Publications by authors named "Mohammed Benzagmout"

36 Publications

Impact of mental imagery on enhancing surgical skills learning in novice's surgeons: a pilot study.

BMC Med Educ 2021 Oct 28;21(1):545. Epub 2021 Oct 28.

Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy of Fez, Sidi Mohammed Ben Abdellah University, BP. 1893; Km 2.200, Sidi Hrazem Road, 30000, Fez, Morocco.

Objective: Mental imagery (MI) has long been used in learning in both fields of sports and arts. However, it is restrictively applied in surgical training according to the medical literature. Few studies have evaluated its' feasibility and usefulness. The aim of this study is to assess the impact of mental imagery on surgical skills learning among novice's surgeons.

Material And Methods: In this pilot prospective randomized comparative study; we recruited 17 residents and interns of surgery education curriculum. They were all included in their first semester of the curricula. Two groups were randomly designed. Group (a) including "Mental Imagery" volunteers (n = 9) which benefited from a mental imagery rehearsal exercise prior to physical practice, while the control group (b) (n = 8) didn't underwent any MI process prior to surgery practice. Each participant of both groups was invited to perform an intestinal hand-sewn anastomosis on bovine intestine. Each procedure was evaluated and analyzed according to 14 qualitative criteria while each criterion was scored 0, 1 or 2 respectively assigned to the gesture was not acquired, gesture was performed with effort, or mastered gesture. The final score is 28 for those who master all 14 gestures. A non-parametric statistical comparison between the both studied groups was performed.

Results: Both groups of surgery students demonstrated equivalent age, sex ratio, laterality, and surgical experience. The mean overall score is significantly higher in the MI group (a) (17.78; SD = 2.42) compared to the control group (b) (10.63, SD = 2.85). However, advanced analysis of individual assessment items showed significant statistical difference between both groups only in 6 out of 14 assessed items.

Conclusion: Indeed, mental imagery will not be able to substitute the traditional learning of surgery for novice surgeons; it is an important approach for improving the technical skills acquisition and shortening the physical learning.
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http://dx.doi.org/10.1186/s12909-021-02987-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555244PMC
October 2021

Subdural Empyema Complicating a Giant Fronto-Ethmoidal Osteoma.

Asian J Neurosurg 2020 Jul-Sep;15(3):737-740. Epub 2020 Aug 28.

Department of Neurosurgery, Hassan II Hospital, Medical School of Fez, University Sidi Mohammed Ben Abdellah, Fez, Morocco.

Osteomas of the paranasal sinuses rarely lead to intracranial manifestations. We present an unusual case of a giant frontal sinus osteoma leading to subdural empyema formation. Determine the origin and the optimal surgical approach of these unusual lesions by analyzing giant osteomas of the frontal and ethmoidal sinuses in the literature. We report a rare case of giant frontoethmoidal osteoma with intracranial extension in a 34-year-old man, revealed by seizures. Neuroradiological studies revealed frontoparietal subdural empyema associated to a large osteoma in the right frontal sinus. The patient underwent surgical evacuation of the empyema and resection of the osteoma in one stage operation of decompressive craniotomy. The patient recovered very well after surgery and postoperative antibiotic therapy. This case represents in the literature only the third-reported case of subdural empyema complicating frontoethmoidal osteoma. The surgical treatment options, including open surgery techniques and endoscopic approaches, as well as pathogenesis are discussed according to the relevant literature.
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http://dx.doi.org/10.4103/ajns.AJNS_196_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591205PMC
August 2020

Bumpy head, unusual gliosarcoma metastasis.

Surg Neurol Int 2020 25;11:311. Epub 2020 Sep 25.

Department of Neurosurgery, Hassan II Hospital, University Medical School Sidi Mohamed Ben Abdellah, Fez, Morocco.

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http://dx.doi.org/10.25259/SNI_548_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568115PMC
September 2020

Letter: Neurosurgery at war with the COVID-19 pandemic: patient's management from an African neurosurgical center.

Acta Neurochir (Wien) 2020 08 30;162(8):1787-1788. Epub 2020 May 30.

Department of neurosurgery, University Hassan II Hospital, Fez, Morocco.

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http://dx.doi.org/10.1007/s00701-020-04406-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261040PMC
August 2020

ATRT of lateral ventricle in a child: A Rare Tumor at a Very Rare Location.

Asian J Neurosurg 2020 Jan-Mar;15(1):225-229. Epub 2020 Feb 25.

