فهرست مطالب

Archives of Neuroscience - Volume:3 Issue:3, 2016
  • Volume:3 Issue:3, 2016
  • تاریخ انتشار: 1395/06/29
  • تعداد عناوین: 10
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  • Manas Kumar Panigrahi*, Manoranjitha Kumari Mani Page 2
    Background
    Due to advancements in technology, endovascular techniques (EVT) are considered a mainstay of treatment for intracranial aneurysms. However, for patients with anatomically complex aneurysms, associated intracranial hematomas requiring evacuation still need an open surgical clipping as the first line of treatment. Microsurgical clipping is an alternative for patients who cannot afford the high cost of EVT treatment.
    Objectives
    This paper presents our experience in surgical clipping of symptomatic intracranial aneurysms performed in our hospital from Jan 2010 to Dec 2013 on 170 patients. Based on the data, this study recommends microsurgical clipping as a viable and cost effective option for symptomatic intracranial aneurysms.
    Patients and
    Methods
    This study was a retrospective analysis of case records of patients who had been treated for symptomatic intracranial aneurysms, including both ruptured and unruptured intracranial aneurysms, at Krishna institute of medical sciences from January 2010 to December 2013. A total of 230 patients, who had clinical and radiological evidence of symptomatic intracranial aneurysms, were admitted into the study. Of the total number of patients, 170 had been managed with microsurgical clipping. The patient’s demographics, the features of the aneurysms, clinical grades, cost effectiveness, and outcomes were analyzed. Excluded from the study were 60 patients who had been treated with the endovascular technique.
    Results
    Of a total of 170 patients who underwent surgical clipping, 158 (93%) patients had an aneurysm in the anterior circulation and 12 (7%) in the posterior circulation. In the study group, 160 (94%) patients survived and 10 (6%) patients expired. One patient (0.58%) in the clipping group had a rebleed, and 4 (6.6%) patients from the coiling group eventually underwent clipping due to failed coiling. The average duration of hospital stay for the study group was 13 days and the cost for the treatment was Rs 2, 89, 238. The reasons for clipping in our patients were complex aneurysmal anatomy, difficulty accessing the aneurysm and MCA location in 60 (35%) patients, cost factor in 72 (42%) patients, non-availability of endovascular operator and hardware in 17 (10%) patients, associated hematoma requiring evacuation in 17 (10%) patients, and failure of the endovascular technique in 4 (2.5%) patients. Regarding outcomes, 83% of patients experienced a good outcome and 17% experienced a bad outcome.
    Conclusions
    These observations suggested that microsurgical clipping is a viable and cost effective alternative in the management of intracranial aneurysms in this endovascular era.
    Keywords: Clipping, Coiling, Intracranial Aneurysm, Outcome
  • Masood Mehrpour*, Leila Hashami, Elham Ghaebi, Fatemeh Taherian, Hoda Karimiyan Page 4
    Introduction
    Anterior communicating artery aneurysm produces symptoms by compression of adjacent neural structures. It can cause nausea and vomiting because of direct compression or destruction of the hypothalamus.
    Case Presentation
    We described a 59-year-old man with refractory nausea and vomiting. He was evaluated completely for this problem yet no gastrointestinal pathology was found. Gastroenterologic examination was normal and he was referred to our center for neurological evaluation. We found anterior communicating artery aneurysm in his brain magnetic resonance imaging (MRI). This finding was confirmed by digital subtraction angiogram (DSA). It was decided to coil the aneurysm. After aneurysm embolization, the patient’s symptoms were surprisingly improved completely.
    Conclusions
    We hereby report refractory vomiting as a rare presentation of un-ruptured anterior communicating artery aneurysm. This may be explained by a direct compressive effect of the aneurysm on adjacent structures.
    Keywords: Refractory Vomiting, Anterior Communicating Artery Aneurysm, Aneurysm Coiling
  • Zahra Tolou, Ghamari*, Hamid Mazdak Page 5
    Context: From the year 2010, for patients with highly active relapsing-remitting (RR) multiple sclerosis (MS), fingolimod could be justified for prescription as an oral medication. Previous published clinical trials identified that the drug could reduce auto-aggressive lymphocyte infiltration into the central nervous system (CNS) through the blood brain barrier (BBB), by stoppage of lymphocyte passage from lymphoid tissues.
