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Research paper thumbnail of Cognitive impairment in COVID-19 patients and its relation to laboratory data

Neuropsychiatria i Neuropsychologia

Introduction: Neuropsychological manifestations are increasingly reported in patients with COVID-... more Introduction: Neuropsychological manifestations are increasingly reported in patients with COVID-19, but the subject is poorly understood and our knowledge about cognitive impairment is limited. This study aimed to investigate neuropsychological involvement of COVID-19 and its relation to laboratory data. Material and methods: This study was conducted among patients admitted to a tertiary medical center in Iran, in the period March 2020 to March 2021. Neuropsychiatric assessments were carried out by the Addenbrooke's Cognitive Examination (ACE) test in all patients and interpreted by a specialist. It was performed using the Persian version of ACE in six domains consisting of attention, orientation, memory, language, visual perception and visuospatial skills. Laboratory data were assessed among all patients. Statistical analyses were performed using SPSS. Results: Among 114 patients with COVID-19, the mean age was 48.46 ±13.61 years, and the male/female ratio was 1.32. The mean values of some abnormal laboratory data were: erythrocyte sedimentation rate (ESR) 57.2 ±29.8, C-reactive protein (CRP) 81.7 ±59.8 and D-dimer 459.3 ±395.4. Cognitive impairment was detected in 41 patients (63%). The mean score of ACE was 80.68 ±19.29. Statistical analysis showed correlations between total result of the ACE test and laboratory findings that were not statistically significant. Conclusions: In our study, no relation was found between laboratory test results and the overall cognitive examination score but statistical analysis showed a correlation between CRP and verbal fluency, between hemoglobin level and language and visuospatial domains, and also between total level of bilirubin and memory. These relations may suggest that we should follow the neurocognitive features in COVID-19 patients earlier.

Research paper thumbnail of Alteration of anxiety and depression after awake craniotomy: a prospective study on patients with language eloquent high-grade glioma

Journal of Neurosurgical Sciences

BACKGROUND Awake Craniotomy (AC) is considered to achieve maximal safe resection of language eloq... more BACKGROUND Awake Craniotomy (AC) is considered to achieve maximal safe resection of language eloquent gliomas. Impact of AC on the psychological status of patients (mainly anxiety, and post-traumatic stress disorder: PTSD) is a potential concern. Despite the studies reporting the early postoperative patient's perception after AC, this study has been performed to quantitatively evaluate the long term influence of AC on the level of anxiety/depression after surgery. METHODS Patients who underwent AC for suspected language eloquent high-grade glioma were enrolled in this study. The anxiety, depression and PTSD of the patients were evaluated via hospital anxiety and depression scale (HADS) one week before and 1 and 6 months after the operation. PTSD symptoms were assessed according to the DSM-V checklist and confirmed by a structured clinical interview for DSM-V. RESULTS Twenty-eight patients (22 men, 6 women) with the mean age of 39.2 years were enrolled. The mean preoperative depressive and anxiety score was 4.9±5.9 and 7.7±5.8 respectively. One month after surgery they were 6±4.9 and 7.4±6.2 and at 6 months' follow-up 5.5±5.1 and 5.4±4.2 respectively. There was no statistically significant trend for alterations of the anxiety/depression levels before and after surgery. Female patients, those suspected to have glioblastoma and patients presenting with speech disturbance had remarkably higher preoperative anxiety levels. Three patients had PTSD symptoms 3 months after AC while at 6 months there was no indication of PTSD. The decremental trend of PTSD score within 6 months was statistically significant. CONCLUSIONS Judicious application of AC is not associated with an escalation of the anxiety/depression level among the patients. Even patients with high preoperative anxiety levels could be managed with AC without severe psychological deterioration.

Research paper thumbnail of The Attitude of Neurosurgeons Toward Telemedicine During COVID-19 Pandemic

Iranian Journal of Neurosurgery

Background and Aim: Telemedicine can be considered a primary modality of patient care for non-eme... more Background and Aim: Telemedicine can be considered a primary modality of patient care for non-emergent conditions in the COVID-19 era. The usage and expansion of telemedicine are important and inevitable issues. We decided to investigate the neurosurgeons’ perspective on telemedicine in the treatment and follow-up of neurosurgical patients during the COVID-19 period. Methods and Materials/Patients: This cross-sectional study was carried out in the Department of Neurosurgery, Tehran, from June 2021 to July 2021. An internet-based questionnaire was distributed among all postgraduate and assistant neurosurgeons at the Tehran University of Medical Sciences. Statistical analysis was performed using SPPS (IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp; 2016). Results: This study was performed among 74 neurosurgeons who were mainly male (89.2%). Their mean age was 33.16±5.69 years (ranging from 27 to 62 years), and telemedicine has not been used previously in 37 precip...

