Hafiza Aziz - Academia.edu (original) (raw)

Papers by Hafiza Aziz

Research paper thumbnail of Platelet-Rich Plasma-A Safe and Cost-effective Dural Sealant in Spinal Surgeries-A Systematic Review

Research Square (Research Square), May 30, 2024

Research paper thumbnail of Intraoperative mapping and preservation of executive functions in awake craniotomy: a systematic review

Neurological sciences, Mar 23, 2024

Research paper thumbnail of Does gender disparity exist in neurosurgery training? Evidence from a nationwide survey from Pakistan

Medical education online, Jan 30, 2024

Research paper thumbnail of Photodynamic Therapy In Adult Intra-Axial Brain Tumours

Journal of the Pakistan Medical Association, Jan 20, 2024

Research paper thumbnail of Prognostic Value of BRAF Mutation in Glioblastoma

Research paper thumbnail of Spinal Schwannomas; Classification, Management And Outcomes

Journal of Pakistan Medical Association, Sep 12, 2023

Research paper thumbnail of Raman Spectroscopy: Can it change the future of Brain Tumour Surgery?

Journal of the Pakistan Medical Association

Raman Spectroscopy (RS) is one of several techniques being used to identify tumour tissue during ... more Raman Spectroscopy (RS) is one of several techniques being used to identify tumour tissue during brain surgery. It is emerging as a novel investigative and diagnostic tool. The application of RS in cancer treatment has displayed promising results. This review centers around its clinical implication in brain tumours. Keywords: Raman spectroscopy, brain tumour, neurosurgery

Research paper thumbnail of Radiological Parameters to Predict Hemorrhagic Progression of Traumatic Contusional Brain Injury

Journal of Neurosciences in Rural Practice, Apr 1, 2019

Research paper thumbnail of Outcome of cranial firearm injuries in civilian population based on a novel classification system

Surgical Neurology International, Jun 27, 2020

Research paper thumbnail of Intraoperative use of ultra-low-field, portable magnetic resonance imaging – first report

Surgical Neurology International

Background: Intraoperative use of portable magnetic resonance imaging (pMRI) has become a valuabl... more Background: Intraoperative use of portable magnetic resonance imaging (pMRI) has become a valuable tool in a surgeon’s arsenal since its inception. It allows intraoperative localization of tumor extent and identification of residual disease, hence maximizing tumor resection. Its utility has been widespread in high-income countries for the past 20 years, but in lower-middle-income countries (LMIC), it is still not widely available due to several reasons, including cost constraints. The use of intraoperative pMRI may be a cost-effective and efficient substitute for conventional MRI machines. The authors present a case where a pMRI device was used intraoperatively in an LMIC setting. Case Description: The authors performed a microscopic transsphenoidal resection of a sellar lesion with intraoperative imaging using the pMRI system on a 45-year-old man with a nonfunctioning pituitary macroadenoma. Without the need for an MRI suite or other MRI-compatible equipment, the scan was conducted...

Research paper thumbnail of Gunshot acquired spinal cord injury in civilians

Turkish Neurosurgery, 2018

Research paper thumbnail of The diagnostic accuracy of straight leg raise test in patients more than 60 years of age suffering lumbar disk herniation with low back pain and sciatica

Journal of Neurosciences in Rural Practice

Objective: To determine the diagnostic accuracy of the SLR test in elderly patients suffering fro... more Objective: To determine the diagnostic accuracy of the SLR test in elderly patients suffering from lumbar disk herniation with sciatica and low back pain, using magnetic resonance imaging (MRI) as the gold standard. Materials and Methods: A cross-sectional study was conducted at Jinnah Postgraduate Medical Center and a total of 120 patients, above 60 years of age, with symptomatic lumbar disk herniation were enrolled. SLR test was performed and the results recorded. MRI of the lumbar spine was undertaken for confirmation of disk herniation. Results: The sensitivity of the SLR test in patients 60 years and older is 33.3%. A decrease in the diagnostic accuracy of the SLR test with an increment in age was also noted. Conclusion: It was found that with an increment in age, there is a steady decline in the diagnostic accuracy of SLR Test.

