Papers by Afsoun Seddighi
Reviews in Clinical Medicine, Dec 1, 2018
Abnormal hyperexcitable electrical discharges of the cerebral cortex lead to the disturbance betw... more Abnormal hyperexcitable electrical discharges of the cerebral cortex lead to the disturbance between the inhibitory and excitatory balance of the neural network. Seizure is caused by four main mechanisms, including metabolic, structural, inflammatory, and infectious mechanisms. Seizures are classified as partial and generalized based on the isolation in a specific area in one brain hemisphere or passing through the nerve fibers and spreading to the other hemisphere as well. Epilepsy is defined as the occurrence of more than two unprovoked and unpredicted repeated seizures. Epilepsy affects more than three million individuals in the United States and approximately 50 million individuals worldwide. Epilepsy may be of an unknown origin, while it could also be associated with certain syndromes. General and specific approaches to seizure treatment encompass a wide range of factors. The general approach should be focused on reassurance and raising the awareness of the patients and their family, and the specific treatment is focused on utilizing pharmacological and surgical approaches. In general, the surgical approaches used for medication-refractory seizures are both palliative and curative, showing promising results if the epileptogenic area is localized using a multidisciplinary approach via live video-electroencephalography monitoring or direct intracranial electrode placement. In addition, the utilization of live modern imaging modalities coupled with surgical approaches could enhance the success rate of the treatment and increase the seizure-free duration.
The Iranian Journal of Neurosurgery
Background and Aim: The methods to detect brain activation with functional MRI (fMRI), and MRI pr... more Background and Aim: The methods to detect brain activation with functional MRI (fMRI), and MRI provide a way to measure the anatomical connections which enable lightning-fast communication among neurons that specialize in different kinds of brain functions. Diffusion tensor imaging (DTI) can measure the direction of bundles of the axonal fibers which are all aligned. Besides mapping white matter fiber tracts, these methods can enable us to detect and characterize white matter disorders in diseases. The objective of this narrative review is to overview current knowledge concerning DTI as one of the prominent popular MRI techniques that provide a planned tool for comprehensive, noninvasive, functional anatomy mapping of the human brain in both research and practical field. This review summarizes the DTI development in recent years concerning the specificity and utility of this technique in brain surgery. Methods and Materials/Patients: The significance of mapping the structure of whit...
International Clinical Neuroscience Journal
Background: Veterans with chronic spinal cord injury usually have various comorbidities. They are... more Background: Veterans with chronic spinal cord injury usually have various comorbidities. They are, therefore, visited by different doctors and use different medications. It is necessary to monitor the health of these veterans. One of the important issues in this regard is the attention to drug interactions. The purpose of this study was to investigate the drugs used and their interactions. Methods: This descriptive study of the cross-sectional studies was carried out retrospectively in 2015 under the Shefa Neuroscience Research Center's supervision, examining the medical records of veterans with spinal cord injury participating in the health screening program at Khatam Alanbiya hospital in Tehran. Demographic data, comorbidities, used drugs, and the level of involvement collected. According to the FDA, drug interactions among the drugs used for each patient has evaluated and classified into three severe, moderate, and weak groups. SPSS v. 21 analyzed data. Results: The study population consisted of 404 men, ranging in age from 41 to 74, with a mean of 51.6 ± 6.4 years. One hundred forty-two of them (35.1%) had a complete injury, and 262 veterans (64.8%) had an incomplete injury. Only 17 veterans (4.2%) had no drug interactions. The number of drug interactions varied from 1 to 38, with an average of 5.9 ± 12.8 interactions per patient. The total number of interactions was 2856, of which 32.5% were weak, 55.3% moderate, and 12.2% severe, with a 95% confidence interval. Among the severe drug interactions in the study, the highest number belonged to the antidepressant drugs. Conclusion: This study highlights the necessity of developing a strategy for investigating and preventing drug interactions in veterans with chronic spinal cord injury. It has recommended that physicians pay more attention to other medications used by the patient and prescribe as little as possible of the drug and the drug with the least number of interactions.