Department of Neurosurgery, Hassan II Hospital, University Sidi Mohammed Ben Abdellah, Fez, Morocco.

Atypical teratoid/rhabdoid tumors (AT/RTs) of infancy are highly malignant central nervous system neoplasms that are most commonly seen during the first 2 years of life with limited therapeutic options. To date, only two cases have been described in the lateral ventricle. A 4-year-old boy presented with a 4-month history of increased intracranial pressure. Cerebral magnetic resonance imaging (MRI) revealed a huge intraventricular tumor, occupying the entire temporal horn and the body of the left lateral ventricle. The boy was operated through a left temporal transventricular approach with gross total removal of the lesion. The histopathological diagnosis was an AT/RT. The infant underwent adjuvant chemotherapy and radiation therapy. The 1-year MRI of control showed a local recurrence of the tumor. Then after, Gamma Knife radiosurgery was performed because of the small volume and the deep location of the lesion. At the 3-month follow-up, the MRI showed a significant growth of the tumor volume, and the child was given additional adjuvant chemotherapy. Unfortunately, he died 9 months later. AT/RT of the lateral ventricle is a very rare tumor in children, associated with a poor prognosis in spite of multimodal treatment. Gamma knife surgery (GKS) was rarely reported as a treatment modality of AT/RT. The aim of this work is to discuss about the rarity of this tumor and the best treatment strategy to improve prognosis.
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http://dx.doi.org/10.4103/ajns.AJNS_128_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057871PMC
February 2020

Posterior epidural migration of a lumbar disc herniation.

Surg Neurol Int 2020 3;11. Epub 2020 Jan 3.

Department of Neurosurgery, University Hospital Hassan II, Morocco.

Background: Posterior epidural migration of a lumbar disc fragment (PEMLDF) refers to the dorsal migration of disc material around the thecal sac that can lead to radiculopathy and/or cause a cauda equina syndrome. It is rare and the diagnosis is often just established intraoperatively.

Case Description: A 50-year-old male with a chronic history of low back pain and psychosis presented with PEMLDF originating at the L4-L5 level.

Conclusion: Lumbar disc herniations rarely present as PEMLDF resulting in symptoms varying from radiculopathy to cauda equina syndrome. These should be included among the differential diagnostic considerations for dorsolateral epidural lesions.
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http://dx.doi.org/10.25259/SNI_67_2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969374PMC
January 2020

Spinal Arteriovenous Fistulas of the Filum Terminale: Case Report and Literature Review.

Asian J Neurosurg 2019 Oct-Dec;14(4):1277-1282. Epub 2019 Nov 25.

Department of Neurosurgery, Hassan II Hospital, University Medical School of Fez, Sidi Mohamed Ben Abdellah, Fez, Morocco.

Spiinal arteriovenous fistulae (AVF) are an uncommon cause of myelopathy that require a high degree of suspicion to diagnose. Treatment strategies have not yet been established. Only a few cases of AVFs of the filum terminale (FT) have been reported. In this review, we describe clinical presentation, imaging, and treatment options for this rare type of spinal AV shunt. A 43-year-old male patient presented with progressive low back pain and paraparesis with gradually worsening bilateral foot paresthesias and sphincter dysfunction. He underwent magnetic resonance imaging, which revealed a hypersignal in the thoracolumbar cord and angiography diagnosed a microfistula of the FT. Surgery was preferred over endovascular treatment and we realized an L5 laminectomy to open the dura mater and found a hypertrophic FT. After identifying the fistula which was closely related to cauda equina, and dissecting the root from the fistula, a permanent clip was placed on the proximal part of the arterialized vein. Surgery was uneventful, and 6 months postoperatively, the patient has fully recovered. FT AVFs although rare should be considered as a differential diagnosis of progressive paraparesis, and successful surgery through clipping relies on the angioarchitecture of the shunt and the clinical manifestations of the patient.
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http://dx.doi.org/10.4103/ajns.AJNS_100_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896622PMC
November 2019

[Spinal schwannomas: case series].

Pan Afr Med J 2019 15;33:199. Epub 2019 Jul 15.

University Hassan II Hospital, Neurosurgery Department, Fez, Morocco.

