en
jalali
1399
10
1
gregorian
2021
1
1
7
1
online
1
fulltext
en
Success Rates and Complications of Ventriculoperitoneal and Ventriculoatrial Shunting: A Systematic Review
Background and Aim: The insertion of Ventriculoperitoneal (VP) or Ventriculoatrial (VA) shunt is the first line of treatment in patients with hydrocephalus and normal-pressure hydrocephalus. The provision of a safety profile for shunting in the treatment of hydrocephalus patients is very important. This study aimed to determine the success rates and complications of VP and VA shunting in patients with hydrocephalus.
Methods and Materials/Patients: This systematic review investigated the complication rates of VP and VA shunting in managing patients with hydrocephalus. All the published studies were searched in three electronic databases of Web of Science, PubMed and Google Scholar from March 20 to April 10, 2020, using the keywords of “Ventriculoperitoneal” and “Ventriculoatrial” in combination with “Hydrocephalus”.
Results: In total, nine articles met the eligibility criteria for being included in this review. Some studies showed a higher rate of shunt obstruction in patients undergoing VA shunting; however, other studies demonstrated no difference in terms of shunt obstruction. The rates of primary revision shunt were various within the ranges of 5.4%-48% and 9.1%-58% for VA and VP shunting, respectively. A higher rate of revision shunt was reported among the patients undergoing VP shunting, compared to that reported for VA shunting. The different mortality rates in various studies were estimated within the range of 0%-10% and at 13.9% for VA and VP shunting, respectively.
Conclusion: In general, no difference was reported between VA and VP shunting regarding the rates of complications and mortality. Due to the ease of placement and revision, VP shunting could be considered the first-line treatment of hydrocephalus. However, this approach has been preferred in newborns, and there have been insufficient data on adults in this regard.
Hydrocephalus, Obstruction, Ventriculoperitoneal Shunt
1
14
http://irjns.org/browse.php?a_code=A-10-411-1&slc_lang=en&sid=1
2020/04/15
1399/1/27
2020/11/10
1399/8/20
Hamid
Rezaee
Department of Neurosurgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
rezaeehm@mums.ac.ir
0031947532846006393
0031947532846006393
No
Amin
Tavallaii
Department of Neurosurgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
0031947532846006394
0031947532846006394
No
Ehsan
Keykhosravi
Department of Neurosurgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
keykhosravie@mums.ac.ir
0031947532846006395
0031947532846006395
Yes
en
Comparing Mononostril, Binostril, and One and a Half Nostril Endoscopic Transsphenoidal Approach for Treating Pituitary AdenomaPituitary Adenoma
Background and Aim: EETA (Endoscopic Endonasal Transsphenoidal Approach) is a preferred choice for pituitary tumors. EETA offers minimal invasiveness, fewer complications, and better outcomes than the sublabial or transseptal microscopic approach. EETA has three approaches: mononostril endoscopic transsphenoidal approach, binostril endoscopic transsphenoidal approach, and one and a half nostril approach. This study aims to compare three different EETAs and compare between microscopic transsphenoidal approach, transcranial approach and EETA.
Methods and Materials/Patients: To provide up-to-date information, we concisely reviewed these three EETAs. Using the keywords of “neuroendoscopy”, “META” (Mononostril Endoscopic Transsphenoidal Approach), “OETA” (One and a half nostril Approach), “BETA” (Binostril Endoscopic Transsphenoidal Approach), “pituitary adenoma”, “EETA”, “endoscopy”, “transsphenoidal approach”, “transcranial approach for pituitary adenoma” and “microscopic transsphenoidal approach”. We retrieved all the relevant articles from Google Scholar, PubMed, and Medline. Then, we reviewed them and critically analyzed them.
Results: In BETA there is free and easy movement of surgical instruments in the surgical field and a broader view of the sphenoid sinus and it is an excellent approach to resect large tumors. The META is suitable in tumors with limited involvement of the intra-sellar and supra-sellar area. The mononostril approach is not suitable and has some limitations for the following situations: a crowded narrow nasal cavity, a harder tumor with the invasive appearance or significant suprasellar extension, and lesions other than pituitary adenomas. The OETA provides a sufficient surgical corridor for a 2-surgeon/4 or 3-hands technique with a minimal injury of the nose and good operative results, free and easy movement of surgical instruments in the surgical field, low post-operative morbidity, and good post-operative quality of life.
