Current Journal of Neurology
Year:2006 | Volume:5 | Issue:13|Papers Count:12

Historical Background: At first time, Cushing reported the use of Decompressive Craniectomy to relieve the pressure caused by the growth of an intracranial tumor. In the 1950s and 1960s, an increasing number of reports were published in which the authors described cases of massive cerebral ischemia accompanied by acute and severe brain swelling. Later, Greenwood used decompressive hemicraniectomy as well as resection of the necrotic parenchyma in the treatment of such cases, which decreased the mortality rate to below 50%. Kjellberg and Prieto described a bifrontal decompressive craniectomy procedure for the treatment of a massive infarction and Rengachary and coworkers reported the first cases in which straightforward craniectomy was undertaken, without removal of necrotic brain tissue.Nowadays, this procedure is used in many neurological centers as a method of treatment in malignant MCA infarction. In this paper we discuss about this procedure on the basis of review of articles.

Background: Monomelic amyotrophy or benign focal amyotrophy is a rare clinical entity, resulting in wasting and weakness localized to the hand and forearm unilaterally, in the absence of any sensory or long tract signs. The onset of the disease is insidious, occurring in males before the age of 30 years, with a clinical course marked by non-progression. Autopsy studies have shown that the affected cervical spinal cord is flattened; the anterior horn is markedly atrophied and gliotic and the numbers of both large and small motor neurons are reduced. The etiology is unknown. Cervical MRI segmental spinal cord atrophy or occasionally an area of increased signal on T2-weighted scans of the cervical spinal cord.In this study we represent a 32 years old man with weakness and atrophy of right upper limb from 2 years ago that his problem fixed from 6 months ago. Lab tests are normal. In EDx, he has Normal sensory and motor NCS. EMG in affected muscles reveal chronic neurogenic process in C5-C6-C7 myotomes. There is no diagnosis of brachial plexopathy. In imaging Hyperintense T2w MRI longitudinal lesion in ventrolateral segment of cord in C4-C5- C6.According to history and physical exam and after rule out of its DDx, benign focal amyotrophy is the best diagnosis for the patient.

Background: Recent studies indicated that stroke is the second cause of death in world wide and due to more intensity, complications and mortality in women (16% of women but only 8% of men) emphasize the importance of stroke in women. The aim o this study was comparison of ischemic stroke's risk factors in female and male.Materials and Methods: This is descriptive cross-sectional study that data were collected and recorded gradually from all patients (n=108) that hospitalized during years of 1381-82 in Fatemiah hospital in Semnan, Iran. We used of checklist that include of demographic data and data regarding to all of risk factors of stroke. Also we doing for all samples Laboratory test include of fasting blood sugar, levels of serum cholesterol, triglyceride and Hematocrite. Finally data analyzed by SPSS software and Kruskal Wallis exam.Results: that the mean age was 7.0 in male and 75 in female years old. Data indicated that overall, 53.7% from the all cerebral strokes patients were female and 46.3% male. The percent of risk factors in women and men were: hypertension (79% and 58%), Diabetic mellitus (47% and 28%) hypercholesterolemia (57% and 30%), hypertriglyceridemia (24%, and 14%) history of heart diseases (43% and 38%), smoking (5.17% and 30%), Polycythemia (4.4% and 2%) and history of previous stroke (30% and 12%). Therefore incidence of hypertension, hypercholesterolemia, Diabetic mellitus and history of previous stroke were significantly more in female than male (P<0.05).Conclusion: Findings above highlight that probably hypertension, Diabetic mellitus, hypercholesterolemia and history of previous stroke but not smoking as risk factors that more incidence in women. Therefore control of these factors can be reducing of prevalence of stroke.

Background: In Iran, the number of neurologists is more than 550 persons and there is near 150 residents in all the country. Training occurs in 8 major cities of Iran and 10 major universities (Tehran, the capital has 3 important medical universities and all of them have neurology training). Each hospital accepts 1-5 residents each year.The number of neurologists is 150 in Tehran so the capital has 1/3- 1/4 of all neurologists of the country.After the primitive above data, analysis should contain both positive and negative aspects to give a general schema of Iran's Neurology.

Background: Stroke in young adults (15-45 y) is not common. More than 40 cause have been recognized for young adults stroke. One less known etiology is arterial thrombosis due to antiphospholipid antibody. This study evaluates the frequency of antiphospholipid antibodies in an unselected young population with cerebral ischemia, also antiphospholipid antibody positive stroke patients were compared with those without them regard to stroke characteristics.Materials and Methods: All admitted patients (15-45 years old) to Imam Khomeini Hospital during 2 years(2003-2004), who suffered cerebral ischemia tested for antiphospholipid and anticardiolipin antibodies and compared with a matched sex and age group without cerebral ischemia. From 47 patients with stroke Twenty five with age (37+/- 5Ay) had inclusion criteria for study, 40 controls (37.12+/- 5.8) were studied. In stroke group there were 14 women and 11 men and in control group there were 24 women and 16 men.The antibodies (both IgG and IgM classes) measured by standardized enzyme-linked immunosorbent assay (ELIZA).Results: About 7.5% of strokes occurred in subjects under 45 years. The prevalence of these antibodies in stroke patients was 24% compared to 5% in the controls (P=<0.05). Mean of all antibodies levels, except the antiphospholipid antibody IgG, were significantly high in stroke group. There was at least one prior cerebral event in 2 of 6 ischemic patients (33.3%) with high antibodies, and 2 of 19 (10.5%) without them had at least one stroke, the difference was not significant.Conclusion: We conclude that the prevalence of antiphospholipid antibodies is rather high in young adults with cerebral ischemia. These patients may have unrecognized systemic lupus erythematosus. The antiphospholipid antibody-positive stroke patients did not differ significantly from antibody-negative stroke patients with regard to stroke characteristics only for mild echocardiographic abnormalities (P= 0.047).