    Evidence Acquisition: The aim of this study was to provide a comprehensive review related to the pharmacotherapy of fingolimod for MS, by gathering data related to previous clinical and laboratory trials. The key words relevant to the topic were searched through the United States national library of medicine. Significant manuscripts associated with fingolimod pharmacotherapy for MS were nominated and studied completely.
    Results
    In patients with MS due to multifactorial pathogenesis, in both white and gray matter of CNS, multifocal lesions might be recognized. CD4 and CD8 effector T cells, sensitive to CNS myelin antigens, are assumed to facilitate the preliminary stage of injury formation. Fingolimod -therapy in patients at the RRMS phase, reserve lymphocyte egress from lymphocyte nodes and disturb its’ recirculation in the CNS. Previous clinical trials confirmed that once-daily oral administration of 0.5 mg fingolimod for one year causes a decrease in annualized relapse rate. Reduction in the annualized relapse rate has been reported, related to the study of 249 patients with RRMS. Reduction in disability progression after three and six months has been reported, respectively. The numbers of new or newly enlarged T2 lesions were shown to have reduced. Head cold, headache, fatigue, macular edema, herpes and zoster infections, bradycardia, relapse and basal-cell carcinoma have been reported as side-effects related to finglimod-therapy for MS.
    Conclusions
    However, fingolimod-therapy could provide flexibility regarding the ease of oral use for patients with RRMS, but rationalization related to the prescription are largely based on inter- and intra- individual variation. Due to unpredictability in disease manifestation and its’ progression, caution must be taken with drug prescription. Additional studies based on advanced pharmacotherapy trials appear to be valuable..
    Keywords: Fingolimod, Multiple Sclerosis, Sphingosine, Immunomodulator
  • Hossein Majedi, S. Ali Emami, S. Maryam Hosseini, Abbas Tafakhori* Page 6
    In this paper we demonstrated an unusual location for sphenopalatine ganglion (SPG) in the pterygopalatine fossa in a 33-year-old woman with intractable atypical trigeminal autonomic cephalalgia, who was a candidate for radiofrequency (RF) thermocoagulation of SPG. The classic radiographic target point is deeply situated in the uppermost part of the sphenopalatine (SP) fossa. This point can be classically addressed in the superomedial angle of the maxillary sinus, adjacent to the lateral wall of the nasal cavity in the AP view of C-Arm fluoroscopy images. In this patient placing the needle deeply in the SP fossa was not possible. However, sensory stimulation of SPG was associated with a satisfactory response and subsequent RF denervation led to adequate pain reduction. This report demonstrated that in difficult technical situations, when advancing the needle deeply in the SP fossa is not easily possible; adequate outcome of the sensory stimulation of the area, may justify accomplishing the procedure. This technique used in a more superficial location in SP fossa will reduce frequent attempts of needle manipulation, hematoma formation, vascular and neural injury, X-Ray exposure and eventually intranasal placement of the needle.
    Keywords: Sphenopalatine Ganglion Block, Cluster Headache, Chemical Neurolysis
  • Ali Shamsizadeh*, Farangis Fatehi, Fatemeh Khajehasani, Gholamhossein Hassanshahi, Mohammad Kazemi Arababadi Page 7
    Background
    The exact pathogenesis of epilepsy is not clear well. Recent studies showed the possible involvement of transient receptor potential vanilloid type 1 (TRPV1) receptors in this disease.
    Objectives
    The aim of this study was to measure the expression of TRPV1 receptors in hippocampus following pentylenetetrazole (PTZ)-induced kindling in male rats.
    Materials And Methods
    In this experimental study, 14 male Wistar rats were allocated into two groups of experimental and control (seven rats in each group). The kindling group received a subconvulsive dose of PTZ (35 mg/kg, intraperitoneally) every 48 hours for 15 sessions, while the control rats were injected with an equal dose of saline. At the end of the injections, rats were decapitated, and their brains were removed. TRPV1 receptor expression in hippocampus region was assessed by real-time polymerase chain reaction method.
    Results
    The results of the current study showed that expressions of TRPV1 receptors were increased in hippocampus following PTZ-induced kindling in male rats.
    Conclusions
    Since the expression of TRPV1 receptors increased in hippocampus of epileptic rats, the TRPV1 receptors may be good candidates for epilepsy treatment.