Research paper thumbnail of Applications of brain-computer interfaces in neurodegenerative diseases

Research paper thumbnail of Disparity of Primary and Secondary Language Outcomes in Bilingual Patients Undergoing Resection of Glioma of the Speech-Related Regions

Research paper thumbnail of Perioperative seizure in patients undergoing brain mapping under awake craniotomy for language-related eloquent region gliomas: a prospective study

Journal of Neurosurgical Sciences

Research paper thumbnail of Adopting and adapting clinical practice guidelines for timing of decompressive surgery in acute spinal cord injury from a developed world context to a developing region

Research paper thumbnail of Partially linear Bayesian modeling of longitudinal rank and time‐to‐event data using accelerated failure time model with application to brain tumor data

Research paper thumbnail of Central nervous system hydatidosis around the world: a systematic review

Journal of Neurosurgical Sciences, Feb 1, 2023

Research paper thumbnail of Pressure ulcers and acute risk factors in individuals with traumatic spinal fractures with or without spinal cord injuries: A prospective analysis of the National Spinal Column/Cord Injury Registry of Iran (NSCIR-IR) data

Chinese Journal of Traumatology

Research paper thumbnail of Aspiration and Drainage of Arachnoid Cysts

Research paper thumbnail of Application of Vagus Nerve Stimulation in Spinal Cord Injury Rehabilitation

Research paper thumbnail of Introduction on Cancer Modifiable Risk Factors and Prevention

Springer eBooks, Dec 15, 2022

Research paper thumbnail of Stem Cells and Targeted Gene Therapy in Brain and Spinal Cord Tumors

Advances in Experimental Medicine and Biology, 2023

Research paper thumbnail of Misdiagnosis of a Fulminant Case of Primary CNS Lymphoma Due to of COVID-19 Overdiagnosis

World Journal of Advance Healthcare Research, Apr 8, 2005

Research paper thumbnail of Presurgical fMRI Affecting the Extent of Resection and Outcome of the Supratentorial Gliomas; a Single-center Experience From a Developing Country

BackgroundFunctional magnetic resonance imaging (fMRI) is one of the available non-invasive imagi... more BackgroundFunctional magnetic resonance imaging (fMRI) is one of the available non-invasive imaging to map the different brain areas, which has been used during the current years. In this study, we aimed to evaluate the effect of fMRI on decision-making, the extent of resection, and the outcome of the patients with supratentorial gliomas.MethodsThis prospective study conducted from 2014 through 2017 to investigate how presurgical fMRI can help the neurosurgeon during glioma surgery. Baseline demographic and clinical data were collected, and standard fMRI protocol was used for each patient.Results Forty-one patients with supratentorial gliomas met inclusion criteria, including 29 males and 12 females ranging in age from 21 to 72. Our results showed a significant association between eloquent areas tumor and the EOR. Eight out of 41 (19.5%) experienced higher EOR than what the neurosurgeon expected after adjusting the fMRI findings with the intraoperative situation. Among these patient...

Research paper thumbnail of Primary isolated skull base eosinophilic granuloma confined to the anterior clinoid process: illustrative case

Journal of Neurosurgery: Case Lessons

BACKGROUND Solitary eosinophilic granuloma (EG) occurs anecdotally in the skull base region, and ... more BACKGROUND Solitary eosinophilic granuloma (EG) occurs anecdotally in the skull base region, and it has been described in only three previous publications. The authors report the first case of EG of the anterior clinoid process (ACP), which was confined to the ACP and presented with decreased vision. OBSERVATIONS A 38-year-old woman presented with decreased vision of the left eye of 5 months’ duration. Her visual acuity was 3/10, other neurological examinations were intact, and there were no other osseous or soft tissue lesions. The lesion was excised using a left-sided craniotomy and transdural clinoidectomy, decompressing the optic nerve both intra- and extradurally. The lesion was characteristic for EG, and no recurrence was detected after 2 years. LESSONS EG can be confined to the ACP and impair vision. Imaging studies are sensitive but not specific, and surgical decompression is both diagnostic and treatment oriented. Close observation and even adjuvant therapy may be indicated...