The Iranian Journal of Neurosurgery
Background and Aim: Numerous efforts have been made over the past century. Various innovation tec... more Background and Aim: Numerous efforts have been made over the past century. Various innovation techniques are increasingly gaining attention and gradually establishing the foundation of recent significant developments in the world of neurosurgery, among which varied stereotactic neuro-navigation designs and other novel emerging systems are being developed every day. This narrative review aims to describe basic concepts in frameless stereotaxy and summarize the primary principles of neuronavigation and clarify basic characteristics, such as the accuracy of this technique (frameless navigation), and emphasize the importance of designing phantom. Methods and Materials/Patients: The application of brain images to steer the surgeon to a target in the brain by utilizing the stereotactic principle of co-registration of the patient with an imaging study that permits brain surgery to be fulfilled with greater safety and smaller incisions by providing precise surgical guidance of the location ...
International Clinical Neuroscience Journal
Despite the development of screening tests and diagnostic tools, neuropathic pain is still identi... more Despite the development of screening tests and diagnostic tools, neuropathic pain is still identified as an underdiagnosed condition lacking proper epidemiological studies. It is difficult to estimate its incidence and prevalence the population. The objective of this narrative review is to summarize current knowledge concerning complications. The underlying mechanisms have also been reviewed in the development of diagnostic or treatment strategies in patients with neuropathic pain to investigate its unique symptoms. The main focus is concentrated on expansion of possible therapeutic options for neuropathic pain treatment. Many therapies are not effective and this often leads to a significant deterioration in the patients’ quality of life. So, the crucial and strategic role of therapeutics in guiding patients in the right direction should not be overlooked. The existing knowledge is so limited and has safety risks. It is truly important to provide alternative treatment strategies in ...
The Iranian Journal of Neurosurgery
Background and Aim: Today, neuroendoscopic surgery is gaining popularity because of its minimal d... more Background and Aim: Today, neuroendoscopic surgery is gaining popularity because of its minimal damage to normal structures, fewer complications, and excellent clinical results. Using an endoscope and related instruments, surgeons can perform complex surgeries through small incisions, especially for minimally invasive spinal and brain surgeries. Neuroendoscopic systems are currently costly and not portable. Our new video solution is portable at a lower cost and can display and record images in 4K resolution. Methods and Materials/Patients: We modified the GoPro Hero 6 camera to serve our purpose. By detaching the original camera lens and its front part and replacing the removed parts with a new design, we made a C-mount camera that can connect to a standard C-mount coupler and various common scopes. For color correction, we used an IR-cut filter in front of the camera sensor. Results: By changing some parts of the camera and connecting it to a C-mount coupler and a scope lens, we ma...
The Iranian Journal of Neurosurgery
Background and Aim: Neurovascular lesions can cause death or disability. Some of them are operabl... more Background and Aim: Neurovascular lesions can cause death or disability. Some of them are operable, but surgical approaches are complicated, and proper access to these lesions is crucial. A few of these surgeries occur during the residency educational program, and residents' experience in operating these lesions may be quite inadequate. Using new technologies like 3D-reconstruction of vascular lesion images may result in better training and improve residents' knowledge and understanding of these operations. Methods and Materials/Patients: Four senior neurosurgery residents were enrolled in this study. They were taught to use a 3D image rebuilding program (3D Slicer). They were then asked to rebuild a 3D image of every patient lesion, practice different surgical views, and review anatomical structures around the lesion before surgery. Results: All residents mentioned that their knowledge of surgical approaches improved, and they learned more from each operation. Two of them c...