Conclusion: In EETA, knowing the size and consistency of tumor, general versus invasive pituitary adenoma, and the extent of parasellar and suprasellar extension, is essential. If we cannot reach a pituitary macroadenoma with a trans-sphenoidal approach, then we can use a transcranial approach for the removal of the tumor. The microscopic transsphenoidal approach is suitable for pediatric pituitary adenoma.
Mononostril endoscopy, Binostril endoscopy, One and a half nostril endoscopy, Transsphenoidal approach
15
22
http://irjns.org/browse.php?a_code=A-10-400-2&slc_lang=en&sid=1
2020/04/152020/04/19
1399/1/31
2020/11/102020/11/13
1399/8/23
Shahrokh
Yousefzadeh-Chabok
Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
kazemimd@msn.com
0031947532846006396
0031947532846006396
No
Guive
Sharifi
Department of Neurosurgery, Skull Base Research Center, School of Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
kazemimd@msn.com
0031947532846006397
0031947532846006397
No
Mohammad
Ghorbani
Department of Neurosurgery, Division of Vascular and Endovascular Neurosurgery, School of Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
kazemimd@msn.com
0031947532846006398
0031947532846006398
No
Mohammad
Samadian
Department of Neurosurgery, Skull Base Research Center, School of Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
kazemimd@msn.com
0031947532846006399
0031947532846006399
No
Navid
Kalani
Department of Anesthesiology, Critical Care and Pain Management Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.
navidkalani@ymail.com
0031947532846006400
0031947532846006400
No
Ali
Kazeminezhad
Department of Neurosurgery, Peymanieh Hospital, Jahrom University of Medical Sciences, Shiraz, Iran.
kazemimd@msn.com
0031947532846006401
0031947532846006401
Yes
en
Estimation of Median Nerve Axonal Degeneration without Needle Electromyography
Background and Aim: The present study aimed to use the median nerve Compound Muscle Action Potential (CMAP) amplitude by stimulation at the palm instead of Abductor Pollicis Brevis (APB) needle Electromyography (EMG) for determining axonal loss in patients with Carpal Tunnel Syndrome (CTS).
Methods and Materials/Patients: This study was performed on 180 patients with CTS referred to the Electrodiagnostic (EDX) Center, Poursina Hospital, Guilan Province, Iran, in 2018-19. In this study, the APB needle EMG diagnostic test was used as the gold standard, and median nerve CMAP amplitude with stimulation at the palm and wrist were used to compare the two nerve stimulation tests.
Results: All of the cases with abnormal amplitude loss detected by median nerve stimulation at the palm also had an axonal loss in the needle EMG of APB. So this test could be a good indicator of axonal loss if there is an abnormality (sensitivity: 73%, specificity: 100%). The results with wrist stimulation were not as accurate as of the palm stimulation, and some cases with decreased CMAP amplitude of median nerve had normal needle EMG of APB muscle (sensitivity: 86.6%, specificity: 94.9%).
Conclusion: In cases with CTS, the abnormally decreased amplitude of the median nerve detected by stimulation at the palm could be a good indicator of axonal loss.
Median nerve, Electromyography, Carpal tunnel syndrome
23
30
http://irjns.org/browse.php?a_code=A-10-410-1&slc_lang=en&sid=1
2020/04/152020/04/192020/09/1
1399/6/11
2020/11/102020/11/132021/11/1
1400/8/10
Mozaffar
Hosseininezhad
Department of Neurology, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
hosseininezhadm@gmail.com
0031947532846006402
0031947532846006402
Yes
Amir Reza
Ghayeghran
Department of Neurology, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
amirreza.ghayeghran@yahoo.com
0031947532846006403
0031947532846006403
No
Paria
Nasiri
Department of Neurology, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Parianasiri199@gmail.com
0031947532846006404
0031947532846006404
No
Sajjad
Saadat
Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran.
