Current Journal of Neurology
Year:2005 | Volume:3 | Issue:9|Papers Count:11

Introduction: Leukoaraiosis (LA) or white matter thinning and rarefaction is common in the patients with stroke.Materials-and Methods: This prospective clinical study was conducted on 100 consecutive patients in Mackenzie hospital, Canada and 100 consecutive stroke patients in Valie Asr hospital, Iran during 2004. Diagnosis of ischemic stroke and LA was performed by stroke neurologists using CT scan. The effects of race, gender, age groups, hypertension, diabetes, hypercholesterolemia and smoking on the frequency rate of LA were evaluated. Chi-Square, Fisher and Regression tests served for statistical analysis and p<0.05 was declared as significant.Results: In the whole studied patients, 12males and 30 females had LA which was significantly more frequent in females (p=0.002). The frequency rate of LA was the same in the North American and Persian stroke patients (p=0.99). Stroke patients aged ³65 years were significantly more preponderant for LA than patients <65 years (p=0.049). LA was significantly more frequent in the hypertensive patients (p=0.04). The effects of diabetes, hypercholesterolemia and smoking on the frequency rate of LA were not significant.Discussion: Age, female gender and hypertension are the risk factors of LA. There is no difference in the frequency rate of LA between the North American and Persian stroke patients.

Background: Hemorrhagic Brain Infarction (HBI) is an important finding which has been reported mainly in cardioembolic strokes. Although clinical status of the patients is not often deteriorated, however decision making for anticoagulation's difficult in HBI patients.Materials and Methods: This descriptive-cross sectional study, was carried out in 100 consecutive patients with HBI admitted in Valie Asr Hospital, Khorasan during 2003-2004. HBI was diagnosed by CT scan within 24-48 hours of stroke onset and the arterial territory of the infarct was confirmed by topographic maps of brain in CT. Clinical status of the patients was evaluated each 12 hours during hospitalization, period. Etiologic work up of our stroke patients included routine blood chemistry and hematologic tests, ECG, transthoracic echocardiography and carotid duplex and transcranial Doppler sonography.Results: 54 females and 46 males with mean age 62.3 had HBI. 88% of the HBI occurred within MCA territory. The lenticulostriate artery was involved alone in 46% and with other MCA branches in 23% of cases. In patients with HBI, clinical status was deteriorated in 16%, recovered in 38% and stabilized in 46%, during hospitalization period respectively.The cardio embolism consisted 40% of etiologies in our HBI patients.Conclusion: Cardioembolism was not the main etiology in our patients with HBI. This finding reduces generality of the Fisher-Adams hypothesis. HBI infrequently leads to clinical deterioration of the patients.

Background: The dorsal raphe nucleus (DRN) is one of the main serotonergic nuclei in the mammalian nervous system which is involved in many functions. The DRN mainly consists of the largest number of serotonergic neurons intermingled with catecholamine containing neurons. In order to define the morphology and location of tyrosine hydroxylase immunoreactive (TH-ir) cells in different areasof DRN we performed TH immunohistochemistry for the adult rat DRN.Material & Methods: Adult Sprague-Dawley male rats (250-300gr) were used in this study. Following transcardially perfusion-fixation with aldehyde solutions, the brain stems were removed. By using vibrotome, 40mM thick coronal sections were cut and then processed for TH immunohistochemistry. Sections were mounted and cover slipped and studied by light microscopy.Results: TH positive neurons were observed mainly in the rostral up to the end of the central part of DRN. Four types of TH-ir neurons with different distribution were observed in the nucleus. Among the total counted cells, the ovoid and polygonal neurons respectively showed the highest and lowest density in DRN.Discussion: The TH positive neurons in DRN that could be dopaminergic in nature may participate in their major projections to the different areas received putative dopaminergic inputs from DRN, i.e. the striatum, hippocampus and the basal forebrain. None of the serotonergic projections from DRN influence the functions of these areas.

Background: Epilepsy's a chronic cerebral disease with various etiologies and clinical features, it is a common neurological disease, usually without any underling factors in its primary type, Resent studies suggest that in sddition to know ethologies of the disease, there may be some other factors, one of which could be the changes in serum iron level. This study was conducted to evaluate the association of serum iron level, serum ferritine & TIBC with primary tonic-clonic selzures.Materials and method: BD cases with crimary tonic-clonic seizures sxperienced for the first time with no underlying factors were matched to BD coritorlse on age, sex, economical status, and TIBC were evaluated in lout groups and the results were analysed by paired T-test.Results: 38 men and 22 women were studied in each of the two groups, the average level of serum iron and TIBC in all men and women of the case group was significantly higher than those in the control group, there was no slgnifiosnt difference between the two groups on the level of serum ferritin.Conclusion: Iron deficiency may be considered as a protective factor against primary tonic-clonic seizures, while it is not accompanied with TIBC level increase.

