samar kamalifar

Ancient schwannoma is one of the rarest subtypes of typical schwannoma, and just two cases of codaequina involvement with this tumor have been reported so far. This type of tumor has large areas without cells (Antony B) and a small part of pericellular areas (Antony A), which in the case of typical schwannoma, it is opposite. The pathological form of this tumor indicates the slow growth of the soft consistency and the benign course of these types of tumors.

Pituitary adenoma (PA) is a frequent intracranial lesion, that needs surgical evacuation. In this study, we  evaluated the surgical outcome of PA treated via endoscopic and microscopic  trans-sphenoidal approach

In this retrospective cross-sectional study, we evaluate ten years of PA surgery experience  in the northwest of Iran. 721 patients underwent trans sphenoidal surgery of PA. Complication of the surgery, extension of tumors resection, demographic and clinical findings (gender, age , tumor type ,..) were reviewed in this study. SPSS version 25 and statistical tests including chi square and T-test were used. P-value ˂0.5 was considered as statistically significant.

483 males (58.9%) and 336 females (41.02%) were included in this study. Mean age of patients was 47.3±1.96 years.The most common initial complaints were deterioration of vision (n=528, 64.4%) and headache (n=343, 41.88%), followed by accelerated development (n=254, 31.01%), amenorrhea and galactorrhea (n=253, 30.8%). 57 (6.95%) patients had symptoms of Cushing’s disease. 105 (12.8%) patients had acromegaly. TR was achieved in 87.5% of cases and sub-TR in 103 (12.5%) cases and no patient had a partial or insufficient resection. After surgery, the endocrine function was normalized in 76 (31.7%) patients who had preoperative hyper hormonal levels. 36 (4.3%) patients developed postoperative CSF leakage; of which, 4 (0.48 %) patients did not improve by lumbar drainage and other conservative treatments  and needed reoperation for reconstruction of the skull base.

The combination of microscopic and endoscopic trans-sphenoidal approach in PA surgery can be lead to total resection of tumors.

L5 Sacralization is normal variation in lumbar anatomy, but many authors believed this condition because of concentration of pressure in L4/ L5 level can speed up degenerative process (disk degeneration or listhesis…). However no study was compare spondylolisthesis radiological parameters in patient with and without sacralization of L5, our purpose is evaluation of radiological parameters in spondylolistesisL4/L5 in patient with and without L5 sacralization.

In cross sectional study we divided 78 patient with spondylolisthesis of L4/L5 in two group with (n=24) and without (n=54) L5 sacralization and evaluated facet osteoarthritis, degree of listhesis (%), disk degeneration, and facet orientation in two group and result was compared,

There was no significant difference in the degree of anterior slippage of L4 on L5 (17.02±6.21 versus 16.65±4.87, p=0.809), facet orientation (54.99±12.18 versus 56.23±4.35, p=0.642), facet osteoarthritis (3.43±0.59 versus 3.53±0.37, p=0.527), or disc degeneration (4.50±0.51 versus 4.35±0.61, p=0.340) between the two groups

There is no significant relation between radiological parameters in two group and we thought influence of L5 sacralization on degenerative process of L4/L5 less significant than previously expected, but future study with large number of patient need to clarify the role of fixed L5 on degenerative process in lumbar spine.

Intraoperative spinal cord and nerve root monitoring is used to identify an insult to the neural elements with the goal of preventing injury,beacause of high rate of neurological deficit in spinal surgery, the use of intraoprative neuromonitoring can detect the iatrogenic neural deficit  in surgery and help the surgeon to review the operation. We introduced the 51 years old women with a cervical cord meningioma to be operated under intraoprative neuromonitoring.

Neuroblastoma is a nervous system malignancy. The extension of intra-abdominal neuroblastoma to the spinal canal is a rare condition. In this case report, we present a patient with monoplegia and a huge intra-abdominal mass with intra spinal extension and cord compression.

Secondary complications management of Subarachnoid Hemorrhage (SAH) is one of the therapeutic challenging issues during Intensive Care Unite (ICU) admission. The complications of patients with SAH admitted to the ICU of Imam Khomeini Hospital of Urumia were investigated in this study. Methods and Materials/Patients: In this descriptive study, the clinical complications of the patients with SAH admitted to ICU including anemia, fever, hyperglycemia, hypertension, electrolyte imbalance, and cardiac arrhythmia were collected from their medical records within a 7-year period. The collected data were analyzed using Chi-squared test and t-test by SPSS.  In total, 483 records of patients with SAH were explored. Moreover, 183 (37.9%) samples had anemia, 174 (36%) suffered from fever, 204 (42.2%) patients were diagnosed with hypertension. A total of 111 (23%) patients had hyperglycemia, 54 (11.2%) individuals suffered from sodium disorders. Additionally, 131 (27.1%) individuals had cardiac arrhythmias. The obtained results suggested that the most prevalent complications following SAH are hypertension, anemia and fever. Furthermore, there was a significant correlation between cardiac arrhythmias, as well as sodium and hyperglycemia disorders, and the treatment outcome of patients. Patients admitted to ICU should be under intensive care to reduce the mortality rate associated with SAH.

Spontaneous Spinal Epidural Hematoma (SSEH) is a rare spinal condition. Early surgical intervention is generally indicated to prevent serious permanent neurological deficits. We encountered a case of spontaneous spinal epidural hematomas associated with motor weakness that was treated successfully by surgical evacuation.