International Clinical Neuroscience Journal

Background: Because of well-established role of obesity in brain lesions, progressing cognitive deficits in obese patients has been recently suggested. In current study and for the first time, we aimed to assess cognition status in Iranian obese people and to compare it with non-obese individuals.

Methods: One hundred and eighteen consecutive patients with the different cardiovascular and metabolic primary complaints were assigned to obese group (n = 25, 21.2%) and non-obese group (n = 93, 78.8%). Cognitive status was assessed at initial visiting using the Montreal Cognitive Assessment (MoCA) questionnaire.

Results: Mean total cognitive score in obese patients was 20.04 ± 4.57 and in non-obese ones was 20.19 ± 5.32 with no difference (p = 0.886). In total, 8.0% of obese patients and 20.4% of non-obese patients had normal cognitive function (p = 0.149). No significant difference was also found in different subdomains of cognitive ability between obese and non-obese groups. None of the cognitive domains had significant association with BMI as the considered indicator for defining obesity. Based on multivariate linear regression modeling, obesity could not predict cognitive deficit (beta = 0.034, SE = 0.1.015, p = 0.973).

Background: Many patients with Parkinson diseases are faced with constant attention disorders and evaluation of these disorders in these patients is important.

Methods: A cross-sectional study was conducted on 80 patients with Parkinson disease and 80 healthy Iranian people aged 40 to 70. All participants in the two groups of healthy and patients were examined by neurologists and psychiatrists. After completing the questionnaire, they were evaluated through computerized cognitive Continuous Performance Test.

Results: There was significance difference between the two groups in age, sex and education status and in some variables of the test (p<0.05). Patients compared with healthy controls and showed a significant difference in test variables (p<0.05). Conclusion: Patients with Parkinson disease compared to healthy subjects face cognitive changes in sustained attention, and identification and evaluation of cognitive changes before and after treatment will be a considerable help in the rehabilitation of brain and a better quality of life for these patients.

Introduction: Chronic radicular low back pain is a common disease that limits patient’s daily activity. Epidural steroid injection (ESI) is becoming the mainstay of therapies for radicular low back pain due to contained bulged disc.

Aim: To determine the effect of adding hypertonic saline to epidural steroid injections to provide pain relief for chronic radiculopathy back pain secondary to foraminal stenosis.

Method: In a randomized clinical trial, 50 patients with unilateral radicular low back pain due to unilateral foraminal stenosis were enrolled. Epidural steroid injections were performed using transforminal approach. In hypertonic saline group 80 mg of triamcinolone plus 2 ml of 10% hypertonic saline, and in control group 80 mg of triamcinolone plus 2 ml of normal saline were injected. Outcome measures were numerical rating scale (NRS), Oswestry disability index (ODI), and proportion of responder patients (NRS<3) were measured at baseline, 1, 3, and 6 months post-procedure.

Results: Comparison of pain score between two groups showed that pain score was not significantly different at 1(p=0.24), 3 (p=0.31) and 6 (p=0.38) month. significant pain relief (NRS<3) in 76% of patients within 1 months. Percent of patient with NRS<3 was 48% and 32% in hypertonic and 40% and 32% in steroid group at 3 and 6 month respectively.

Conclusion: hypertonic saline added to steroid did not significantly increase pain relief effect of epidural steroid injection.

Brain tumors in elderly are increasing as the number of people, who comprise the older population, does.About half of the patients with brain tumors appear to be over 60 years of age.In this review article, Glioblastoma multiform, as the most common malignant tumor of the central nervous system in elderly is discussed in details of definition, prognosis, diagnosis, treatment and differential diagnosis. Other tumors such as meningioma, pituitary adenoma, CNS lymphoma and metastasis are also included to be reviewed.  Treatment plans, either conservative or aggressive, classic or novel, approved or under investigation, are presented. Furthermore different attitudes of treatment in the past and recently are also argued. Conventional therapy, Surgery, Radiotherapy, chemotherapy radioimmunotherapy, hormonal therapy and some other novel methods of treatments are discussed in details for the glioma.

Determining factors which may be associated to the patient's response to each treatment planare also discussed. Finally, some age related issues are provided to be paid attention to consider an old patient with brain tumor, and planning an optimal treatment in order to make the best management decisions.Until recently,  peoplewith brain tumors in elderly, were used to be treated in conservative plans and often were excluded of the clinical trials but now the number of patients who desire and receive more aggressive therapy for brain tumors is increasing.

Eye Movement Desensitization and Reprocessing (EMDR) process encompasses several nervous system components such as medulla, pons, midbrain, cerebellum, basal ganglia, parietal, frontal and occipital lobes. The role of Eye Movement (EM) has been documented previously in relation with cognitive processing mechanisms. By EMDR we can reach some parts of memory which were inaccessible before and also emotionally intolerable. EM also decreases the memory's image clarity and the accompanying excitement and it is done simultaneously for gaining patient's attention to an external stimulus when he/she is concentrating on a certain internal subject. A series of systemic experiments have shown that the eyes spontaneous movement is associated with emotional and memory changes and results into decreased excitement, flexibility in attention, memory processing, and enhanced semantic recalling. Researches emphasize on the effectiveness of EMDR in memory changes and memory washing. 

Purpose: In this study we aimed to investigate the benefits of far-lateral approach without partial condylectomy in patients with foramen magnum meningiomas over surgical approach with condylectomy.

Methods: From 1980 to 2011, a total of 17 patients with foramen magnum meningiomas were treated surgically via far-lateral approach without condylectomy. The follow up period of this study was 6 to 24 months.

Result: In this study, most of the tumor removals were done as complete resection. Operative deaths and significant complications were not noticed during procedure. Although all of the patients improved in their motor function, sensory deficits were resolved in 85% of patients by microsurgical far-lateral approach without partial condylectomy.

Conclusion: Results of this study revealed that far-lateral approach without condylectomy is safe and effective in resection of foramen magnum meningiomas.

Cerebral stroke is a rare disease in children. Moyamoya (MM) is one of the infrequent cerebrovascular diseases with unknown etiology. We report an 8 year-old-boy with chief complain of sudden onset bilateral parietal lobe headache. He mentioned that his headache was first started about three weeks ago and was associated with visual disturbance. His mother declared that the boy developed gait problems few days later and only could walk with assistance. He was diagnosed with MM disease. After, medical treatment his symptoms were mildly improved and because of   his family disagreement cerebral revascularization surgery was not performed.

The clivus is the surface of a portion of the occipital and sphenoid bones in the base of the skull. (1)It is surrounded by the neurovascular structures of the brainstem, as well as internal carotid arteries. Tumors of the clivus can be benign (chordoma)or malignant (chondrosarcoma).(2) Chordomas are rare, aggressive, slow-growing, invasive, and locally destructive tumors that arise from the notochord, a structure that appears in embryonic stages and guides the growth of the bony skull and spine. Normally, notochordal remnants form part of the intervertebral discs. A chordoma occurs when additional notochordal cells are enclosed by the developing bones. Although these  tumors are benign and slow-growing, they may invade nearby structures and destroy surrounding tissue and spread to other parts of the body.(2)

Most arachnoid cysts are probably present at birth, or develop soon after. Once they are formed, they are thought to remain stable, apparently in some kind of equilibrium with the rest of the intracranial space(3). We report a rare case of clivus chordoma associated with an arachnoid cyst.