Spinal schwannomas are benign tumors accounting for 30% of all spinal tumors. They originate from the shwann cells of the spinal roots. We report our experience in managing patients with spinal shwannomas, from diagnosis to treatment modalities, in the Department of Neurosurgery at the University Hospital Hassan II in Fez over a period of 13 years. The patients with spinal shwannomas accounted for 19.5% of those with spinal cord compression treated surgically over the same period. The average age of patients was 45 years, with a discreet female predominance. Spinal schwannomas had an insidious onset, then the median of consultation time was 18 months. The main symptoms were spinal and radicular pain. Half of our patients had neurological deficits. Medullary MRI was performed in all of our patients. Spinal schwannomas occurred predominantly in the chest (40%); 62% of shwannomas were intradural lesions, rarely extradural lesions (8%) and mixed lesions(4%). Complete Surgical resection was performed in 96% of cases with osteosynthesis in two cases and arthrodesis in a single case. Histological examination confirmed the diagnosis of benign neurinoma in 23 cases, malignant shwannoma in one case and neurofibroma in one case. Outcome was favorable in the majority of cases, two patients had complications, an infection of the wall and neurological worsening. The interest in the subject of our study is to highlight the features of these lesions and to compare the results of our case series with the data in the literature.
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http://dx.doi.org/10.11604/pamj.2019.33.199.17921DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6814336PMC
November 2019

Giant cystic schwannoma of the cauda equina.

Ann Afr Med 2019 Jul-Sep;18(3):180-183

Department of Neurosurgery, University Hospital of Fez, Fez, Morocco.

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http://dx.doi.org/10.4103/aam.aam_61_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704803PMC
February 2020

Variation of Ventricular Size after Surgical Treatment of Chronic Subdural Hematoma.

Asian J Neurosurg 2019 Jan-Mar;14(1):122-125

Department of Neurosurgery, University Hospital Hassan II, Fes, Morocco.

Background: Surgical removal is the treatment of choice for chronic subdural hematoma (CSDH). Despite clinical improvement after surgery, computed tomography (CT) scan control often showed residual collection, which may discuss the possibility of failed surgery. The aim of this study is the assessment of ventricular size before and after surgery and to study its relation with residual hematoma.

Methods: In this prospective study (2013-2016), 63 patients who had burr-hole drainage of CSDH were sequentially allocated to either two groups; Group 1 with CT scan control under the 3 day of surgery and Group 2 with delayed CT scan control (from 4 to 7 day). Linear measure of ventricular size was assessed by Evans' index. We reviewed and analyzed the data between both groups.

Results: There were 33 patients in Group 1 and 30 patients in Group 2. Preoperatively, the average thickness of hematoma was 20.5 mm in Group 1 versus 19.9 mm in Group 2 ( = 0.67); the mean midline shift was 8.5 mm in each group; Evans' index was 26.7% in Group 1 and 27% in Group 2 ( = 0.7). Postoperatively, the mean thickness of the residual hematoma was 7.7 mm in Group 1 and 8.4 mm in Group 2 ( = 0.57); the mean midline shift was 3.3 mm in Group 1 and 1.9 mm in Group 2 ( = 0.08); Evan's index was 28.5% in Group 1 and 32.1% in Group 2 ( = 0.002).

Conclusion: The adoption of Evans' index, for assessing the variation of ventricular size after surgery, by neurosurgeons appears to be a good and simple method for evaluation and following the success of surgical removal of CSDH, despite the observation of some residual collection in early CT scan control.
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http://dx.doi.org/10.4103/ajns.AJNS_298_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417319PMC
April 2019

Emotion processing in Parkinson's disease: a blood oxygenation level-dependent functional magnetic resonance imaging study.

Neural Regen Res 2019 Apr;14(4):666-672

Laboratory of Clinical Neuroscience, Faculty of Medicine, Fez, Morocco; Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France.

Parkinson's disease is a neurodegenerative disorder caused by loss of dopamine neurons in the substantia nigra pars compacta. Tremor, rigidity, and bradykinesia are the major symptoms of the disease. These motor impairments are often accompanied by affective and emotional dysfunctions which have been largely studied over the last decade. The aim of this study was to investigate emotional processing organization in the brain of patients with Parkinson's disease and to explore whether there are differences between recognition of different types of emotions in Parkinson's disease. We examined 18 patients with Parkinson's disease (8 men, 10 women) with no history of neurological or psychiatric comorbidities. All these patients underwent identical brain blood oxygenation level-dependent functional magnetic resonance imaging for emotion evaluation. Blood oxygenation level-dependent functional magnetic resonance imaging results revealed that the occipito-temporal cortices, insula, orbitofrontal cortex, basal ganglia, and parietal cortex which are involved in emotion processing, were activated during the functional control. Additionally, positive emotions activate larger volumes of the same anatomical entities than neutral and negative emotions. Results also revealed that Parkinson's disease associated with emotional disorders are increasingly recognized as disabling as classic motor symptoms. These findings help clinical physicians to recognize the emotional dysfunction of patients with Parkinson's disease.
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http://dx.doi.org/10.4103/1673-5374.247470DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352597PMC
April 2019

Assessment of Primary Brain Lymphoma Using Multimodal Magnetic Resonance Imaging and Proton Magnetic Resonance Spectroscopy.

