Neurology Commons^™

Preservation Of Hearing And Facial Nerve Function With The Microsurgical Excision Of Large Vestibular Schwannomas: Experience With The Retrosigmoid Approach, Muhammad Shaheryar Ahmed Rajput, Ahmad Nawaz Ahmad, Asif Ali Arain, Muhammad Adeel, Syed Akram, Mohammad Sohail Awan, Muhammad Ehsan Bari

Section of Neurosurgery

Introduction: Vestibular schwannomas (VS) are the most common benign neoplasms of a cerebellopontine angle (CPA), which arise from the Schwann cells of the vestibulocochlear nerve. Eighty percent of CPA tumors are VS followed by meningioma as the second common mass lesion in this critical potential space. Treatment options range from watchful waiting with serial imaging studies to radiosurgery or a microsurgical excision or a combination of surgery and radiation therapy. The primary objective of the study was to assess hearing and facial nerve status before and after the surgery via the retrosigmoid approach.
Methods: The database of Aga Khan University …

Role Of Stereotactic Radiosurgery In The Treatment Of Acromegaly, Komal Naeem, Aneela Darbar, Muhammad Shahzad Shamim

Section of Neurosurgery

Acromegaly is a rare, indolent disease due to overproduction of growth hormone. Surgery is identified as primary treatment, but has its limitation, thus frequently requiring alternate treatment options as adjunct to surgery. Stereotactic radiosurgery (SRS) has been used as adjuvant and alternate therapy in patients with inoperable or residual disease; or those not fit for surgery. It has shown reasonable results for treating macroadenoma and tumours invading cavernous sinuses with significant reduction in tumour size and durable endocrinological remission. Factors favouring better outcomes include time from last resection to SRS, older age, peri-procedural withdrawal of medication, higher margin and maximum …

The Sin Of Missing Data: Is All Forgiven By Way Of Imputation?, Joseph R Dettori, Daniel C Norvell, Jens R Chapman

Articles, Abstracts, and Reports

No abstract provided.

Bilateral Sternocleidomastoid Variant With Six Distinct Insertions Along The Superior Nuchal Line., Graham Dupont, Joe Iwanaga, Juan J Altafulla, Stefan Lachkar, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Anatomical variations of the sternocleidomastoid muscle (SCM) have been observed to occupy multiple origins and insertion points and have supernumerary heads, sometimes varying in thickness. During routine dissection, a SCM was observed to have six distinct insertions that interface with the course of the superior nuchal line, ending at the midline, bilaterally. This variation was also seen to receive innervation from the accessory nerve as well as the great auricular nerve. To our knowledge, this variant of supernumerary insertions and nerve innervations has not yet been reported. These variants may pose as problematic during surgical approaches to the upper neck …

Cost-Utility Of Revisions For Cervical Deformity Correction Warrants Minimization Of Reoperations., Samantha R Horn, Peter G Passias, Aaron Hockley, Renaud Lafage, Virginie Lafage, Hamid Hassanzadeh, Jason A Horowitz, Cole A Bortz, Frank A Segreto, Avery E Brown, Justin S Smith, Daniel M Sciubba, Gregory M Mundis, Michael P Kelley, Alan H Daniels, Douglas C Burton, Robert A Hart, Frank J Schwab, Shay Bess, Christopher I Shaffrey, Richard A Hostin, Christopher P Ames

Articles, Abstracts, and Reports

Background: Cervical deformity (CD) surgery has become increasingly more common and complex, which has also led to reoperations for complications such as distal junctional kyphosis (DJK). Cost-utility analysis has yet to be used to analyze CD revision surgery in relation to the cost-utility of primary CD surgeries. The aim of this study was to determine the cost-utility of revision surgery for CD correction.

Methods: Retrospective review of a multicenter prospective CD database. CD was defined as at least one of the following: C2-C7 Cobb >10°, cervical lordosis (CL) >10°, cervical sagittal vertical axis (cSVA) >4 cm, chin-brow vertical angle (CBVA) …

The Ratio Of Observed To Expected: How Much Of It Is Unexpected?, Jens R Chapman, Karsten Wiechert, Jeffrey C Wang

Articles, Abstracts, and Reports

No abstract provided.

