Publications by authors named "Bahram Aminmansour"

11 Publications

  • Page 1 of 1

Bifrontal Epidermoid Cyst.

Adv Biomed Res 2018 23;7:77. Epub 2018 May 23.

Department of Neurosurgery, Isfahan University of Medical Sciences, Alzahra Hospital, Isfahan, Iran.

In this paper, we will present a case of a 63-year-old female with bifrontal epidermoid tumor who has gone under bilateral craniotomy. In a case report study, a 63-year-old female with a chief complaint of progressive headache that has been admitted to Department of Neurosurgery was studied. Magnetic resonance imaging was performed for better evaluation. After detection of bifrontal epidermoid cyst, the patient underwent surgery, and following the surgery, a cut of the tumor has been excised, sent for pathology sampling and reviewed for detection of cyst. Microscopic review of the resected part reported normal brain tissue along with sections containing parts of cyst wall covered by squamous epithelium and huge amount of irregularly stratified keratin within its lumen, which clearly emphasizes on diagnosis of a typical epidermoid tumor. Bifrontal epidermoid cyst is rare, and according to our study, the clinical symptoms and patients imaging were consistent with other studies.
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http://dx.doi.org/10.4103/abr.abr_107_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991290PMC
May 2018

Association between Outcome of Severe Traumatic Brain Injury and Demographic, Clinical, Injury-related Variables of Patients.

Iran J Nurs Midwifery Res 2018 May-Jun;23(3):211-216

Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Traumatic brain injury (TBI) is a main health problem among communities. There exists a variety of effective factors on the outcome of patients with TBI. We describe the demographic, clinical, and injury related variables of the patients with severe TBI, and determine the predictors of outcome.

Materials And Methods: We did this cross-sectional study on all 267 adult patients with severe TBI admitted to three trauma centers of Isfahan University of Medical Sciences (IUMS) from March 20, 2014 to March 19, 2015. Data were extracted from patients' profiles. We considered the patients' outcome as discharged and died. We analyzed the collected data using descriptive (frequency, mean, and standard deviation) and analytical (independent -test, Mann-Whitney U-test, Kruskal-Wallis test and logistic regression) statistics in Statistical Package for the Social Sciences (SPSS) 16.0. We considered < 0.05 as the significance level.

Results: The mean (SD) age of patients was 43.86 (18.40) years. The majority of the population was men (87.27%). Road traffic accidents (RTAs) were the most common mechanism of trauma (79.40%). The mean (SD) of Glasgow coma scale (GCS) was 6.03 (3.11). In 50.19% of the patients, the pupillary reflex was absent. One hundred and twenty-four patients (46.44%) died before discharge. We found age, gender, GCS, pupillary reflex, hypernatremia, and increased intracranial pressure (IICP) as the predictors of death in severe TBI.

Conclusions: In this study, the mortality rate of patients with severe TBI was high. In addition, some factors were determined as the significant predictors of outcome. The findings can assist in planning to enhance the quality of care and reduce the mortality rate in the patients with severe TBI.
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http://dx.doi.org/10.4103/ijnmr.IJNMR_65_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954643PMC
June 2018

Effects of Mannitol 20% on Outcomes in Nontraumatic Intracerebral Hemorrhage.

Adv Biomed Res 2017 27;6:75. Epub 2017 Jun 27.

Department of Neurosurgery, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: A large number of stroke patients are not the perfect candidate for craniotomy and invasive procedures, so providing an alternative and noninvasive method, which is applicable in terms of costs and facilities, is necessary. Thus, the present study aimed to determine the effects of mannitol 20% on outcome of the patients with nontraumatic intracerebral hemorrhage (ICH) in patients admitted to Isfahan's Al-Zahra Hospital during 2012 and 2013.

Materials And Methods: This is a clinical trial study which is conducted during 2012-2013 in Isfahan's Al-Zahra Hospital. In this study, 41 patients suffering from ICH received mannitol 20% for 3 days, and volume of hemorrhage and Glasgow Coma Scale (GCS) of patients were controlled every 12 h. The collected data were analyzed via SPSS software.

Results: The mean ICH volume was 22.1 ± 6.3 ml in pre intervention and 38.4 ± 19.3 ml in post intervention, and according to the -paired test, before and after treatment the difference was significant ( < 0.001). Hemorrhage volume was stable in nine patients (22%), it increased in 25 patients (61%), and decreased in seven patients (17.1%). The mean index of GCS before and after treatment was 11.85 ± 1.6 and 9.37 ± 2.65, respectively. Moreover according to -paired test, the difference was significant before and after treatment ( < 0.001). During using mannitol, the GCS index was stable in eight patients (19.5%), it increased in eight patients (19.5%) and decreased in 25 patients (61%).