Introduction: Back pain is known as an important cause of debilitation of the working adult population in all countries, especially industrialized ones. Cigarette smoking and strenuous physical activity are recognized as the factors involved in the etiology of the back pain syndrome. Identification of risk factors of back pain can assist the physicians in taking preventive measures and rehabilitating patients. This 7-year study deals with some of the risk factors of the back pain. Materials & Methods: This is a seven-year study of 450 patients with back pain who ultimately underwent surgical treatment. Demographical factors such as age, gender, occupation and type of physical activity (including jobs which require strenuous activity, clerical jobs and those which involve long standing hours) were classified and studied. The established diagnoses of patients which had been confirmed by surgical and pathological findings were extracted from their medical records. Data were analyzed using SPSS software.Results: 450 patients were studied. 58.2% of patients were men and 41.8% were women (1.3:1). 40% of the patients were aged between 21 and 40 and 36% were between 41 and 60 years. Only 24% of the patients were over 60 and below 20 years of age. 29.4% of patients were laborers or porters, 8.2% had jobs with long working hours and 25.5% had clerical jobs. In this study the cause of patient referral was intervertebral disc hernia in 53.3%, spinal stenos is in 12.6%, trauma in 11.1% of cases and spinal column in 10% of cases. 76% of patients in this study were aged between 20 and 60 years, most of whom were men, at the height of their physical activity.Discussion: Given the similarity of findings of this study and those of other studies, it is recommended that the risk of back pain be more precisely identified and that suitable jobs be chosen for different individuals accordingly, in an effort to reduce the incidence of the debilitating complications of back pain.

73 patients with lumbar radicular pain syndrome were treated in a prospective, randomized donble blind fashion with either 7 mm of Methylprednisolone acetate and procaine or 7mm of physiological saline solution and procaine.All patients had radiological confirmation of lumbar nerve root compration consistent with the clinical diagnosis of either an acute herniated nucleolus pulpous or canal stenosis.No statistically significant difference was observed between the control and experimental patients with either the patients with acute hernia ion and canal stenosis. Long-term follow-up failed to demonstrate the efficacy of a second injection of epidural steroids and also there was not any different between the two drugs that have been injected. Therefore it shown that injection of drugs in the epidural space cannot improve the chance of well being.

Among all the neurologic diseases of adult life the cerebrovascular disease clearly rank first in frequency and importance. Several factors are to known to increase the liability to stroke.Chronic infection may increase the risk for ischemic stroke. There is increasing evidence from both clinical and experimental observation that inflammation plays an important role in the development of atherosclerotic lesions in patients with ischemic stroke. Available data suggest that the prevalence of H.pylori infection may be increased in patients with stroke. We performed a case-series study in 106 patients with acute ischemic stroke. All patients who admitted at the department of neurology of Sina hospital. Serum level of H.pylori antibody was assessed by elisa and titer of antibody> 1.1 are considered positive. anti helicobacter pylori antibody were found in 78 (73.58%) and the mean age of these patients 64.75 years (Sd 8.41) and 44 (45.42%) were male. previous Gi symptoms and history of stroke or transient ischemic attack in patient with positive antibody titer were 46.15% and 32.05%respectively.abnormal Doppler were 50.7% (server stenos is more than 70% was 13.43%) in seropositive patients and 14.28% (server stenos is more than 70% was 3.5%) in seronegative patient. it seems, the correlation between H.pylori antibody and carotid stenos is significant (p<1.01). at present, the evidence linking H.pylori to stroke is still contradictory. however, there is still need for larger and particularly for prospective studies investigating the contribution of H.pylori infection to stroke risk. infection with H.pylori is a well-treatable conduction and its identification as a risk factor for stroke would have an important impact on stroke prevention and its eradication may reduce the risk of subsequent strokes.

Today the neurodegenerative disease interestingness only for neuropathology's and neurologists but also for neuroanatomists. Since the neurode generative diseases, specially in early stages, have not any special par-aclinical tests, diagnosis is mainly clinical. For explaining the symptoms and signs and localizing the lesion, we must have adequate information about neuroanatomical connections among different parts of CNS. Diagnosis of neurodegenerative diseases, specially in early stages, is also difficult during an autopsy. It needs adequate information about Norma macroscopic and microscopic morphology of different parts of CNS.It is believed that we couldn't find any symptom and sign of a nucleus dysfunction until a definite percentage of its neurons and degenerated. So many of autopsies have no report from symptoms and signs of a neurodegenerative disease if his/her Knowledge bout normal macroscopic and microscopic structure of different brain nuclei is not adequate. On the other hand, neruoanatomists con find the neurodegenerative disease very interesting because the diseases can help them to find undiscovered neural pathways in human brain. All of experiment always for tracing the neural pathways cannot be used on human brain ethically. So neurodegenerative disease provides a golden opportunity for tracing the degenerated nerve fibers in human brain.Therefore we can conclude that neuroanatomical knowledge is very important in neuropathological diagnosis of neurodegenerative disease specially in early stages. So the neuroanatomical diagnostic courses are necessary for residents of neurology and pathology. On the other hand, it is very important for neuroanatomists which develop their morphometrical researches on different regions of human brain, both macroscopically and microscopically, in order to minimize the controversy about morphometrical parameters of human brain structures. Tracing of degenerated nerve fibers and involving of particular regions of CNS during a systemic neurodegenerative disease can help to find new connections in human brain and to develop of neuroanatomical knowledge limits.

This study evaluated the effects of total extract of valeriana officinal is as adjunctive therapy for generalized refractory epilepsy (medical, vagal nerve stimulation, not candidate for surgery). Patients with symptomatic epilepsy having refractory seizures despite treatment with other antiepileptic drugs, were eligible (n=13). This open-label study comprised a Base-line phase, an Escalation phase which valeriana extract was titrated to a target dose and a Maintenance phase during which doses of valeriana extract and other concomitant antiepileptic were maintained.Our results have shown that almost 73% of patients who completed study, experienced at least 25% reduction in seizure frequency during the Maintenance phase related to Base-line phase (p<0.05).