Austin Journal of Clinical Case Reports, 2021
Sarcomas rise from mesenchymal layers and may transform to variable malignant lesions in multiple... more Sarcomas rise from mesenchymal layers and may transform to variable malignant lesions in multiple organs systems. Although they are mostly localized, many of them have predilection of distant sites away from their primary origins and subsequent metastasis to different anatomical locations of body. Soft Tissue Sarcomas (STSs) represent one percent of adult and about 7% of pediatric malignancies. Although insignificant in number, these tumors may complicate patient’s overall health status compared with other malignancies, because of their numerous subtypes and variable features which may pose an everlasting challenge to both clinical and surgical treatment strategies. Existence of these complications and a relatively small available data regarding Central Nervous System’s (CNS) sarcomas, encouraged authors to conduct a retrospective study in a 6-year period to evaluate the specific epidemiological features of CNS sarcomas, including brain, spinal cord and meningeal layer sarcomas extr...
Men's health journal, 2020
Introduction: Pituitary adenomas are commonly benign, slow-growing tumors that arise from cells i... more Introduction: Pituitary adenomas are commonly benign, slow-growing tumors that arise from cells in the pituitary gland and consist of a common type of intracranial space-occupying lesions. Based on the functionality and size of the adenoma, both medical and surgical approaches have been described. In this study, the authors aim to determine the effects of contributing factors of patients with pituitary adenoma undergoing trans-sphenoidal endoscopic surgery to their postoperative clinical status. Material and Methods: From March 2015 to November 2016, 100 patients diagnosed with pituitary adenoma confirmed by Magnetic Resonance Imaging (MRI) underwent a trans-sphenoidal endoscopic approach in the department of Neurosurgery of Shohada Tajrish Hospital. Demographic data, as well as pre-defined relevant contributing factors regarding clinical status, were recorded. All patients underwent neuroimaging and neurological examination before surgery and were followed in the postoperative peri...
International Journal of Cancer Management, 2017
Introduction: Epidermoid cysts (ECs) are rare, slow growing tumors which usually affect lumbosacr... more Introduction: Epidermoid cysts (ECs) are rare, slow growing tumors which usually affect lumbosacral area as an extramedullary lesion and mostly associated with spinal malformations. In this report we describe a very rare case of multi-segmental intramedullary EC. Case Presentation: A 42-year-old male presented with low back pain and paresthesia of left lower limb and also intermittent urinary retention. Urodynamic study showed weak contractions in bladder. MRI demonstrated multi-segmental lobulated intramedullary lesion extending from C7 to L2, which has high intensity on both T1 and T2-weighted images. Laminectomy of T11-L3 for symptomatic parts of the lesion and subtotal resection of the tumor was performed and histopathological investigation confirmed EC. Conclusions: Prompt evaluation of every patient with combination of neurological and urologic disturbances should be carried out. This report suggests that rare intraspinal tumors such as EC may affect multiple locations of the spinal cord, thus appropriate surgical intervention may prevent unwanted sequelae.
Austin Journal of Clinical Case Reports, 2021
Object: Based on previous studies, 30 to 40% of cancer patients are diagnosed with bone metastasi... more Object: Based on previous studies, 30 to 40% of cancer patients are diagnosed with bone metastasis. Median Overall Survival (OS) of patients who are diagnosed with spinal metastasis (vertebral structures) is about 7 to 9 months which with recent progresses in oncologic and radiotherapy treatment modalities, their prognosis is slightly developed. In this study, authors plan to evaluate the effects of Intra-operative Radiation Therapy (IORT) in patients who are candidate for Kyphoplasty procedure. Methods: In this study, we have included patients who are diagnosed with spinal metastasis with radiological and histopathological confirmation. From July 2017 to December 2018, we have included 9 patients who fulfilled our predefined inclusion and exclusion criteria into our case-series study performed on Shohada Tajrish Hospital. Patients underwent radiotherapy during Kyphoplasty by our IORT device INTRABEAM (Carl Zeiss AG, Germany) as “Kypho-IORT’ procedure. We have evaluated these patien...