Research paper thumbnail of Intramedullary Subependymoma of Lower Thoracic Cord

Journal of the Pakistan Medical Association

Spinal subependymoma (SSE) is a rare intramedullary, benign tumour. Surgical excision is the pref... more Spinal subependymoma (SSE) is a rare intramedullary, benign tumour. Surgical excision is the preferred approach. However, the interwoven pattern of neural tissue within the tumour dictates the extent of resection. Where gross total resection is linked with possible neurological deficits, subtotal resection or close observation may support better functional outcomes. The evidence for the management of SSE is based mostly on case reports. Herein, we review the existing literature regarding treatment options and clinical outcomes of spinal subependymoma.

Research paper thumbnail of Utilization of an ultra-low-field, portable magnetic resonance imaging for brain tumor assessment in lower middle-income countries

Surgical Neurology International

Background: Access to neuroimaging is limited in low-middle-income countries (LMICs) due to finan... more Background: Access to neuroimaging is limited in low-middle-income countries (LMICs) due to financial and resource constraints. A new, ultra-low-field, low-cost, and portable magnetic resonance imaging (pMRI) device could potentially increase access to imaging in LMICs. Case Description: We have presented the first brain tumor case scanned using an Ultra-low-field pMRI at Aga Khan University Hospital in Karachi, Pakistan. Conclusion: The imaging results suggest that the pMRI device can aid in neuroradiological diagnosis in resource-constrained settings. Further, research is needed to assess its compatibility for imaging other neurological disorders and compare its results with conventional MRI results.

Research paper thumbnail of Unusual presentation in syndrome of trephined – A unique case observation

Surgical Neurology International

Background: Syndrome of trephined (SoT) is a well-recognized complication of decompressive cranie... more Background: Syndrome of trephined (SoT) is a well-recognized complication of decompressive craniectomy (DC). The understanding of SoT has improved more recently with the increasing utilization of DC for severely raised intracranial pressure. It usually presents after a period of weeks or months with a cluster of adverse neurological symptoms, most commonly with worsening of motor strength. Case Description: An elderly gentleman with traumatic brain injury underwent DC. He later developed a sinking flap and unexplained agitation which responded to cranioplasty by returning to a state of calm. His cognitive function further improved over a period of 6 months. This is an unusual observation reported in this case. Conclusion: Timely recognition of the cognitive complications of craniectomy that may respond to early cranioplasty promises to decrease the length of hospital stay and enhance rehabilitation in such patients.

Research paper thumbnail of 308 Comparison of Demographics and Outcomes Between Surgical and Conservative Management in Patients Undergoing Treatment for Posterior Cranial Fossa Hemorrhages—Experience from a Low-Resource Country

Neurosurgery

INTRODUCTION: Posterior Cranial Fossa Hemorrhages (PCFH) often require surgical intervention. How... more INTRODUCTION: Posterior Cranial Fossa Hemorrhages (PCFH) often require surgical intervention. However, comparison between outcomes in surgical vs conservative management has ben rarely sought in the literature. METHODS: Retrospective review of patient data was conducted under IRB approval. All patients managed for PCFH at Aga Khan University, Karachi, Pakistan, from January 2009 to December 2020 were included. SPSS (IBM) was utilized to analyze data. RESULTS: Surgery vs Conservative: Out of 79 patients, 30.7% vs 69.6% patients underwent each, respectively. Mean age 51 +/- 16.4 vs 56+/-10.7. Males (62.5% vs 70.9%), and females (37.5% v 29.1%). Median GCS at presentation was 9 vs 13. Surgery was indicated at initial presentation (54.2%) or if clinical deterioration was observed (29.2%). Radiographically, significant differences were noted in the mean Intracranial Hemorrhage Score (ICH) (3 vs 2; p = 0.036), maximum hematoma diameter (3.37 vs 2.31 cm; p < 0.001), brainstem involvemen...

Research paper thumbnail of An Epidemiological Study: Assessment of Symptomatic Osteoarthritis and its Management in General Population of Karachi with Joint Pain

INTERNATIONAL JOURNAL OF ENDORSING HEALTH SCIENCE RESEARCH (IJEHSR), 2016

Research paper thumbnail of Value of achieving a watertight dural closure, and the use of dural sealants after supratentorial cranial surgery

JPMA. The Journal of the Pakistan Medical Association, 2020

Dural closure at the end of cranial surgery is considered an extremely important step to maintain... more Dural closure at the end of cranial surgery is considered an extremely important step to maintain anatomical continuity, separate the intradural space with the extradural one, and to prevent possible complications related to cerebrospinal fluid leak. Wherein its usefulness in posterior fossa craniotomy is established, many surgeons do not perform it routinely in supratentorial craniotomies, citing unnecessary delay and lack of evidence supporting it. Herein, we have reviewed the data to find evidence in support of watertight suture based dural closures compared to other dural closure techniques, in supratentorial craniotomies.

