Alireza Tabibkhooei

Background: Intraoperative language tasks often inadequately assess complex grammatical processes. This study aims to improve Persian cortical mapping by integrating object naming and sentence completion tasks. Multi‐task language (MTL), consisted of an object naming task and a semantically relevant verb, was designed. Methods: The content validity ratio (CVR) and index (CVI) were calculated to determine task items retention. Twenty‐five right‐handed patients with brain mass lesions in language‐associated regions were enrolled. Each patient received a medical recommendation for awake surgery, and preoperative fMRI data were collected through verb and syntax generation tasks. Activations in language‐related regions for object naming, word generation, and MTL were compared. Lateralization of brain activity was evaluated for each participant by calculating the Laterality Index (LI). Results: The CVR for all items ranged from 0.9 to 1 (0.93 ± 0.09), while the CVI ranged from 0.8 to 1 (0.94 ± 0.07). Significant activations were identified during object naming, particularly in the left precentral gyrus and inferior frontal gyrus ( z = 7.53). For word generation, activations were bilateral in the fusiform gyrus and Broca ( z = 5.54). The MTL task showed its highest activation in the fusiform and inferior temporal gyrus ( z = 6.86). A significant difference was found between the LI of object naming and word generation ( p = 0.003), while MTL comparisons were not statistically significant. Conclusion: The developed Persian intraoperative language paradigm, named MTL, demonstrated validity and feasibility, with significant activation in key language areas, particularly the left inferior frontal gyrus.

Introduction: Astrocyte dysfunction plays a crucial role in epileptogenesis by impacting neuronal excitability and synaptic transmission. This study investigates how specific small molecules (SMs) affect the survival of astrocytes derived from various brain regions (the neocortex, hippocampus, or amygdala) of patients with medically refractory epilepsy. Methods: This study evaluated astrocyte responses ...

Aim: Brain arteriovenous malformations (AVMs) represent a complex vascular anomaly that carries a significant risk of complications. The Spetzler–Martin (SM) grading system and its supplementary variant (supp-SM) have been developed to estimate surgical risk; however, there remains a lack of consensus regarding grading systems that can accurately predict patient outcomes. Method: This study evaluated a cohort of 26 patients with brain AVM who underwent surgical resection at a single institution over seven years. The primary clinical and imaging characteristics of the patients were assessed. Utilizing Python for data analysis, this study aimed to identify correlations among the SM and supp-SM grading, Glasgow Coma Scale (GCS) scores, postoperative Karnofsky Performance Scale (KPS), duration of intensive care unit admission, and intraoperative blood loss. In addition, we did a literature review on AVM surgical outcomes. Results: Incorporating GCS into the supp-SM grading framework significantly enhanced the predictive ability regarding intraoperative blood loss and KPS at discharge compared to using the SM or supp-SM grading in isolation. Conclusion: The combination of supp-SM grading and GCS is a more reliable indicator of postoperative outcomes for patients with brain AVMs. Nevertheless, additional longitudinal studies are required to substantiate this conclusion further.

Introduction: Carboxymethylcellulose/polyethylene oxide, also known as Oxiplex gel, is commonly used during lumbar discectomy operations. It serves to cover the surgical site, preventing adhesions and providing relief from pain and symptoms. However, there is ongoing debate regarding the extent of its beneficial effects on postoperative pain intensity, level of disability, and overall improvement of musculoskeletal conditions. Therefore, the objective of this study is to evaluate the advantages and limitations of using Oxiplex gel in lumbar laminectomy procedures specifically for herniated discs. Methods: A randomized controlled trial was conducted on 56 consecutive patients who were candidates for unilateral lumbar discectomy on one lumbar surface. The patients were chosen based on their clinical manifestations and imaging findings. After the initial assessment, the patients underwent either laminectomy or laminotomy surgery. Following the surgery, the patients were randomly assigned to either the intervention group (receiving Oxiplex gel) or the control group. This assignment was done using a computerized random number generator. Assessments were conducted before the operation, as well as 3 and 6 months post-surgery for all patients. Results: There was no significant difference found between the Oxiplex gel and control groups in terms of radicular and low back pain intensity, as well as disability scores, at different time points after surgery (p = 0.336, p = 0.65, and p = 0.336, respectively). Additionally, there were no significant differences found in the prevalence of sexual or sphincteric disorders between the two groups during postoperative assessments (p = 0.639 and p = 0.15, respectively). Furthermore, no significant differences were observed in the results of the postsurgical neuromuscular evaluation under different lower extremities conditions between the two groups. Conclusions: Based on our findings, it was observed that Oxiplex gel did not demonstrate any improvement in post-unilateral lumbar discectomy symptoms or musculoskeletal power.

Introduction: The primary and definitive diagnosis of meningioma is based on histological assessment; however, employing imaging methods, like Magnetic Resonance Imaging (MRI) is very helpful to describe lesion’s characteristics. Accordingly, we decided to study the effect of imaging factors, like MRI data on the volume of hemorrhage (estimated blood loss) during meningioma surgery. Methods: This was a cross-sectional, retrospective, and analytical study. The eligible patients were those with meningioma who were candidates for surgery. A total of 40 patients with meningioma were selected and assessed. The preoperative imaging findings were recorded, then estimated blood loss during the surgery was determined Results: A reverse association was revealed between the degree of proximity to the nearest sinus and the rate of bleeding. Furthermore, the size of the mass was positively associated with the rate of bleeding; however, there was no significant correlation between the volume of bleeding and other parameters, including the degree of edema, the volume of mass, the site of the tumor in the brain, and the histological subtype of the tumor. The mean time of operation was strongly correlated with blood loss. The rate of bleeding was more expected in hypertensive versus normotensive patients. Conclusion: Bleeding in various volumes could be a frequent finding in intracranial meningioma surgery. Overall, tumor size, the duration of surgery, a history of hypertension, and distance to the nearest sinuses were the main determinants for the severity of hemorrhage in patients undergoing meningioma surgery.

Introduction: We report a rare case of skull deformity in a child with shunted hydrocephalus. Case report: A 2.5-year-old boy with a history of cerebral palsy (CP), shunted hydrocephalus and seizures was admitted to our children's hospital with status epilepticus. This was initially controlled with anesthesia. He referred to us intubated. Head examination found a skull deformity (brachycephaly). Head CT revealed a remarkable deformity and bilateral chronic subdural hematomas. MRI demonstrated voluminous extra-axial masses over the cerebral convexities with high signal on T1 and T2 sequences in favor of hematoma. The patient had a bilateral frontoparietal craniotomy and evacuation of subdural/epidural hematomas. Neurological status improved on the next day but because of co-existent medical problems, the patients gradually deteriorated and died. Conclusion: Shunt-induced craniosynostosis is rarely seen nowadays thanks to early detection and treatment of infantile hydrocephalus. But in the setting of child neglect or low socioeconomic culture, it can occur. Although it usually results in a skull deformity similar to the primary craniosynostosis such as scaphocephaly, brachycephaly, it can induce a macrocephalic skull and subsequently associated chronic haematomas.