.org/article-1-82-en.html}, eprint = {http://irjns.org/article-1-82-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Rezaei, Omidvar and Moradian-Kokhdan, Karim and Razmeh, Saeed and Ebrahimzadeh, Kaveh and Sharifi, Guive and Samadian, Mohamm}, title = {Symptomatic Unilateral Subdural Effusion as the First Presentation of Suprasellar Arachnoid Cyst}, abstract ={Background and Importance: Arachnoid cysts are benign nontumoral lesions that are usually found incidentally in brain imaging. Suprasellar Arachnoid Cysts (SSACs) are rare. They can cause hydrocephalus and increased intracranial pressure, lower cranial nerve impairment and endocrine disorder. Sometimes arachnoid cysts become complicated by subdural hematoma/hygroma.  Case Presentation: We describe a patient with a suprasellar arachnoid cyst that was complicated with symptomatic subdural effusion and increased intracranial pressure after minor trauma. Conclusion: Although these cysts are rarely complicated with subdural hematoma/hygroma, and intracystic hemorrhage, the probability of subsequent subdural hygroma and increased intracranial pressure should not be underestimated.}, Keywords = {Subdural effusion, Suprasellar arachnoid cyst}, volume = {3}, Number = {3}, pages = {115-118}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.3.115}, url = {http://irjns.org/article-1-92-en.html}, eprint = {http://irjns.org/article-1-92-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} } @article{ author = {Ghorbani, Mohammad and Hejazian, Ebrahim}, title = {Transradial Neurointerventional Approach to Basilar Tip Aneurysm: Case Report and Technical Note}, abstract ={Cerebral angiography through transfemoral approach is preferred in most of the situation though in cardiovascular surgery transradial angiography is accounted as the superior standard. The present study aimed at presenting our early experience of transradial approach to cerebral angiography and intervention of a patient with basilar tip aneurysm that had inappropriate vasculature to perform routine transfemoral approach. The patient was a 65 year-old man with a large basilar tip aneurysm that was candidate for endosacular coiling through transfemoral route. But due to very tortuous iliac artery, aortic arch and its branches, navigation transfemorraly via both vertebral arteries was impossible. Therefore we decided to do the procedure through right transarterial route. The procedure was started by doing Allen`s test to confirm good perfusion of right hand by collateral arteries. After that cerebral angiography and neurointervention was done transradially without any complication. As a result, although a transradial approach is not a routine way for cerebral angiography and intervention, it can be used safely as an alternative way in specific cases.}, Keywords = {Transradial, Angiography, Cerebral, Aneurysm}, volume = {3}, Number = {3}, pages = {119-123}, publisher = {Neurolosurgical Society of Iran}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/irjns.3.3.119}, url = {http://irjns.org/article-1-114-en.html}, eprint = {http://irjns.org/article-1-114-en.pdf}, journal = {Iranian Journal of Neurosurgery}, issn = {2423-6497}, eissn = {2423-6829}, year = {2017} }