Conclusions: Mannitol injection was not effective in reducing hemorrhage size, and its use is not recommended, also, further studies in this field have been proposed.
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http://dx.doi.org/10.4103/2277-9175.192628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501019PMC
June 2017

Effects of progesterone and vitamin D on outcome of patients with acute traumatic spinal cord injury; a randomized, double-blind, placebo controlled study.

J Spinal Cord Med 2016 05 17;39(3):272-80. Epub 2015 Dec 17.

d Department of Psychiatry , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.

Background: Steroid hormones offer promising therapeutic perspectives during the acute phase of spinal cord injury (SCI) while the role of progesterone and vitamin D remain controversial. The aim of the current study was to investigate the effects of progesterone and vitamin D on functional outcome of patients with acute traumatic SCI.

Methods: This was a randomized clinical trial including 64 adult patients with acute traumatic SCI admitted within 8 hours of injury. All the patients received methylprednisolone on admission according to standard protocol (30 mg/kg as bolus dose and 15 mg/kg each 3 hours up to 24 hours). Patients were randomly assigned to receive intramuscular injection of 0.5 mg/kg progesterone twice daily and 5µg/kg oral vitamin D3 twice daily up to 5 days (n = 32) or placebo (n = 32). Patients were visited 6 days, 3 and 6 months after injury and motor and sensory function was assessed according to American Spinal Injury Association (ASIA) score.

Results: There was no significant difference between two study groups regarding age (P = 0.341), sex (P = 0.802) and therapy lag (P = 0.609). The motor powers and sensory function increased significantly after 6 months in both study groups. Those who received progesterone and vitamin D had significantly higher motor powers and sensory function after 6 months of therapy. Those who received the therapy within 4 hours of injury, had significantly higher motor powers and sensory function 6 months after treatment in progesterone and vitamin D group. Therapy lag was negatively associated with 6-month motor powers and sensory function in progesterone and vitamin D group.

Conclusions: Administration of progesterone and vitamin D in acute phase of traumatic SCI is associated with better functional recovery and outcome.
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http://dx.doi.org/10.1080/10790268.2015.1114224DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073761PMC
May 2016

Does disk space degeneration according to Los Angeles and Modic scales have relation with recurrent disk herniation?

Adv Biomed Res 2014 20;3:220. Epub 2014 Nov 20.

Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: After single disk herniation operation, about 5-20% recurrences may occur. Different etiology may affect the prevalence of recurrence. Disk degeneration according to Modic and Los Angles scales could affect recurrence rate. This study wants to show the relationship between disk space degeneration according to these scales on severity, time, and prevalence of disk herniation recurrence.

Materials And Methods: Thirty-four patients presented with radicular pain (with or without back pain) and history of lumbar disk surgery was included in this prospective study. Pre- and postoperative T2-weighted sagittal magnetic resonance imaging (MRI) compared for Modic and Los Angeles disk degeneration grading, then, data analysis on SPSS (version 20) software, paired t-test, and others.

Results: The result of study shows for first operation that grade (II) Los Angeles is the most common, but, for second procedure grade (IV) was less common and the mostly decreased (from 14.7 to 9.2%). In addition, Wilcoxon test shows no change of Los Angeles grading for both first and second surgery (P = 0.06). Whereas; based on Modic criteria grading was different from first operation, in other words, grade (I) (41.2%) in first operation was changed to 20.6% in second operation (P = 0.007).

Conclusion: Our study showed that the Los Angeles criterion is more practical and useful for prediction of recurrence and in the patients with Los Angles grade III and IV and grade II and III on Modic scale, the chance of recurrence is less than patients with lower grades.
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http://dx.doi.org/10.4103/2277-9175.145125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260280PMC
December 2014

The efficacy of Cyclosporine-A on Diffuse Axonal Injury after Traumatic Brain Injury.

Adv Biomed Res 2014 14;3:35. Epub 2014 Jan 14.

Farzan Institute of Clinical Research, Tehran, Iran.

Background: To evaluate the efficacy and side-effects of cyclosporine-A (CsA) in improvement of consciousness and cognitive dysfunction of patients with diffuse axonal injury (DAI) after traumatic brain.