International Clinical Neuroscience Journal, 2014
B a c k ground: Over the past decades, instruments and techniques of the transsphenoidal approach... more B a c k ground: Over the past decades, instruments and techniques of the transsphenoidal approach have improved greatly. All of these procedures, whether microscopic or endoscopic, must pass through the sphenoid sinus to reach the lesions. The sphenoid sinus is surrounded by several vital anatomical structures. Knowing the details of the anatomy of the sphenoid sinus and the extent of pneumatization can guide the surgeon through difficult corners of this approach. Purpose: This work aimed to determine the incidence of the different anatomical variations of the sphenoid sinus in Iranian patients with pituitary adenomas as detected by preoperative MRI and CT scans. Methods: Preoperative CT scan and MRI of 64 adult patients with pituitary adenomas were retrospectively reviewed regarding degree of pneumatization and septation of the sphenoid sinus. Results: Regarding the degree of pneumatization, there were 34 cases with sellar type (59.4%), 10 patients with presella...
International Clinical Neuroscience Journal, 2015
Neurocysticercosis, is the infection caused by the larval form of the tapeworm Taenia solium. It ... more Neurocysticercosis, is the infection caused by the larval form of the tapeworm Taenia solium. It is considered as the most common parasitic disease of the central nervous system and the most common cause of acquired epilepsy. This has primarily been a disease that remains endemic in countries with poor economy , but because of increased migration neurocysticercosis is being diagnosed more frequently worldwide. During the past decades improved diagnostics, imaging, and treatment have led to more accurate diagnosis and improved prognosis for patients. This article is a review about the current data about neurocysticercosis, including recent diagnostics and treatment developments.
International Clinical Neuroscience Journal, 2014
Our case was a 48-year-old man with cervical pain radiatingto the upper limbs. Imaging showed an ... more Our case was a 48-year-old man with cervical pain radiatingto the upper limbs. Imaging showed an intradural tumor with extradural component encasing the vertebral artery.Thetumor diagnosed asa neurinomaand had been removed surgically.The post operationmagnetic resonance imagingshowed that the tumor was completely removed andthe vertebral arterywas intact at theentire length.The goal of surgery of neurinoma is a total removal of the tumor,however if the vertebral artery is completely encasing by the tumor, it is advisable to remove the tumor to the level that the vertebral intactness issaved.
International Clinical Neuroscience Journal, 2017
Background: Arachnoid cysts are cerebrospinal fluid (CSF) fluid-filled sacs that are located betw... more Background: Arachnoid cysts are cerebrospinal fluid (CSF) fluid-filled sacs that are located between the brain and spinal cord. Spinal column arachnoid cysts are rare and mostly asymptomatic, being mostly located in intradural regions. We reported a patient who presented with neurological deficits and mid-thoracic extradural arachnoid cyst treated with en-bloc resection. Case Presentation: Patient was a 34-year-old female who presented with progressive back pain, lower extremity weakness and paresthesia in her lower limbs. Magnetic resonance imaging (MRI) study revealed an extradural hyperintense signal lesion in T2-weighted, extending from T7 to T9, which did not enhance on T1-weighted post-contrast MRI. Patient underwent T6-T10 laminectomy and en-bloc resection of the lesion which was compatible with arachnoid cyst after histopathological examination. Patient did not experience worsening of neurological symptoms and lesion recurrence in clinical and imaging evaluation during 2-yea...
Reviews in Clinical Medicine, 2018
Abnormal hyperexcitable electrical discharges of the cerebral cortex lead to the disturbance betw... more Abnormal hyperexcitable electrical discharges of the cerebral cortex lead to the disturbance between the inhibitory and excitatory balance of the neural network. Seizure is caused by four main mechanisms, including metabolic, structural, inflammatory, and infectious mechanisms. Seizures are classified as partial and generalized based on the isolation in a specific area in one brain hemisphere or passing through the nerve fibers and spreading to the other hemisphere as well. Epilepsy is defined as the occurrence of more than two unprovoked and unpredicted repeated seizures. Epilepsy affects more than three million individuals in the United States and approximately 50 million individuals worldwide. Epilepsy may be of an unknown origin, while it could also be associated with certain syndromes. General and specific approaches to seizure treatment encompass a wide range of factors. The general approach should be focused on reassurance and raising the awareness of the patients and their f...