sajjadsaadat69@gmail.com
0031947532846006405
0031947532846006405
No
Katayoun
Esmaili
Department of Neurology, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Katayoun.esmaili@ ymail.com
0031947532846006406
0031947532846006406
No
Enayatollah
Homaei Rad
Research Assistant Professor of Health Economics, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
homaierad@gmail.com
0031947532846006407
0031947532846006407
No
Zahra
Gholipour Soleimani
Department of Nursing, Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran.
elahe.gholipour20@hotmail.com
0031947532846006408
0031947532846006408
No
en
Three-dimensional Anaglyph Indocyanine Green Video Angiography: A New Technology for Cerebrovascular Surgeries
Background and Aim: Indocyanine Green (ICG) angiography has become the standard of practice in many centers managing cerebrovascular diseases. Though 3D stereoscopic recording of the surgeries has received widespread attention, there is a need for a technology to display and record real-time 3D ICG angiographies. In this study, we designed and constructed an ICG angiography camera to display the real-time 3D ICG angiographies.
Methods and Materials/Patients: Our project had three phases. In phase I, a handmade ICG camera was designed and constructed in our laboratory. The second phase included creating a 3D camera to display real-time images in 3D anaglyph format. In the last phase, we developed a 3D ICG camera to demonstrate 3D ICG angiographies in real-time.
Results: We successfully completed all three phases of the project and could display real-time 3D ICG angiography of a mouse mesenteric arteries, recorded it, and took pictures.
Conclusion: We proposed a method and proved its feasibility for producing a 3D ICG angiography camera to be mounted on the next generation of neurosurgical microscopes.
Technology, Angiography, Indocyanine green, Three-dimensional
31
36
http://irjns.org/browse.php?a_code=A-10-1-26&slc_lang=en&sid=1
2020/04/152020/04/192020/09/12020/06/18
1399/3/29
2020/11/102020/11/132021/11/12020/10/23
1399/8/2
Mohsen
Nouri
Department of Neurosurgery, Jamaica Hospital Medical Center, New York, USA.
mnouri@jhmc.org
0031947532846006409
0031947532846006409
Yes
Amir
Azarhomayoun
Stone Lion Clinic, Gundishapour Academy of Neuroscience, Ahvaz, Iran.
dr.azarhomayun@gmail.com
0031947532846006410
0031947532846006410
No
en
Outcomes of Surgical Decompression for Spinal Metastases From Gynecological Cancers: A Retrospective Cohort Study
Background and Aim: Gynecological cancer is one of the most common types of cancer worldwide. Nonetheless, spinal metastasis from gynecological cancer is scarcely reported in the literature. In cases of spinal cord compression, the standard treatment is a decompressive surgery followed by radiotherapy treatment for selected patients. This study aimed to report the overall survival and surgical results in patients presenting with gynecological spinal metastases who underwent spinal cord/nerve root decompression and stabilization.
Methods and Materials/Patients: A total of 18 patients were included in this study. The surgical procedures were performed from 2012 to 2019. The evaluation of neurological status, spinal stability, and pain were performed using the American Spinal Injury Association Impairment Scale (ASIA), Spinal Instability Neoplastic Score (SINS), and Visual Analogue Scale (VAS), respectively.
Results: The lumbar spine was the most affected location (n=30; 50.0%). Regarding the preoperative neurological deficits, 16 cases (n=16; 88.9%) presented ASIA graded A–D before the surgery, being reduced to five (n=5; 27.8%) after the procedures. The pain level means (pre-and postoperative) were 9.39±0.79 and 2.28±1.44. The overall median survival was 6.1 months (95% Confidence Interval [CI] of 1.10–11.13 months). The mean survival of ambulatory and non-ambulatory patients before the surgery was 7.36 months and 3.2 months, respectively (P=0.007 – Log-rank Mantel–Cox).
Conclusion: Decompressive surgery and stabilization promote mechanical pain relief, spinal stability, an improvement of neurological function, and indirectly improving quality of life, despite a dismal overall survival of patients who present with metastatic spinal compression disease.