Research paper thumbnail of Adopting Clinical Practice Guidelines for Pharmacologic Management of Acute Spinal Cord Injury from a Developed World Context to a Developing Global Region

Archives of Iranian Medicine

Background: Proper utilization of high-quality clinical practice guidelines (CPGs) eliminates the... more Background: Proper utilization of high-quality clinical practice guidelines (CPGs) eliminates the dependence of patients’ outcomes on the ability and knowledge of "individual" health care providers and reduces unwarranted variation in care. The aim of this study was to adapt/adopt two CPGs for pharmacologic management of acute spinal cord injury (SCI) using guideline adaptation methods. Methods: This study was conducted based on the ADAPTE process. Following establishment of an organizing committee and choosing the health topics, we appraised the quality of the CPGs using the Appraisal of Clinical Guidelines for Research & Evaluation II (AGREE II). Then, the authors extracted and categorized suggestions according to Population, Intervention, Professions, Outcomes and Health care setting (PIPOH). The decision-making process was based on systemic evaluation of each suggestion, utilizing a combination of AGREE II scores, the quality of supporting evidence for or against each ...

Research paper thumbnail of Pitfalls in diagnosis of cord tethering in scoliosis: Lessons learned from a series in a single centre

Interdisciplinary Neurosurgery

Research paper thumbnail of ‘The Association of Scoliosis Properties with Spinal Cord Tethering: A Statistical Model for Prognostication’

ObjectiveTo evaluate the relationship between the structural measures of scoliosis and underlying... more ObjectiveTo evaluate the relationship between the structural measures of scoliosis and underlying spinal cord tethering (SCT) and proposing a statistical prognostication model.Study designCross-sectional.SettingAcademic healthcare centerMethods128 definite scoliosis cases that were candidates for corrective surgery were enrolled. Anterior-posterior whole column digital radiographs and whole-spine MRI (supine for all samples and adjuvant prone MRI for suspected cases with tight filum terminal) were performed. Univariate and multiple logistic regression were used for the analysis of association and interaction. Association of SCT with structural features of scoliosis –Cobb angle, convexity, and type (idiopathic and congenital)– age, and sex were assessed.ResultsNone of the study variables showed a statistical association with SCT in univariable and multiple logistic regressions. After inclusion of Cobb angle-convexity-type interaction, higher Cobb angle, idiopathic scoliosis, dextroso...

Research paper thumbnail of Cognitive impairment in COVID-19 patients and its relation to laboratory data

Neuropsychiatria i Neuropsychologia

Introduction: Neuropsychological manifestations are increasingly reported in patients with COVID-... more Introduction: Neuropsychological manifestations are increasingly reported in patients with COVID-19, but the subject is poorly understood and our knowledge about cognitive impairment is limited. This study aimed to investigate neuropsychological involvement of COVID-19 and its relation to laboratory data. Material and methods: This study was conducted among patients admitted to a tertiary medical center in Iran, in the period March 2020 to March 2021. Neuropsychiatric assessments were carried out by the Addenbrooke's Cognitive Examination (ACE) test in all patients and interpreted by a specialist. It was performed using the Persian version of ACE in six domains consisting of attention, orientation, memory, language, visual perception and visuospatial skills. Laboratory data were assessed among all patients. Statistical analyses were performed using SPSS. Results: Among 114 patients with COVID-19, the mean age was 48.46 ±13.61 years, and the male/female ratio was 1.32. The mean values of some abnormal laboratory data were: erythrocyte sedimentation rate (ESR) 57.2 ±29.8, C-reactive protein (CRP) 81.7 ±59.8 and D-dimer 459.3 ±395.4. Cognitive impairment was detected in 41 patients (63%). The mean score of ACE was 80.68 ±19.29. Statistical analysis showed correlations between total result of the ACE test and laboratory findings that were not statistically significant. Conclusions: In our study, no relation was found between laboratory test results and the overall cognitive examination score but statistical analysis showed a correlation between CRP and verbal fluency, between hemoglobin level and language and visuospatial domains, and also between total level of bilirubin and memory. These relations may suggest that we should follow the neurocognitive features in COVID-19 patients earlier.