Research paper thumbnail of Radiological Parameters to Predict Hemorrhagic Progression of Traumatic Contusional Brain Injury

Journal of Neurosciences in Rural Practice, 2019

Introduction: Traumatic intracerebral contusion is a frequent factor culminating in death and dis... more Introduction: Traumatic intracerebral contusion is a frequent factor culminating in death and disability, and its progression relates to unfavorable outcome. We evaluated the radiological factors associated with hemorrhagic progression of contusions (HPC). Materials and Methods: Two hundred and forty-six patients were enrolled in this prospective cohort over a period of 1 year. Contusion volume was quantified using the “ABC/2” technique, whereas progression was considered as >30% increase in the initial volume. Univariate and multivariate statistics were used to examine the correlation between the risk factors of interest and HPC. Results: HPC was seen in 110 (44.7%) patients. Binary logistic regression showed in the final adjusted model that multiplicity (relative risk [RR]: 2.24, 95% confidence limit [CL]: 1.00–5.48), bilateral lesions (RR: 2.99, 95% CL: 1.08–8.25), initial volume of contusion (RR: 4.96, 95% CL: 1.87–13.13), frontal location (RR: 1.42, 95% CL: 1.08–3.56), and p...

Research paper thumbnail of Glioblastoma imitating a cavernoma radiologically: A unique image report

Surgical Neurology International

Background: Glioblastoma is the most common primary malignant brain tumor with characteristic rad... more Background: Glioblastoma is the most common primary malignant brain tumor with characteristic radiological features in most cases. Case Description: We highlight an unusual case of a 54-year-old woman, neurologically intact, with a diagnostically challenging lesion. The patient’s magnetic resonance imaging revealed a left frontal lesion with surrounding edema and a hemosiderin ring, misleading it to be a cavernoma. Intraoperatively, the lesion was found to be a solid tumor with hematoma and was confirmed to be glioblastoma on histopathology. Conclusion: The dilemma associated with our patient’s radiological findings and longstanding history of epilepsy is rare and a diagnostic challenge.

Research paper thumbnail of Platelet-Rich Plasma-A Safe and Cost-effective Dural Sealant in Spinal Surgeries-A Systematic Review

Research Square (Research Square), May 30, 2024

Research paper thumbnail of Intraoperative mapping and preservation of executive functions in awake craniotomy: a systematic review

Neurological sciences, Mar 23, 2024

Research paper thumbnail of Does gender disparity exist in neurosurgery training? Evidence from a nationwide survey from Pakistan

Medical education online, Jan 30, 2024

Research paper thumbnail of Photodynamic Therapy In Adult Intra-Axial Brain Tumours

Journal of the Pakistan Medical Association, Jan 20, 2024

Research paper thumbnail of Prognostic Value of BRAF Mutation in Glioblastoma

Research paper thumbnail of Spinal Schwannomas; Classification, Management And Outcomes

Journal of Pakistan Medical Association, Sep 12, 2023

Research paper thumbnail of Raman Spectroscopy: Can it change the future of Brain Tumour Surgery?

Journal of the Pakistan Medical Association

Raman Spectroscopy (RS) is one of several techniques being used to identify tumour tissue during ... more Raman Spectroscopy (RS) is one of several techniques being used to identify tumour tissue during brain surgery. It is emerging as a novel investigative and diagnostic tool. The application of RS in cancer treatment has displayed promising results. This review centers around its clinical implication in brain tumours. Keywords: Raman spectroscopy, brain tumour, neurosurgery

Research paper thumbnail of Radiological Parameters to Predict Hemorrhagic Progression of Traumatic Contusional Brain Injury

Journal of Neurosciences in Rural Practice, Apr 1, 2019

Research paper thumbnail of Outcome of cranial firearm injuries in civilian population based on a novel classification system

Surgical Neurology International, Jun 27, 2020

Research paper thumbnail of Intraoperative use of ultra-low-field, portable magnetic resonance imaging – first report