Female genital neoplasms, Neoplasm metastasis, Spinal cord compression, Epidural neoplasms
37
48
http://irjns.org/browse.php?a_code=A-10-407-1&slc_lang=en&sid=1
2020/04/152020/04/192020/09/12020/06/182020/06/2
1399/3/13
2020/11/102020/11/132021/11/12020/10/232020/11/12
1399/8/22
Luiz Alves
Vieira Netto
Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
netto261@gmail.com
0031947532846006411
0031947532846006411
No
Luís Felipe
Araújo Peres
Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
luis_fel10@hotmail.com
0031947532846006412
0031947532846006412
No
Nayara
Matos Pereira
Department of Neurological Surgery, Clinics Hospital of the Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
naymp_naymp@hotmail.com
0031947532846006413
0031947532846006413
No
Alice
Jardim Zaccariotti
Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
alicejz@hotmail.com
0031947532846006414
0031947532846006414
No
Vladimir
Arruda Zaccariotti
Department of Neurological Surgery, Clinics Hospital of the Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
zaccariotti@hotmail.com
0031947532846006415
0031947532846006415
No
Romulo Alberto
Silva Marques
Department of Neurological Surgery, Clinics Hospital of the Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
romulo.alberto@icloud.com
0031947532846006416
0031947532846006416
No
João
Batista Arruda
Department of Neurological Surgery, Clinics Hospital of the Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
arrudajb@msn.com
0031947532846006417
0031947532846006417
No
Edésio
Martins
Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
prof.edesio@gmail.com
0031947532846006418
0031947532846006418
No
Rodrigo Alves
de Carvalho Cavalcante2
Department of Neurological Surgery, Clinics Hospital of the Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
drigocavalcante@yahoo.com.br
0031947532846006419
0031947532846006419
Yes
en
Risk of Dependency Following Microsurgical Clipping in Good Grade Patients With Ruptured Anterior Circulation Aneurysms
Background and Aim: Most good grade (WFNS I and II) patients who undergo microsurgical clipping achieve a favorable outcome. However, some independent patients before surgery face unfavorable outcomes after the operation, signifying the impact of microsurgical clipping. This study aimed to identify the risk of developing dependency in patients without previous neurological deficits.
Methods and Materials/Patients: We reviewed 50 consecutive good grade patients with ruptured anterior circulation aneurysms who underwent microsurgical clipping between May 2017 and May 2020 in the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan. The clinical outcome at discharge and three months follow-up was assessed using the Glasgow Outcome Scale (GOS).
Results: In this study, seven patients (14%) became dependent (GOS II and III) following clipping. Of whom, five patients (10%) suffered surgical insult in the form of intraoperative rupture (4%), post-op infarct (4%), and direct brain damage (2%).
Conclusion: Patients without neurologic deficit pre-operatively still suffer unfavorable outcomes mainly due to operative complications. Vascular injuries remain the main cause of morbidity-producing dependency. Therefore, all surgical techniques must minimize the risk to vessels, both during dissection and at clip placement.
Intracranial Aneurysm, Clips, Surgical, Dependence, Anterior Circulation
49
56
http://irjns.org/browse.php?a_code=A-10-398-1&slc_lang=en&sid=1
2020/04/152020/04/192020/09/12020/06/182020/06/22020/09/19
1399/6/29
2020/11/102020/11/132021/11/12020/10/232020/11/122020/12/2
1399/9/12
Sundus
Ali
Punjab Institute of Neurosciences, Lahore, Pakistan.
sundusunn@gmail.com
0031947532846006420
0031947532846006420
Yes
Fauzia
Sajjad
Punjab Institute of Neurosciences, Lahore, Pakistan.
drfauziasajjad@gmail.com
0031947532846006421
0031947532846006421
No
Asif
Shabbir
Punjab Institute of Neurosciences, Lahore, Pakistan.
drasifshabbir@gmail.com
0031947532846006422
0031947532846006422
No
Akmal
Azeemi
Punjab Institute of Neurosciences, Lahore, Pakistan.
drakmalazeemi@gmail.com
0031947532846006423
0031947532846006423
No
en
Intracerebral and Intraventricular Hemorrhage With COVID-19: A Case Report
Background and Importance: SARS-CoV-2 virus causes COVID-19. The virus’s primary target is the respiratory system, but it can also affect other systems, such as the cardiovascular and the central nervous system.