Albuminuria In Diabetic Patients With Stroke., Zahid Gul Jadoon, Raheel Jahangir Jadoon, Mir Jalal Ud-Din, Nayab Balqees, Muhammad Munir Noor, Syed Affan Ali

Pakistan Journal of Neurological Sciences (PJNS)

Diabetes is a major health burden worldwide. There is a close association between albuminuria and development of stroke in diabetics. This study was conducted to determine the frequency of albuminuria among diabetic patients presenting with stroke

Levels Of Par-1 Kinase Determine The Localization Of Bruchpilot At The Drosophila Neuromuscular Junction Synapses., Kara R. Barber, Martin Hruska, Keegan M. Bush, Jade A. Martinez, Hong Fei, Irwin B. Levitan, Matthew B. Dalva, Yogesh P. Wairkar

Farber Institute for Neuroscience Faculty Papers

Functional synaptic networks are compromised in many neurodevelopmental and neurodegenerative diseases. While the mechanisms of axonal transport and localization of synaptic vesicles and mitochondria are relatively well studied, little is known about the mechanisms that regulate the localization of proteins that localize to active zones. Recent finding suggests that mechanisms involved in transporting proteins destined to active zones are distinct from those that transport synaptic vesicles or mitochondria. Here we report that localization of BRP-an essential active zone scaffolding protein in Drosophila, depends on the precise balance of neuronal Par-1 kinase. Disruption of Par-1 levels leads to excess accumulation of …

Early Identification Of Depression In Patients With Pediatric Epilepsy, Erin Fecske, Paul Glasier, Lines Vargas Collado, Elizabeth Rende

Posters

Describes the use of the Neurological Disorders Depression Inventory-Epilepsy-Youth (NDDI-E-Y) in adolescent patients in a comprehensive epilepsy center to identify patients who need referral for mental health care.

Dementia- Is It High Time To Replace The Term In Neurological Nosology?, Qurat Ul Ain Khan

Pakistan Journal of Neurological Sciences (PJNS)

Dementia is a term used universally by clinicians and researchers for cognitive impairment that affects a person’s ability to function ((1). This is the term used by the American Academy of Neurology (AAN) in their nosology. Diagnostic and Statistical Manual of Mental Disorders V (DSM V) has replaced the term with Major Neurocognitive Disorder (2). The term HIV- associated dementia (HAD) was also replaced by HIV- associated neurocognitive disorder (HAND) by the AAN AIDS Task force

Non Availability Of Antiepileptic Medications, Farida Jan

Pakistan Journal of Neurological Sciences (PJNS)

It was the best of times, it was the worst of times” quoting Charles Dickens, I feel living in an era very similar to those times, with an ever widening gap between the different economical classes in our society. With the relative improvement in Health services across Pakistan may over the last 70 years and the absolute disastrous growth of 2.4% in population within the last decade, there is still a lot of disparity between the health care demand and supply for common man.1

Awareness And Approach To Headache: A Survey Of Family Physicians In Pakistan, Abdul Malik, Safia Awan, Aziz Sonawalla, Fayyaz Ahmed, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Headache is one of the most common complaints in the general population and the most common symptom for a neurology out-patient visit. According to the WHO, the prevalence of adults complaining of recent headache (at least one episode within the last year) is 47%. Despite the large burden of disease, headaches are often overlooked, underdiagnosed and under-resourced. There are several reasons that include lack of awareness among the general public and healthcare professionals and lack of training at both undergraduate and post-graduate level. There is limited data available from many third world countries including Pakistan. Family Physicians (FPs) equivalent to …

Awareness Of Stroke Among General Practitioners, Waleed Shahzad, Hafiza Faiza Mushtaq, Tehmina Inayat, Muhammad Hassan, Haris Majid Rajput, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is the 2nd leading cause of death and 3rd leading cause of disability after cancer and ischemic heart disease. The recognition of acute stroke symptoms and knowledge about timely and prompt referral of a patient for possible thrombolysis is a need of time for which general practitioners (as they have to be the first responders many a times across Pakistan) need to be equipped with the advance knowledge about stroke treatment.