Surgical Neurology International

Background: Intraoperative use of portable magnetic resonance imaging (pMRI) has become a valuabl... more Background: Intraoperative use of portable magnetic resonance imaging (pMRI) has become a valuable tool in a surgeon’s arsenal since its inception. It allows intraoperative localization of tumor extent and identification of residual disease, hence maximizing tumor resection. Its utility has been widespread in high-income countries for the past 20 years, but in lower-middle-income countries (LMIC), it is still not widely available due to several reasons, including cost constraints. The use of intraoperative pMRI may be a cost-effective and efficient substitute for conventional MRI machines. The authors present a case where a pMRI device was used intraoperatively in an LMIC setting. Case Description: The authors performed a microscopic transsphenoidal resection of a sellar lesion with intraoperative imaging using the pMRI system on a 45-year-old man with a nonfunctioning pituitary macroadenoma. Without the need for an MRI suite or other MRI-compatible equipment, the scan was conducted...

Research paper thumbnail of Gunshot acquired spinal cord injury in civilians

Turkish Neurosurgery, 2018

Research paper thumbnail of The diagnostic accuracy of straight leg raise test in patients more than 60 years of age suffering lumbar disk herniation with low back pain and sciatica

Journal of Neurosciences in Rural Practice

Objective: To determine the diagnostic accuracy of the SLR test in elderly patients suffering fro... more Objective: To determine the diagnostic accuracy of the SLR test in elderly patients suffering from lumbar disk herniation with sciatica and low back pain, using magnetic resonance imaging (MRI) as the gold standard. Materials and Methods: A cross-sectional study was conducted at Jinnah Postgraduate Medical Center and a total of 120 patients, above 60 years of age, with symptomatic lumbar disk herniation were enrolled. SLR test was performed and the results recorded. MRI of the lumbar spine was undertaken for confirmation of disk herniation. Results: The sensitivity of the SLR test in patients 60 years and older is 33.3%. A decrease in the diagnostic accuracy of the SLR test with an increment in age was also noted. Conclusion: It was found that with an increment in age, there is a steady decline in the diagnostic accuracy of SLR Test.

Research paper thumbnail of Intramedullary Subependymoma of Lower Thoracic Cord

Journal of the Pakistan Medical Association

Spinal subependymoma (SSE) is a rare intramedullary, benign tumour. Surgical excision is the pref... more Spinal subependymoma (SSE) is a rare intramedullary, benign tumour. Surgical excision is the preferred approach. However, the interwoven pattern of neural tissue within the tumour dictates the extent of resection. Where gross total resection is linked with possible neurological deficits, subtotal resection or close observation may support better functional outcomes. The evidence for the management of SSE is based mostly on case reports. Herein, we review the existing literature regarding treatment options and clinical outcomes of spinal subependymoma.

Research paper thumbnail of Utilization of an ultra-low-field, portable magnetic resonance imaging for brain tumor assessment in lower middle-income countries

Surgical Neurology International

Background: Access to neuroimaging is limited in low-middle-income countries (LMICs) due to finan... more Background: Access to neuroimaging is limited in low-middle-income countries (LMICs) due to financial and resource constraints. A new, ultra-low-field, low-cost, and portable magnetic resonance imaging (pMRI) device could potentially increase access to imaging in LMICs. Case Description: We have presented the first brain tumor case scanned using an Ultra-low-field pMRI at Aga Khan University Hospital in Karachi, Pakistan. Conclusion: The imaging results suggest that the pMRI device can aid in neuroradiological diagnosis in resource-constrained settings. Further, research is needed to assess its compatibility for imaging other neurological disorders and compare its results with conventional MRI results.

Research paper thumbnail of Unusual presentation in syndrome of trephined – A unique case observation

Surgical Neurology International

Background: Syndrome of trephined (SoT) is a well-recognized complication of decompressive cranie... more Background: Syndrome of trephined (SoT) is a well-recognized complication of decompressive craniectomy (DC). The understanding of SoT has improved more recently with the increasing utilization of DC for severely raised intracranial pressure. It usually presents after a period of weeks or months with a cluster of adverse neurological symptoms, most commonly with worsening of motor strength. Case Description: An elderly gentleman with traumatic brain injury underwent DC. He later developed a sinking flap and unexplained agitation which responded to cranioplasty by returning to a state of calm. His cognitive function further improved over a period of 6 months. This is an unusual observation reported in this case. Conclusion: Timely recognition of the cognitive complications of craniectomy that may respond to early cranioplasty promises to decrease the length of hospital stay and enhance rehabilitation in such patients.