    Keywords: Kindling, Pentylenetetrazole, Hippocampus, TRPV1
  • Muhammad Umair Majid, Muhammad Sufyan Tahir, Qurban Ali*, Abdul Qayyum Rao, Bushra Rashid, Arfan Ali, Idrees Ahmad Nasir, Tayyab Husnain Page 8
    Context: Ebola virus is infamous due to its reputation in hemorrhagic fever disease outbreaks in various countries of the world including West Africa. Different species of Ebola virus along with Marburg virus under the family Filoviridae are 90% associated with mortality.
    Evidence Acquisition: The current paper briefly discussed the history of Ebola virus along with its origin, geographical distribution, structure, replication, reservoirs, hosts, pathogenicity, viral entry mechanism, mode of action, epidemiology, viral transmission, disease symptoms, diagnostic strategies, clinical applications, medication and protective measures to create awareness among people.
    Results
    Before 2014, approximately the total loss of 1500 lives was recorded out of 2400 recognized cases, since the first discovery of Ebola virus in 1976. But the ongoing West African outbreak is the largest Ebola virus disease outbreak in the history, world health organization (WHO) reported a total of 28,599 cases observed and 11,289 deaths from this outbreak by 10 November 2015.
    Conclusions
    Despite the known severity of Ebola outbreaks, no effective vaccine or therapeutic drug is developed so far because of the RNA coded nature of this virus, but many candidate vaccines are going on trial basis. Lethal and infectious nature of this virus requires the effective diagnostic methods. Scientists working in this field should be cooperative and committed to combat this natural disaster effectively.
    Keywords: Ebola Virus, Reservoirs, Hosts, Pathogenicity, Viral Entry Mechanism, Mode of Action, Epidemiology, Viral Transmission
  • Hooshang Dadgar*, Javad Alaghband Rad, Anahita Khorrami, Zahra Soleymani Page 9
    Many researchers are focusing on different medication and intervention methods to treat problems associated with autism spectrum disorder (ASD). Transcranial magnetic stimulation (TMS) is one of the novel techniques that currently have been investigated as a treatment for certain symptoms of autism. The aim of this study was to review the available evidence to determine the efficacy of TMS in autism. Medline, Embase, CINAHL, Web of Science, Scopus, Wiley, Ovid and Google Scholar databases were searched for relevant controlled clinical trials. The terms “autism, autism spectrum disorders combined with transcranial magnetic stimulation, repetitive transcranial magnetic stimulation” were used as text words. Most of these studies targeted the dorsolateral prefrontal cortex (DLPFC) and used low-frequency stimulation. These studies had some limitations; however, the results of all of them showed that TMS is effective in improvement of ASD symptoms. Moreover, repetitive TMS might become useful in the rehabilitation of ASD patients. Finally, integrated approaches utilizing TMS together with other rehabilitation techniques, as well as using TMS to target the objective problems in ASD are proposed.
    Keywords: Transcranial Magnetic Stimulation, Autism Spectrum Disorder, Treatment
  • Mahnaz Pourallahvirdi, Farzad Rahmani*, Fatemeh Ranjbar, Haniyeh Ebrahimi Bakhtavar, Arezu Ettehadi Page 10
    Background
    Addiction is a social disease that has physical and psychological complications. Determination of causes of drug addiction plays an important role in the health planning.
    Objectives
    The aim of this study was to determine to the major causes of drug addiction in addicts referred to addiction centers of Tabriz city, east Azarbaijan province, Iran, in 2015.
    Patients and
    Methods
    In this cross-sectional study, 525 drug addicts who were referred to the addiction centers of Tabriz, Iran, were enrolled. The researcher-made questionnaire included open and closed questions and aimed to evaluate the causes of drug addiction. The questionnaire’s reliability and validity were evaluated and approved. Data were analyzed using descriptive statistics by SPSS software version 17.
    Results
    From a total of 525 addicts, 488 cases were male and 37 were female. Failures in life and escape from problems were the major causes of drug addiction. There was a significant difference between male and female addicted persons in most of the drug addiction causes (P
    Conclusions
    The tendency towards drug addiction has different causes. In the present study, the most common causes are failure in life and escape from problems. Given that the population of this study is limited to addiction centers, further studies should be performed on the patients referred to the hospitals or clinics..
    Keywords: Drug Addiction, Drug Addicts, Opiate Alkaloids