Iranian Journal of Neurosurgery
Volume:2 Issue: 4, Autumn 2016

Various landmarks are discussed to find the facial nerve during parotid surgery. The surgeon should use existing landmarks for a safe surgical use. To evaluate two new landmarks in parotid surgery, this study was done.
Methods & Materials/Patients: This cross-sectional study was conducted on 43 patients with parotid masses, whom were referred to Alzahra and Kashani tertiary hospitals in 2013. In a parotid surgery, the greater auricular nerve was detected; then the greater auricular nerve and facial nerve diameter were measured by the compass with precision of 0.1 millimeter and recorded. After facial nerve exploration, if the other landmarks of vascular and tail signs are detected, they are recorded in the files.
This study contained 43 patients, 22 men and 21 women. There were 21 (48.8%) masses in deep lobes and others on superficial lobes. In 36 cases (83.7%), vascular signs were observed. In 23 cases (53.5%), tail signs were found. The diameter of facial nerve was 2.647(±4641) mm (minimum: 2 mm and maximum: 4 mm). The diameter of greater auricular nerve was 2.691(±4545) mm (minimum: 2 mm and maximum: 4 mm). By paired T-test, there was no significant difference between the diameter of facial and greater auricular nerves. Of all cases, 76.7% had differences less than 0.5 mm.
This study showed that greater auricular nerve can be used as a proper graft for facial nerve, and we can use “vascular sign” as a good indicator of facial nerve.

Disabilities resulting from road accidents, especially spinal cord injury, which often occur in the early or middle ages of life, cause psychiatric symptoms and worsen the quality of life in these people. The present study aimed to determine the role of depressed mood in the quality of life of patients with spinal cord injury in Guilan Province (in the north of Iran).
Methods & Materials/Patients: The present research was a cross-sectional, descriptive study. The statistical population included all patients in Spinal Cord Injury Association of Guilan Province, 97 of whom were selected as the sample based on convenience sampling method. The required data were collected using an author-made demographics questionnaire, the Spinal Cord Injury Quality-of-Life-23 questionnaire, and Beck Depression Inventory- Short Form. After removal of demographic confounders, Pearson correlation coefficient, independent student t-test, and hierarchical regression model were used for statistical analysis of the obtained data in SPSS.
Correlation coefficients showed that there is a significant and direct relationship between depressed mood and quality of life (P The study findings emphasize the prevention and treatment of depressed mood to improve the quality of life in patients with SCI.

Post-traumatic subdural hygroma can be associated with subdural or epidural hematoma. It is usually silent with mild symptoms and often disappears spontaneously needing no treatment. In this study, we investigated the clinical characteristics of subdural hygroma in patients with traumatic brain injury.
Methods & Materials/Patients: In a cross-sectional study, data of 3244 patients with head injury admitted to Poursina hospital were collected through a questionnaire which included variables of age, sex, GCS on admission, mechanism of trauma, accompanying cranial injuries and treatments, unilateral/bilateral hygroma, and size, volume, and location of hygroma. Finally, the data were analyzed using SPSS (version 19) and descriptive statistics.
In this study, 81.8% of patients were men and 18.2% women with mean age of 60.91±26.07 years old. Accident was the most common cause (63.6%) and the severity of head injury was mild in majority of patients (63.6%) according to GCS. The average time of diagnosis was 10.4 days after the head injury was located in frontal (36.4%) and fronto-parietal (36.4%) areas in most patients. Most of the accompanying cranial injuries were brain contusion (36.4%) and subarachnoid hemorrhage (27.3%). The majority of patients (81.8%) underwent conservative treatment and showed a favorable outcome (63.6%).
Most of the times, subdural hygroma is observed in older people and disappears over time with vanishing clinical symptoms. Most cases have to undergo conservative treatment.

Background and Importance: Intradural lumbar disc herniation is a rare and uncommon presentation of lumbar disc herniation. It signifies a challenge for diagnostic and therapeutic scheme, and is associated with a greater incidence of cauda equina syndrome at presentation.
We describe two cases of intradural disc herniation who underwent surgery in Senegal review literature, and discuss difficulties in the preoperative diagnosis, surgical technique and functional outcome of our patients.
We conclude that diagnosis of this affection in developing countries is done during surgery, and the functional outcome of patients can be excellent.

Background and Importance: Hypoparathyroidism is due to parathyroid hormone deficiency and categorized as an endocrine disorder. Acute clinical presentations of hypoparathyroidism are muscle cramps and spasms, tetany, weakness, paresthesia and seizure. Hypoparathyroidism may be accompanied with psychosis, depressio n, seizures and extrapyramidal manifestations in chronic condit ion.
The present case reported about a 37-year-old man who presented with the history of several episodes of seizures, slurred speech, progressive limbs and trunk stiffness and increa sed muscle tone and rigidity.
Paraclinical investigations revealed hypocalcemia and very low parathyroid hormone levels with extensive intracranial calcification involving bilateral basal ganglia, cerebellum and subcortical white matters on brain CT scan.

Background and Importance: Inflammatory pseudotumors are benign tumors-like lesions of unknown cause. The most familiar sites for inflammatory pseudotumors are the orbit and respiratory tract. An inflammatory pseudo tumor of costo-vertebral junction is rare.
We presented here a 50-year-old male with two month history of progressive left cervico-brachial pain. The MRI showed an expansive process at the left costo-vertebral gutter with epidural extension through the lateral foramen, causing spinal cord compression from C7 to D3. The thoraco-abdominal CT scan did not identify other lesions.
The inflammatory pseudotumor is a chronic inflammatory process of unknown origin. The location of the costo-vertebral gutter is rare and the treatment involves surgery, steroids and radiotherapy.