Research paper thumbnail of Alteration of anxiety and depression after awake craniotomy: a prospective study on patients with language eloquent high-grade glioma

Journal of Neurosurgical Sciences

BACKGROUND Awake Craniotomy (AC) is considered to achieve maximal safe resection of language eloq... more BACKGROUND Awake Craniotomy (AC) is considered to achieve maximal safe resection of language eloquent gliomas. Impact of AC on the psychological status of patients (mainly anxiety, and post-traumatic stress disorder: PTSD) is a potential concern. Despite the studies reporting the early postoperative patient's perception after AC, this study has been performed to quantitatively evaluate the long term influence of AC on the level of anxiety/depression after surgery. METHODS Patients who underwent AC for suspected language eloquent high-grade glioma were enrolled in this study. The anxiety, depression and PTSD of the patients were evaluated via hospital anxiety and depression scale (HADS) one week before and 1 and 6 months after the operation. PTSD symptoms were assessed according to the DSM-V checklist and confirmed by a structured clinical interview for DSM-V. RESULTS Twenty-eight patients (22 men, 6 women) with the mean age of 39.2 years were enrolled. The mean preoperative depressive and anxiety score was 4.9±5.9 and 7.7±5.8 respectively. One month after surgery they were 6±4.9 and 7.4±6.2 and at 6 months' follow-up 5.5±5.1 and 5.4±4.2 respectively. There was no statistically significant trend for alterations of the anxiety/depression levels before and after surgery. Female patients, those suspected to have glioblastoma and patients presenting with speech disturbance had remarkably higher preoperative anxiety levels. Three patients had PTSD symptoms 3 months after AC while at 6 months there was no indication of PTSD. The decremental trend of PTSD score within 6 months was statistically significant. CONCLUSIONS Judicious application of AC is not associated with an escalation of the anxiety/depression level among the patients. Even patients with high preoperative anxiety levels could be managed with AC without severe psychological deterioration.

Research paper thumbnail of The Attitude of Neurosurgeons Toward Telemedicine During COVID-19 Pandemic

Iranian Journal of Neurosurgery

Background and Aim: Telemedicine can be considered a primary modality of patient care for non-eme... more Background and Aim: Telemedicine can be considered a primary modality of patient care for non-emergent conditions in the COVID-19 era. The usage and expansion of telemedicine are important and inevitable issues. We decided to investigate the neurosurgeons’ perspective on telemedicine in the treatment and follow-up of neurosurgical patients during the COVID-19 period. Methods and Materials/Patients: This cross-sectional study was carried out in the Department of Neurosurgery, Tehran, from June 2021 to July 2021. An internet-based questionnaire was distributed among all postgraduate and assistant neurosurgeons at the Tehran University of Medical Sciences. Statistical analysis was performed using SPPS (IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp; 2016). Results: This study was performed among 74 neurosurgeons who were mainly male (89.2%). Their mean age was 33.16±5.69 years (ranging from 27 to 62 years), and telemedicine has not been used previously in 37 precip...

Research paper thumbnail of Applications of brain-computer interfaces in neurodegenerative diseases

Research paper thumbnail of Disparity of Primary and Secondary Language Outcomes in Bilingual Patients Undergoing Resection of Glioma of the Speech-Related Regions

Research paper thumbnail of Perioperative seizure in patients undergoing brain mapping under awake craniotomy for language-related eloquent region gliomas: a prospective study

Journal of Neurosurgical Sciences

Research paper thumbnail of Adopting and adapting clinical practice guidelines for timing of decompressive surgery in acute spinal cord injury from a developed world context to a developing region

Research paper thumbnail of Partially linear Bayesian modeling of longitudinal rank and time‐to‐event data using accelerated failure time model with application to brain tumor data

Research paper thumbnail of Central nervous system hydatidosis around the world: a systematic review

Journal of Neurosurgical Sciences, Feb 1, 2023

Research paper thumbnail of Pressure ulcers and acute risk factors in individuals with traumatic spinal fractures with or without spinal cord injuries: A prospective analysis of the National Spinal Column/Cord Injury Registry of Iran (NSCIR-IR) data

Chinese Journal of Traumatology

Research paper thumbnail of Aspiration and Drainage of Arachnoid Cysts

Research paper thumbnail of Application of Vagus Nerve Stimulation in Spinal Cord Injury Rehabilitation

Research paper thumbnail of Introduction on Cancer Modifiable Risk Factors and Prevention

Springer eBooks, Dec 15, 2022

Research paper thumbnail of Stem Cells and Targeted Gene Therapy in Brain and Spinal Cord Tumors

Advances in Experimental Medicine and Biology, 2023

Research paper thumbnail of Misdiagnosis of a Fulminant Case of Primary CNS Lymphoma Due to of COVID-19 Overdiagnosis

World Journal of Advance Healthcare Research, Apr 8, 2005

Research paper thumbnail of Presurgical fMRI Affecting the Extent of Resection and Outcome of the Supratentorial Gliomas; a Single-center Experience From a Developing Country