International Clinical Neuroscience Journal, 2016
Myelography is a diagnostic procedure to indicate spinal defects. After the inception of new mean... more Myelography is a diagnostic procedure to indicate spinal defects. After the inception of new means of spinal cord imaging, use of myelography has been limited. Since there are contraindications for other modalities in some patients, we have to use myelography. The most common complication of myelography is post myelography headache (PMH). Many methods have been proposed to alleviate the pain. In this clinical trial study we assess the role of steroid in PMH.
International Clinical Neuroscience Journal, 2017
Background: Cerebrospinal fluid (CSF) is contained in an anatomic space, including cerebral ventr... more Background: Cerebrospinal fluid (CSF) is contained in an anatomic space, including cerebral ventricles and subarachnoid spaces and cisterns of brain and spine. Distraction of normal anatomy of any containing parts of this system will result in CSF leakage which could be associated with morbidity and mortality with variable degrees. In this study, we aimed to present 3 patients with history of blunt head trauma, who presented with delayed CSF leak and underwent endonasal endoscopic approach under image guided surgery using neuronavigation system with fluorescein illumination. Case Presentation: Three patients were referred to neurosurgery department of Shohada Tajrish Hospital with previous history of blunt head trauma, complained from CSF rhinorrhea. They underwent thin slice Computed Tomography scan and received intrathecal fluorescein for better visualization of leakage source under live endonasal endoscopic approach, using image guided neuronavigation technology. Autologous fat t...
International Clinical Neuroscience Journal, 2016
PURPOSE: To record the MRI features of primary central nervous system lymphoma (PCNSL) and compar... more PURPOSE: To record the MRI features of primary central nervous system lymphoma (PCNSL) and compare these properties in monofocal and multifocal disease. METHODS: Eleven cases of monofocal disease were compared to 9 cases of multifocal disease. All patients were examined by non-enhanced and contrast-enhanced MRI. Tumor location, signal intensity, enhancement characteristics, age distribution, peritumoral edema, cystic changes, and the presence of calcifications were assessed. The MRI features were compared between the monofocal and multifocal patients. RESULTS: There were 20 cases including both the monofocal and multifocal cases. Contrast-enhanced images showed variable enhancement patterns: homogeneous enhancement (14 patients), and hetrogenous enhancement (6 patients). One case of hemorrhage and two cases of cystic formation were observed. Intra-tumoral calcification was not detected. The frontal lobe, the corpus callosum and the basal ganglia were commonly involved in both the mo...
International Clinical Neuroscience Journal, 2015
Brain tumors in elderly are increasing as the number of people, who comprise the older population... more Brain tumors in elderly are increasing as the number of people, who comprise the older population, does.About half of the patients with brain tumors appear to be over 60 years of age.In this review article, Glioblastoma multiform, as the most common malignant tumor of the central nervous system in elderly is discussed in details of definition, prognosis, diagnosis, treatment and differential diagnosis. Other tumors such as meningioma, pituitary adenoma, CNS lymphoma and metastasis are also included to be reviewed. Treatment plans, either conservative or aggressive, classic or novel, approved or under investigation, are presented. Furthermore different attitudes of treatment in the past and recently are also argued. Conventional therapy, Surgery, Radiotherapy, chemotherapy radioimmunotherapy, hormonal therapy and some other novel methods of treatments are discussed in details for the glioma. Determining factors which may be associated to the patient's response to each treatment ...
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Papers by Afsoun Seddighi