Case Presentation: In this study, we introduce an 83-year-old man who was referred due to a reduced level of consciousness and hemiparesis in the left part of his body without symptoms such as fever, cough, muscle aches, and fatigue. In High-Resolution Computed Tomography (HRCT) of the lung, the Ground-Glass Opacification/Opacity (GGO) view indicated COVID-19 disease, and in Computerized Tomography (CT) scans of the brain, hemorrhage was evident in the right thalamus, lateral and right ventricle. The Polymerase Chain Reaction (PCR) test performed on the upper part of the nose was also positive. This research is a case report of intracranial and intraventricular hemorrhage in an aged man with asymptomatic COVID-19.
Conclusion: Low level of consciousness in the elderly can be a sign of infection with the SARS-CoV-2 virus.
COVID-19, Intracranial hemorrhage, Aged
57
60
http://irjns.org/browse.php?a_code=A-10-378-1&slc_lang=en&sid=1
2020/04/152020/04/192020/09/12020/06/182020/06/22020/09/192020/08/15
1399/5/25
2020/11/102020/11/132021/11/12020/10/232020/11/122020/12/22020/11/25
1399/9/5
Masoomeh
Abdi
Department of Nursing, Aligoudarz School of Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran.
masoomeh.abdi21@yahoo.com
0031947532846006424
0031947532846006424
Yes
Kioumars
Karamizadeh
Department of Nursing, Aligoudarz School of Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran.
k.karamizadeh98@yahoo.com
0031947532846006425
0031947532846006425
No
Mona
Nabovvati
Department of Nursing, Aligoudarz School of Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran.
m.nabovvati@gmail.com
0031947532846006426
0031947532846006426
No
en
Penetrating Orbitocranial Injury With a Good Aesthetic and Functional Outcome: A Case Report
Background and Importance: Transorbitocranial assaults with sharp objects like a knife are rare neuro-ophthalmologic emergencies. However, they can have dramatic functional and life-threatening consequences. Our presentation aims to report the importance of an urgent multidisciplinary approach and to raise awareness among the general population on the importance of preventing violent behavior.
Case Presentation: A 33-year-old man was a victim of a knife attack without obvious brain or ophthalmological lesions. The knife entered the medial part of the orbit. Neurological examination was normal, and Computed Tomography (CT) scan showed intracranial trajectory through the orbit to the frontal horn of the lateral ventricle. The knife was extracted without complications. The patient reported spectacular improvement in visual acuity without neurological or oculomotor deficit at long-term follow-up. In this case report, we will discuss the radiological diagnosis and surgical management of transorbital and orbitocranial injuries by foreign body penetration.
Conclusion: Urgent multidisciplinary management in orbitocranial trauma by stabbing is mandatory to avoid life-threatening complications and irreversible damages.
Craniofacial Penetrating, Foreign body, Computed tomography, Extraction, Infection
61
66
http://irjns.org/browse.php?a_code=A-10-251-1&slc_lang=en&sid=1
2020/04/152020/04/192020/09/12020/06/182020/06/22020/09/192020/08/152020/06/13
1399/3/24
2020/11/102020/11/132021/11/12020/10/232020/11/122020/12/22020/11/252020/11/11
1399/8/21
Youssef
Fahde
Department of Neurosurgery, Mohammed VI Teaching Hospital, Cadi Ayyad University, Marrakech, Morocco.
u.fahde@gmail.com
0031947532846006462
0031947532846006462
Yes
Davis
Mpando
Department of Neurosurgery, Mohammed VI Teaching Hospital, Cadi Ayyad University, Marrakech, Morocco.
davismpando@gmail.com
0031947532846006463
0031947532846006463
No
Mehdi
Laghmari
Department of Neurosurgery, Mohammed VI Teaching Hospital, Cadi Ayyad University, Marrakech, Morocco.
me.laghmari@uca.ma
0031947532846006464
0031947532846006464
No
Houssine
Ghannane
Department of Neurosurgery, Mohammed VI Teaching Hospital, Cadi Ayyad University, Marrakech, Morocco.
hghannane@gmail.com
0031947532846006465
0031947532846006465
No
Said
Aitbenali
Department of Neurosurgery, Mohammed VI Teaching Hospital, Cadi Ayyad University, Marrakech, Morocco.
aitbenalis@yahoo.fr
0031947532846006466
0031947532846006466
No