فصلنامه علوم اعصاب شفای خاتم
پیاپی 2 (بهار 1392)

Irreversible absence of cerebral and brainstem functions defined as brain death. The criteria for brain death includes a patient in a comatose state, absence of brain stem reflexes on neurologic examination, and a core body temperature >90°F. Assessing brain death may sometimes be difficult especially when a discrepancy between the clinically and EEG-assessed brain death is presented. This may lead to misdiagnosis of brain or brain stem death. Nuclear medicine techniques were used to support the diagnosis of brain death. Uptake of Tc99mHMPO in the cerebral and cerebellar cortices was detected in patients suspicious of the brain death. Nuclear imaging demonstrated an absence of intracerebral uptake of the tracer in patients with brain death. In patients with severe closed head injuries, a nuclear medicine perfusion test revealed the lack of uptake of radionuclides in the neocortex.
Nuclear medicine tests as well as a non-contrasted CT scan or computed tomographic angiography can be also performed at the same time with minimal additional risks to evaluate the lack of blood flow to the brain and improve our diagnosis of the brain death.

Cancers are among the most common causes of deaths worldwide and just the third cause of deaths as well as they are more common in elderly, with an aging population in Iran. Iran is going to face an increase in the incidence of malignancies in the next decades.
This study has tried to use the existing evidences through a systematic review beside the national cancer registry (NCR) database between 2000 and 2009 to find out the incidence of primary malignant and benign CNS tumors in Iran. International databases of Medline, Embase, ISI web of knowledge and Google scholar along with three major Persian indexing websites of SID, MagIran and IranMedex are searched. Primary searches resulted in finding of 966 papers of which 11 were selected for analysis.
Primary malignant CNS tumors form 2.3% of all tumors in the ten-year registry data. Incidence of primary malignant brain tumors in Iran is 3.3 per 100,000 person-year, 3.9 for males and 2.8 for females. A total number of 10,797 cases are registered in the NCR data, which demonstrate astrocytoma (32.4%), glioblastoma (29%), oligodendroglioma (6.2%), medulloblastoma (6.1%), and ependymoma (2.7%) as the most common pathologies in primary brain tumors. Primary malignant spinal cord tumors consists 6.8% of all CNS tumors. Common pathologies in spinal cord tumors are malignant neoplasm, ependymoma, astrocytoma and lymphoma. However, the two benign spinal cord tumors of neurofibroma and schwannoma are believed to be more frequent than malignant ones.
Most common benign pathologies are meningioma (27.8%), pituitary adenoma (11.3%), schwannoma (5.8%), and congenital tumors (2.4%). Primary benign tumors in Iran have an incidence of 3.5 per 100,000 person-year.

Caloric restriction (CR) has been considered as a kind of diet therapy for some neurological diseases. This study was aimed to investigate the effect of CR on the seizure behavior induced in rats.
CR was applied with deprivation of food and water for 24 hours every other day for a period of four weeks. Seizure induced by pentylenetetrazol (PTZ) injection. Animals in CR1 group were accessed caloric restriction before PTZ injection. Animals in CR2 group were accessed caloric restriction after PTZ injection. Animals in CR3 group were accessed caloric restriction before and after PTZ injection.
The scores of seizure behaviors were significantly decreased in groups of animals that received CR before PTZ injection.
These findings suggest the CR reduces scores of seizure behaviour and may be helpful in the refractory epilepsy.

Spreading depression (SD) is a wave of depolarization, which passes through the brain and depresses neuronal activities. Various mechanisms have been postulated for SD-induced neurotoxicity. Some of these pathways include ionic imbalances, intracellular calcium accumulation and bioelectrical changes. The hippocampus is one of the most sensitive regions of the brain for SD injuries as the first signs of tissue damage appear in this subcortical structure. Correlations between hippocampal injuries and some neurodegenerative disease have been previously suggested. Inflammatory responses may trigger hippocampal injuries after SD.
In the present study 36 Wistar rats were treated by dexamethasone before induction of SD to investigate the role of inflammatory responses in SD-induced neurotoxicity.
Histological assessments indicated that neural cell death was significantly reduced by pretreatment of dexamethasone.
This suggested the possible role for inflammatory response in cell injuries after SD induction.

