International Clinical Neuroscience Journal

Background: CSF is a clear liquid that its mechanical properties are to a large extent similar to water properties.

Regarding the lack of a numerical index for diagnosis of diseases resulting from increased CSF pressure such as hydrocephalus, evaluation of hydrodynamic conditions of CSF in cerebral ventricular system is of great importance. Methods: At first, the diagram of velocity in Sylvius aqueduct which was obtained through a 3D FSI analysis in ADINA was compared to the similar diagram extracted from CINE-PC-MRI of the same test subject. The next step after ensuring that the two diagrams coincide with each other, was to make sure that the problem assumptions and solution are correct. Thereafter, the Womersley number in Sylvius aqueduct of a healthy subject was calculated. Results: The amount of this number was 3.25 and indicated the pulsatility of the fluid flow. The difference between the maximum and minimum pressure exerted by CSF on the brain tissue in Sylvius aqueduct was 81.5 Pa. This pressure difference was introduced for the first time in this study as an index for assessing hydrocephalus. Finally, the CSF pressure values calculated in this study and the pressure data obtained from LP test were compared. Conclusion: This comparison showed that utilizing a proper pressure gauge for LP test makes it possible to use the LP test results, alongside with the study results, as an index to assess the CSF conditions in ventricular system for diagnosis of that group of diseases resulting from increase in CSF pressure.

Abstract

Background: The purpose of this study is to evaluate anterior cervical discectomy. Materials and Methods: This retrospective study was conducted on 43 patients underwent surgery through standard Smith-Robison Technique with fusion. Postoperative follow-up period was 24 months. Clinical assessment was done through Odom criteria, Neck disability index and VAS for neck pain. Results: According to Odom criteria, patients after surgery had more than 80% acceptable satisfaction. Based on Neck disability index and VAS, patients had significantly improved. Before surgery, none of the participating patients had lack of disability or mild disability. The most common indicator in these patients was severe disability which was observed in 34 cases (79.1%). After surgery, no one had complete disability while mild disability was the most common indicator among 20 patients (46.5%). The successful fusion rate was 95%. The most common symptom was neck pain and sensory disorder was the most prevalent sign. The most common level involved was C5-6. Medium-term of medical treatment was 4.5 months. The main causes of surgery were motor defect and neck pain. Conclusion: Due to the possibility of complete discectomy and complete removal of compression, anterior surgery approach is preferred over posterior one. 

Background: Several studies have indicated that executive dysfunction is the main neuropsychological feature of Parkinson’s disease (PD). The Frontal Assessment Battery (FAB) is a short tool for the assessment of executive functions. Purpose: The aim of this study was to determine the relationship between Persian version of FAB scores and age, education, Mini-Mental State Examination (MMSE), and severity of the disease in Iranian patients with PD. Methods: The study involved 60 healthy participants and 60 patients with idiopathic PD. Age, sex, disease duration, and Unified Parkinson’s Disease Rating Scale (UPDRS) scores were noted. FAB and MMSE were administered to all participants. Both groups were compared according to FAB scores, MMSE, age, and education. Results: FAB scores were significantly lower in patients with PD than in healthy controls (P<0.05). In patients with PD, FAB scores were correlated with MMSE (P<0.05) but not with UPDRS (P=0.93). Conclusion: FAB scores were significantly lower in Iranian patients with PD in comparison to controls and it can indicate that this battery has good discriminate validity and can be a useful tool to identify executive dysfunction in  Iranian patients with Parkinson’s disease. Also it seems that FAB is not useful test to show disease severity in Iranian patients.

ABSTRACT

Purpose: This study aimed to correlation between the grading stenosis and the STarT Back Screening Tool (SBST) in

patients diagnosed with lumbar central canal stenosis (LCCS). Methods: In a prospective clinical study, a total of

269 patients with LCCS were asked to respond to the questionnaire at their first visits. Grading of LCCS on MRI was determined and also the severities of the disease were observed based on SBST as the gold standard. Finally grading on MRI and calcification of the SBST were determined, and sensitivity analysis carried out to evaluate severity of LCCS on grading of MRI using the SBST. Results: The mean age of patients was 58.6 (SD= 10.9) years; and 56.5% were female. According to patients’ imaging they have been diagnosed as grade 1 (n = 86), grade 2 (n =

107) and grade 3 (n = 76). The sensitivity, specificity and accuracy of the estimated grading of LCCS on MRI for low, medium, and high risk groups were found to be desirable: 97.6%, 66.7%, 96.5% for low risk; 93.1%, 83.3%, 92.5% for medium risk, and 97.2%, 66.7%, 94.7% for high risk, respectively. Conclusion: Our findings indicate that grading of LCCS on MRI correlate with SBST and suggest that it is a reliable measure for screening LCCS patients.