Azygos Anterior Cerebral Artery Causing Bifrontal Infarcts: A Case Report, Abdul Khaliq, Palwasha Gul, Pari Gul

Pakistan Journal of Neurological Sciences (PJNS)

The azygos anterior cerebral artery (AACA) is an uncommon anatomical variant. There is absence of the anterior communicating artery (ACom) and bilateral anterior cerebral arteries (ACA) form a common trunk and travels superiorly in the interhemispheric fissure. It can result in bilateral frontal infarcts in case of thromboembolism. Therefore its correct diagnosis is of grave importance for better patient clinical outcome. Cerebrovascular infarction is a common condition, however simultaneous symmetrical bilateral infarction secondary to arterial occlusion is a rare entity. We report a case of a 50 years male with thromboembolic event in azygos anterior cerebral artery resulting in bifrontal …

Bilateral Carotid Body Tumors: A Case Report And Review, Dr Asma, Pari Gul, Palwasha Gul

Pakistan Journal of Neurological Sciences (PJNS)

Carotid body tumors (CBTS) also known as chemodectomas are a type of paragangliomas which originate from the carotid body. Carotid body tumors present as a palpable mass in anterolateral aspect of the neck causing splaying of the external carotid artery (ECA) and internal carotid artery (ICA). Bilateral carotid body tumors are uncommon with a reported incidence of 5 - 10%. CBTs are commonly seen in 4th to 5th decades with female predilection. We report a case of 16 years old boy with bilateral carotid body tumors.

Association Of Fahr Disease With Rhabdomyolysis And Hypoparathyroidism, Suneel Kumar, Ahsan Ali Gaad, Mohsin Irshad Abbasi, Munir Afzal, Shahnaz Shah, Dileep Kumar

Pakistan Journal of Neurological Sciences (PJNS)

Fahr syndrome is an idiopathic deposition of calcium in the basal ganglia (most commonly in the Globus pallidus) of the brain; other most common sites may include striatum pallidum. It can have a wide variety of presentations like progressive psychosis, dementia, movement disorders, gait disturbances or it can also be asymptomatic. Department of Neuro-medicine Hyderabad admitted this 28 year old male first. And then was referred to us in the department of Neuro-medicine JPMC Karachi. He is a known case of epilepsy for 8 years, who now presented with the complaint of fever, fits, and altered sensorium for 3 days. …

Rapidly Progressive Dementia A Case Of Sporadic Creutzfeldt-Jakob Disease (Scjd), Harwindar Kumar, Mian Ayaz Ul Haq, Saad Ali Saddiqui, Jasvindar Kumar, Amjad Iqbal, Danish Nabi

Pakistan Journal of Neurological Sciences (PJNS)

Sporadic CJD is a rare and fatal spongiform encephalopathy characterized by rapidly progressive dementia and myoclonus. It is a rare cause of dementia with an estimated incidence of the disease in one patient per million per year worldwide, however, no data is available for Pakistan. As it is a rare cause of dementia, so rarely considered in differential diagnosis of rapidly progressive dementia.

Diagnostic Dilemma In Non-Ketotic Hyperglycemic Seizures On Mr Imaging, Javerya Sattar, Ateeq Ahmed Khan

Pakistan Journal of Neurological Sciences (PJNS)

Acute metabolic encephalopathy is potentially a reversible condition and requires an early diagnosis and management to reduce morbidity and mortality, as in under diagnosed patients, permanent damage can result. Diabetic encephalopathy is an emerging complication of both type I and type II diabetes. Besides T1 hperintensities in bilateral basal ganglia in diabetic encephalopathy patients, reported in most of the literature reviewed, patients with hyperglycemic seizures can present with subcortical hyperintensities , with predilection for occipital lobes. Here, we report a case of type II diabetic, 40 year-female patient who was referred for MR brain to our department, presented with acute …

Challenges & Barriers For Neuro Rehabilitation In Developing Countries, Muhammad Naveed Babur, Maria Liaqat

Pakistan Journal of Neurological Sciences (PJNS)

People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it.

Triggers, Protectors, And Predictors In Episodic Migraine., Michael J. Marmura

Department of Neurology Faculty Papers

PURPOSE OF REVIEW: A wide variety of triggers prompt attacks in episodic migraine. Although experimental triggers such as glyceryl trinitrate reliably produce migraine, natural triggers are much less predictable and vary in importance between individuals. This review describes the most common triggers in episodic migraine and provides strategies for managing them in clinical practice.

RECENT FINDINGS: Multiple migraine attack triggers have been established based on patient surveys, diary studies, and clinical trials. Stress, menstrual cycle changes, weather changes, sleep disturbances, alcohol, and other foods are among the most common factors mentioned. Clinical studies have verified that fasting, premenstrual periods in …