BackgroundFunctional magnetic resonance imaging (fMRI) is one of the available non-invasive imagi... more BackgroundFunctional magnetic resonance imaging (fMRI) is one of the available non-invasive imaging to map the different brain areas, which has been used during the current years. In this study, we aimed to evaluate the effect of fMRI on decision-making, the extent of resection, and the outcome of the patients with supratentorial gliomas.MethodsThis prospective study conducted from 2014 through 2017 to investigate how presurgical fMRI can help the neurosurgeon during glioma surgery. Baseline demographic and clinical data were collected, and standard fMRI protocol was used for each patient.Results Forty-one patients with supratentorial gliomas met inclusion criteria, including 29 males and 12 females ranging in age from 21 to 72. Our results showed a significant association between eloquent areas tumor and the EOR. Eight out of 41 (19.5%) experienced higher EOR than what the neurosurgeon expected after adjusting the fMRI findings with the intraoperative situation. Among these patient...

Research paper thumbnail of Primary isolated skull base eosinophilic granuloma confined to the anterior clinoid process: illustrative case

Journal of Neurosurgery: Case Lessons

BACKGROUND Solitary eosinophilic granuloma (EG) occurs anecdotally in the skull base region, and ... more BACKGROUND Solitary eosinophilic granuloma (EG) occurs anecdotally in the skull base region, and it has been described in only three previous publications. The authors report the first case of EG of the anterior clinoid process (ACP), which was confined to the ACP and presented with decreased vision. OBSERVATIONS A 38-year-old woman presented with decreased vision of the left eye of 5 months’ duration. Her visual acuity was 3/10, other neurological examinations were intact, and there were no other osseous or soft tissue lesions. The lesion was excised using a left-sided craniotomy and transdural clinoidectomy, decompressing the optic nerve both intra- and extradurally. The lesion was characteristic for EG, and no recurrence was detected after 2 years. LESSONS EG can be confined to the ACP and impair vision. Imaging studies are sensitive but not specific, and surgical decompression is both diagnostic and treatment oriented. Close observation and even adjuvant therapy may be indicated...

Research paper thumbnail of Adopting Clinical Practice Guidelines for Pharmacologic Management of Acute Spinal Cord Injury from a Developed World Context to a Developing Global Region

Archives of Iranian Medicine

Background: Proper utilization of high-quality clinical practice guidelines (CPGs) eliminates the... more Background: Proper utilization of high-quality clinical practice guidelines (CPGs) eliminates the dependence of patients’ outcomes on the ability and knowledge of "individual" health care providers and reduces unwarranted variation in care. The aim of this study was to adapt/adopt two CPGs for pharmacologic management of acute spinal cord injury (SCI) using guideline adaptation methods. Methods: This study was conducted based on the ADAPTE process. Following establishment of an organizing committee and choosing the health topics, we appraised the quality of the CPGs using the Appraisal of Clinical Guidelines for Research & Evaluation II (AGREE II). Then, the authors extracted and categorized suggestions according to Population, Intervention, Professions, Outcomes and Health care setting (PIPOH). The decision-making process was based on systemic evaluation of each suggestion, utilizing a combination of AGREE II scores, the quality of supporting evidence for or against each ...

Research paper thumbnail of Pitfalls in diagnosis of cord tethering in scoliosis: Lessons learned from a series in a single centre

Interdisciplinary Neurosurgery

Research paper thumbnail of ‘The Association of Scoliosis Properties with Spinal Cord Tethering: A Statistical Model for Prognostication’

ObjectiveTo evaluate the relationship between the structural measures of scoliosis and underlying... more ObjectiveTo evaluate the relationship between the structural measures of scoliosis and underlying spinal cord tethering (SCT) and proposing a statistical prognostication model.Study designCross-sectional.SettingAcademic healthcare centerMethods128 definite scoliosis cases that were candidates for corrective surgery were enrolled. Anterior-posterior whole column digital radiographs and whole-spine MRI (supine for all samples and adjuvant prone MRI for suspected cases with tight filum terminal) were performed. Univariate and multiple logistic regression were used for the analysis of association and interaction. Association of SCT with structural features of scoliosis –Cobb angle, convexity, and type (idiopathic and congenital)– age, and sex were assessed.ResultsNone of the study variables showed a statistical association with SCT in univariable and multiple logistic regressions. After inclusion of Cobb angle-convexity-type interaction, higher Cobb angle, idiopathic scoliosis, dextroso...