Research paper thumbnail of 308 Comparison of Demographics and Outcomes Between Surgical and Conservative Management in Patients Undergoing Treatment for Posterior Cranial Fossa Hemorrhages—Experience from a Low-Resource Country

Neurosurgery

INTRODUCTION: Posterior Cranial Fossa Hemorrhages (PCFH) often require surgical intervention. How... more INTRODUCTION: Posterior Cranial Fossa Hemorrhages (PCFH) often require surgical intervention. However, comparison between outcomes in surgical vs conservative management has ben rarely sought in the literature. METHODS: Retrospective review of patient data was conducted under IRB approval. All patients managed for PCFH at Aga Khan University, Karachi, Pakistan, from January 2009 to December 2020 were included. SPSS (IBM) was utilized to analyze data. RESULTS: Surgery vs Conservative: Out of 79 patients, 30.7% vs 69.6% patients underwent each, respectively. Mean age 51 +/- 16.4 vs 56+/-10.7. Males (62.5% vs 70.9%), and females (37.5% v 29.1%). Median GCS at presentation was 9 vs 13. Surgery was indicated at initial presentation (54.2%) or if clinical deterioration was observed (29.2%). Radiographically, significant differences were noted in the mean Intracranial Hemorrhage Score (ICH) (3 vs 2; p = 0.036), maximum hematoma diameter (3.37 vs 2.31 cm; p < 0.001), brainstem involvemen...

Research paper thumbnail of An Epidemiological Study: Assessment of Symptomatic Osteoarthritis and its Management in General Population of Karachi with Joint Pain

INTERNATIONAL JOURNAL OF ENDORSING HEALTH SCIENCE RESEARCH (IJEHSR), 2016

Research paper thumbnail of Value of achieving a watertight dural closure, and the use of dural sealants after supratentorial cranial surgery

JPMA. The Journal of the Pakistan Medical Association, 2020

Dural closure at the end of cranial surgery is considered an extremely important step to maintain... more Dural closure at the end of cranial surgery is considered an extremely important step to maintain anatomical continuity, separate the intradural space with the extradural one, and to prevent possible complications related to cerebrospinal fluid leak. Wherein its usefulness in posterior fossa craniotomy is established, many surgeons do not perform it routinely in supratentorial craniotomies, citing unnecessary delay and lack of evidence supporting it. Herein, we have reviewed the data to find evidence in support of watertight suture based dural closures compared to other dural closure techniques, in supratentorial craniotomies.

Research paper thumbnail of Radiological Parameters to Predict Hemorrhagic Progression of Traumatic Contusional Brain Injury

Journal of Neurosciences in Rural Practice, 2019

Introduction: Traumatic intracerebral contusion is a frequent factor culminating in death and dis... more Introduction: Traumatic intracerebral contusion is a frequent factor culminating in death and disability, and its progression relates to unfavorable outcome. We evaluated the radiological factors associated with hemorrhagic progression of contusions (HPC). Materials and Methods: Two hundred and forty-six patients were enrolled in this prospective cohort over a period of 1 year. Contusion volume was quantified using the “ABC/2” technique, whereas progression was considered as >30% increase in the initial volume. Univariate and multivariate statistics were used to examine the correlation between the risk factors of interest and HPC. Results: HPC was seen in 110 (44.7%) patients. Binary logistic regression showed in the final adjusted model that multiplicity (relative risk [RR]: 2.24, 95% confidence limit [CL]: 1.00–5.48), bilateral lesions (RR: 2.99, 95% CL: 1.08–8.25), initial volume of contusion (RR: 4.96, 95% CL: 1.87–13.13), frontal location (RR: 1.42, 95% CL: 1.08–3.56), and p...

Research paper thumbnail of Glioblastoma imitating a cavernoma radiologically: A unique image report

Surgical Neurology International

Background: Glioblastoma is the most common primary malignant brain tumor with characteristic rad... more Background: Glioblastoma is the most common primary malignant brain tumor with characteristic radiological features in most cases. Case Description: We highlight an unusual case of a 54-year-old woman, neurologically intact, with a diagnostically challenging lesion. The patient’s magnetic resonance imaging revealed a left frontal lesion with surrounding edema and a hemosiderin ring, misleading it to be a cavernoma. Intraoperatively, the lesion was found to be a solid tumor with hematoma and was confirmed to be glioblastoma on histopathology. Conclusion: The dilemma associated with our patient’s radiological findings and longstanding history of epilepsy is rare and a diagnostic challenge.