Purpose: This study was conducted to determine the relationship between depression and anxiety with love

among married peoples. Methods: It was a post event study performed on 90 married peoples and the sample was randomly selected. Married people were invited to volunteer by calling and they were entered to study after filling consent form. Then participants were evaluated by demographic, Boston stern Norse Love, Beck Depression and Hamilton Anxiety questionnaires. Results: Based on the performance assessment of participants a significant inverse relationship was observed between love with depression and anxiety (P<0.05) and simulated love reduces depression and anxiety. Conclusion: Increased love was associated with reduced depression and anxiety. It seems mental disorders could be reduced by creating favorable positions for romantic sentiment in the family.

Background: Over the past decades, instruments and techniques of the transsphenoidal approach have improved

greatly. All of these procedures, whether microscopic or endoscopic, must pass through the sphenoid sinus to reach the lesions. The sphenoid sinus is surrounded by several vital anatomical structures. Knowing the details of the anatomy of the sphenoid sinus and the extent of pneumatization can guide the surgeon through difficult corners of  this approach.  Purpose:  This work  aimed  to determine  the incidence  of  the different  anatomical variations of the sphenoid sinus in Iranian patients with pituitary adenomas as detected by preoperative MRI and CT  scans.  Methods:  Preoperative  CT  scan  and  MRI  of  64  adult  patients  with  pituitary  adenomas  were retrospectively reviewed regarding degree of pneumatization and septation of the sphenoid sinus. Results: Regarding the degree of pneumatization, there were 34 cases with sellar type (59.4%), 10 patients with presellar type  (15.6%), and  16 cases with conchal  type  (25%).  Regarding  degree  of  septation, no absence  of  septum observed in any of our cases. A single intersphenoid septum observed in 18 of cases (28.1%), and 46 of cases had more than one intersphenoid septum (71.9%). Also, one onodi cell was identified. Conclusion: Enrichment of the knowledge of the sphenoid sinus anatomic variation would aid in reducing complications. Surgeons must meticulously study the preoperative imaging to become familiar with the nuances and variations unique to each case and proceed accordingly to decrease the risk of complications.

ABSTRACT

Cerebral  aneurysms  are  the  major  cause  of  subarachnoid  hemorrhage.  Common  ascribed  etiologies  are

hemodynamic  factors  such  as  atherosclerosis,   hypertension,  infection,  trauma,  polycyctic   kidney  disease, connective tissue disorders like Ehlers-Danlos disease, Marfan syndrome, and familial predisposition. However, its association with ankylosing spondylitis (AS) is not clear. Here, we report 2 patients with AS who presented with subarachnoid hemorrhage which was finally confirmed to be due to cerebral aneurysms, one in posterior communicating artery and the other in basilar artery tip). The patients had no history of hypertension or any other disease. Our data may not strongly suggest that vascular changes due to AS are etiological factors for developing intracranial aneurysm, but this report may show the possibility for existence of an association between these diseases, which has to be confirmed by more genetic and pathologic studies.

ABSTRACT

Our patient was a 43-year-old woman with a suboccipital headache and pain in the upper cervical region from 3 years ago with a progressive generalized weakness in the last 3 months. Neuroimaging study showed a dumbell shaped lesion with compression of the spinal cord in the cervical region that was identified as a neurinoma. The tumor had been completely removed by surgery but after the operation, site of surgery bulged and consequently the patient was reevaluated. The bulging was diagnosed as a pseudomeningocele that did not response to conservative management and was removed surgically. Possible causes for the development of post operative pseudomeningocele can be soft tissues and paravertebral muscles damage or high intradural pressures that cause leakage of cerebrospinal fluid from a very small dural defect. Shunt insertion should be reserved for patients with impaired cerebrospinal fluid absorption or those with a refractory fistula despite medical therapies and direct surgical repairs.