Materials And Methods: This study is designed as a randomized double-blind placebo-controlled with 100 patients suffered from DAI. CsA was administered to the intervention group (n = 50) as 5 mg/kg/24 h via 250 ml dextrose water (DW) 5% solution (DW 5%) during the first 8 h after trauma. The control group (n = 50) received only DW 5% in the same course. The presenting Glasgow coma scale in addition to the Glasgow outcome scale-extended (GOS-E) and mini-mental state examination (MMSE) in the 3(rd) and 6(th) months after trauma were documented. The serum values for complete blood count (CBC), blood urea nitrogen (BUN), creatinine (Cr), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) were checked to assess for complications.

Results: Most patients in both groups had type II DAI (46%). There was no significant difference between groups in the GOS-E scores after 3 and 6 months. All participants were in moderate or severe classes of MMSE with no statistically significant difference. Except for the higher BUN level in the cyclosporine treated group, 48 h after admission (P = 0.012), the difference in the level of Cr, AST, ALT, and ALP was not significant and all were in the normal range. The CBC results showed only significant difference for White Blood Cell (WBC) count at 12 h (P = 0.000).

Conclusion: The administration of CsA is not effective in the improvement of consciousness and cognitive function. However, it brings about no adverse effects.
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http://dx.doi.org/10.4103/2277-9175.125031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929016PMC
March 2014

A case of chondrosarcoma that primarily developed in the cervical spine.

Iran J Radiol 2012 Mar 25;9(1):57-9. Epub 2012 Mar 25.

Department of Radiology, Image Processing and Signal Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

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http://dx.doi.org/10.5812/iranjradiol.6344DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3522341PMC
March 2012

Comparison of the administration of progesterone versus progesterone and vitamin D in improvement of outcomes in patients with traumatic brain injury: A randomized clinical trial with placebo group.

Adv Biomed Res 2012 28;1:58. Epub 2012 Aug 28.

Department of Neurosurgery, Isfahan University Of Medical Sciences, Isfahan, Iran.

Background: Due to the heterogeneity of traumatic brain injury (TBI), many of single treatments have not been successful in prevention and cure of these kinds of injuries. The neuroprotective effect of progesterone drug on severe brain injuries has been identified, and recently, the neuroprotective effect of vitamin D has also been studied as the combination of these two drugs has shown better effects on animal samples in some studies. This study was conducted to examine the effect of vitamin D and progesterone on brain injury treatment after brain trauma.

Materials And Methods: This study was performed on patients with severe brain trauma (Glasgow Coma Scale (GCS) ≤ 8) from April to September, 2011. The patients were divided to 3 groups (placebo, progesterone, progesterone-vitamin D), each with 20 people. Upon the patients' admission, their GCS and demographic information were recorded. After 3 months, they were reassessed, and their GCS and GOS (Glasgow outcome scale) were recorded. The collected data were analyzed using SPSS 18 software (SPSS Inc., Chicago IL, USA).

Results: Before intervention, GCS mean of the placebo, progesterone, and progesterone-vitamin D groups were 6.3 ± 0.88, 6.31 ± 0.87, and 6 ± 0.88, respectively. They increased to 9.16 ± 1.11, 10.25 ± 1.34, and 11.27 ± 2.27, respectively 3 months after intervention. There was a significant difference among GCS means of the 3 groups (P-value = 0.001). GOS was classified to 2 main categories of favorable and unfavorable recovery, of which, favorable recovery in placebo, progesterone, and progesterone-vitamin D was 25%, 45%, and 60%, respectively which showed a statistical significant difference among the groups (P-value = 0.03).

Conclusion: The results showed that recovery rate in patients with severe brain trauma in the group receiving progesterone and vitamin D together was significantly higher than that of progesterone group, which was in turn higher than that of placebo group.
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http://dx.doi.org/10.4103/2277-9175.100176DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544099PMC
January 2013

Effect of decompressive hemicraniectomy on mortality of malignant middle cerebral artery infarction.

J Res Med Sci 2010 Nov;15(6):344-7

Associate Professor of Neurosurgery, Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Increasing intracranial pressure (ICP) is one of the leading causes of mortality in patients with malignant infarction of the middle cerebral artery (MCA). We prospectively evaluated patients with MCA infarction for one month survival after decompressive hemicraniectomy.

Methods: This study was conducted at Alzahra University Hospital, Isfahan (Iran). Twenty patients with infarction in total MCA distribution area, resulting in midline shift of brain tissue for greater than 5mm, underwent decompressive hemicraniectomy. Mortality rate was estimated one month after surgery.