Today herbal therapy has been developed as a non-invasive and less side effect treat for a variety of diseases. This study was aimed to evaluate the effect of anise oil on the hippocampal damages followed by generalized seizures.
Anise oil was applied before seizure induction in rats. Anise oil was administered at different doses before induction of seizure attacks.
Anise oil reduced seizure severity and decreased hippocampal injuries in all treated groups.
our findings suggest that anise oil may be a potential therapy in the generalized epilepsy.

Disease modifying treatment strategies for Alzheimer’s disease (AD) have led to a severe need for finding biomarkers to be able to establish a reliable diagnosis at a very early stage and also to follow up the patient and their response to therapy. Amyloids β (Αβ) which predominate in amyloid plaques constitute one major neuropathologic hallmark in AD, are produced by all types of cells in the central nervous system and almost all cells in peripheral tissues. Increased plasma level of this peptide is reported in prodromal stage of AD, in mild cognitive impairment.
Different genetic, imaging and biochemical studies suggest that increased plasma Aβ can begin many years before the onset of symptoms in AD, indicating that it does not require preexisting neural abnormalities. It remains to be verified if the proof of plasma Aβ in clinically healthy subjects represents a prognostic factor pointing to a risk of pending AD.

The glutamergic receptors affect the synchronization of spike and wave discharges in different animal models of absence seizure. We studied the distribution of a NMDA subtype receptor in CA1 area of the hippocampus.
Expression of NMDA subreceptor R2, the predominant excitatory neurotransmitter receptor in the brain, was investigated in rats suffering from absence-like seizures.
Rats with absence-like seizures exhibited decreased number of these NMDA subreceptors in the hippocampal formation.
Changes of expression of these receptors in the hippocampus may be involved in cognition deficits in absence epilepsy.

Melatonin is synthesized in the pineal gland as well as in several peripheral tissues. The melatonin signal is translated through activation of two G –protein coupled receptors, MT1 and MT2, and involves in several actions like regulation of circadian rhythms and sleep promotion. Melatonin is also suggested to play a role in treatment of different disorders especially neurological disorders like Alzheimer’s disease, Parkinson's disease and Huntington ’s disease through its anti-inflammatory and anti-apoptotic effects.
The aim of the present review is to discuss the effect of melatonin in the above mentioned neurological disorders.

In order to provide a forum to discuss and present the state of art and up-to-date neurosurgical treatments, operative techniques, clinical and technological advances, and making ground for research in the neuroscience field, the first Razavi International Neurosurgery Congress was held in Razavi Neuroscience Center in Razavi Hospital, Mashhad, Iran from July 11-13, 2012. Twenty-Five neurosurgeons from around the world (USA, Germany, England, Italy, Egypt, Switzerland, Syria, Bulgaria, Afghanistan, Brazil and Australia) participated in this congress, alongside many locals. The Sarah Jane Brain Foundation (located in New York, USA) was an official partner of this congress. Lectures presented spanned a wide spectrum of neurological diseases including: cerebrovascular, endovascular, peripheral nerve, trauma, intracranial tumors, pain and functional, pediatric neurosurgery and basic neuroscience. Over 100 lectures and poster presentations were shared in this congress. All with one purpose is to enhance the collaboration between clinical neurosurgeons and neuroscientists in Iran and their colleagues from around the world and provide the highest neurosurgical care and management to the Iranian people and surrounding region. More than 50 percent of the members of the audience in this Congress were younger than 30 years of age training of these young clinicians and scientists by well-known neurosurgeons raises hope for a brighter future for patients in this region.