Results: Patients were 8 (40%) males and 12 (60%) females with a mean age of 49.9 ± 3.8 (25 to 70) years. Left and right MCA were involved in 7 (35%) and 13 (65%) patients, respectively. Four (20%) patients died within one month after surgery (3 females and one male, mean age of 59.0 ± 4.5 vs. 47.6 ± 3.4 in survived patients, p < 0.001). The mean of baseline Glasscow Coma Scale (GCS) score estimated 8.60 ± 1.55 in survived patients and 6.75 ± 0.95 in patients who died (p < 0.05).

Conclusions: The survival rate of malignant MCA infarction treated with decompressive hemicraniectomy was the same as previous reports. MCA infarction mortality increased with age and lower admission GCS score.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3082838PMC
November 2010

Cerebral vasospasm following traumatic subarachnoid hemorrhage.

J Res Med Sci 2009 Nov;14(6):343-8

Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Cerebral vasospasm is a preventable cause of death and disability in patients who experience aneurysmal subarachnoid hemorrhage (SAH). The aim of this study is to investigate the incidence of cerebral vasospasm following traumatic SAH and its relationship with different brain injuries and severity of trauma.

Methods: This cross-sectional study was conducted from October 2006 to March 2007 in department of Neurosurgery in Al-Zahra Hospital. Consecutive head-injured patients who had SAH on the basis of an admission CT scan were prospectively evaluated. The severity of the trauma was evaluated by determining Glasgow Coma Scale (GCS) score on admission. Transcranial Doppler ultrasonography evaluations were performed at least 48 hours after admission and one week thereafter. Vasospasm in the MCA and ACA was defined by mean flow velocity (FV) of more than 120 cm/sec with a Lindegaard index (MVA/ICA FV ratio) higher than 3. Basilar artery vasospasm was defined by FV higher than 85 cm/sec.

Results: Seventy seven patients with tSAH were enrolled from whom 13 were excluded. The remaining were 52 (81.2%) men and 12 (18.7%) women, with a mean age of 37.89 years. Trauma was severe in 11 (17.2%), moderate in 13 (20.3%), and mild in 40 (62.5%) patients. From all, 27 patients (42.1%) experienced at least one vasospasm during the study period and MCA vasospasm was the most common in the first and second weeks (55.5%).

Conclusions: Traumatic SAH is associated with a high incidence of cerebral vasospasm with a higher probability in patients with severe TBI.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3129077PMC
November 2009

Effect of high-dose intravenous dexamethasone on postlumbar discectomy pain.

Spine (Phila Pa 1976) 2006 Oct;31(21):2415-7

Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.

Study Design: A prospective, randomized triple-blind clinical trial.

Objective: To evaluate the effect of 40 and 80 mg intravenous (IV) dexamethasone versus placebo to reduce postlumbar diskectomy pain.

Summary Of Background Data: Lumbar discectomy is a procedure to ablate radicular and low pack pain (LBP) in select patients. Unfortunately, some patients have radicular pain for several days after successful surgery, possibly caused by nerve root inflammation.

Methods: A total of 61 patients with single-level herniated lumbar disc at L4-L5 or L5-S1 were randomly assigned to 3 groups. After the skin incision, group 1 received 40 mg, group 2 received 80 mg IV dexamethasone, and group 3 received placebo. All patients also received 50 mg ranitidine IV at the same time. Preoperative and postoperative radicular and LBP were evaluated using the visual analog scale. Morphine was administered and recorded as a sole pain-killer during hospital admission if indicated. Collected data were analyzed using the 1-way analysis of variance test.

Results: A total of 61 consecutive patients entered the study. There were 19 patients who received 40 mg dexamethasone IV (group 1), 20 received 80 mg (group 2), and 22 received placebo (group 3). Preoperative data, including age, sex, level of disc herniation, and radicular and LBP, were statistically matched among groups. Postoperative LBP was decreased in all groups equally. Based on the visual analog scale, mean radicular pain was significantly decreased 4.26 points in group 1, 4.15 points in group 2 versus 2.73 points in group 3 (P = 0.006). Mean total morphine used was also significantly lower in group 1 versus group 3 (5.26 vs. 9 mg P = 0.012).

Conclusion: Intraoperative IV injection of 40 mg dexamethasone could effectively reduce postoperative radicular leg pain and narcotics usage in patients with single-level herniated lumbar disc.
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http://dx.doi.org/10.1097/01.brs.0000238668.49035.19DOI Listing
October 2006