Asian J Neurosurg 2018 Oct-Dec;13(4):1205-1208

Department of Biophysics, Clinical Neuroscience Laboratory, Faculty of Medicine and Pharmacy, University of Fez, Fez, Morocco.

Objectives: The primary lymphoma of the central nervous system is a cancer rare. The diagnosis of this tumoral entity must be considered as an emergency considering the therapeutical involved. Therefore, we report this entity while reporting diagnostic challenges.

Patients And Methods: Unfortunately, the conventional clinical and imaging signs can be confusing and might contribute to delay the diagnosis process of potentially curable pathological entity. The diagnosis confirmation in immunocompetent patients is based on a stereotaxic biopsy.

Results And Conclusion: In this paper, we report a case illustrating the contribution of multimodal imaging including diffusion-weighted magnetic resonance imaging (MRI), diffusion tensor MRI, perfusion MRI, and proton MR spectroscopy to the diagnostic approach of the atypical primary lymphoma of the central nervous system.
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http://dx.doi.org/10.4103/ajns.AJNS_137_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208237PMC
November 2018

Infected Intradural Dermoid Cyst with Complete Dermal Sinus of Posterior Fossa.

World Neurosurg 2018 Aug 16;116:219-224. Epub 2018 May 16.

Department of Neurosurgery, Hassan II Teaching Hospital, Sidi Mohamed Ben Abdellah University, Fez, Morocco.

Background: Intracranial dermoid cysts are benign embryologic tumors. They occur most often in children and young adults. Infected intradural dermoid cyst with complete dermal sinus of posterior fossa is rare. The main feature of this dermal sinus is the continuity from the intradural cyst through the occipital bone to the skin.

Methods: We report 2 cases of infected intradural dermoid cyst with complete dermal sinus of posterior fossa in children, with special attention to the clinical and anatomical features of this rare combination of anomalies.

Results: A 5-year-old boy presented with a midline cystic lesion responsible for triventricular hydrocephalus revealed by a cerebellar syndrome and a dermal sinus. The second case was a 36-month-old girl who had an occipital cystic lesion that was limited by a pseudo-wall with diffusion restriction revealed by a double dermal sinus. We inserted an external shunt to relieve the increased intracranial pressure then performed a suboccipital approach for excision followed by systemic antibiotic therapy. Both cases had satisfactory outcomes.

Conclusions: Infected intradural dermoid cyst with complete dermal sinus of posterior fossa is rare, and a double dermal sinus has not yet published, to our knowledge.
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http://dx.doi.org/10.1016/j.wneu.2018.05.011DOI Listing
August 2018

Amplification and Mutations in Glioblastoma Patients of the Northeast of Morocco.

Biomed Res Int 2017 13;2017:8045859. Epub 2017 Jul 13.

Pathological Anatomy and Molecular Pathology Service, University Hospital Hassan II of Fez, Fez, Morocco.

Glioblastomas are the most frequent and aggressive primary brain tumors which are expressing various evolutions, aggressiveness, and prognosis. Thus, the 2007 World Health Organization classification based solely on the histological criteria is no longer sufficient. It should be complemented by molecular analysis for a true histomolecular classification. The new 2016 WHO classification of tumors of the central nervous system uses molecular parameters in addition to histology to reclassify these tumors and reduce the interobserver variability. The aim of this study is to determine the prevalence of mutations and amplifications in the population of the northeast region of Morocco and then to compare the results with other studies. . codon 132 and codon 172 were directly sequenced and the amplification of exon 20 of gene was investigated by qPCR in 65 glioblastoma tumors diagnosed at the University Hospital of Fez between 2010 and 2014. . The R132H mutation was observed in 8 of 65 tumor samples (12.31%). No mutation of was detected. amplification was identified in 17 cases (26.15%). . A systematic search of both histological and molecular markers should be requisite for a good diagnosis and a better management of glioblastomas.
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http://dx.doi.org/10.1155/2017/8045859DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5530437PMC
April 2018

Blood Oxygenation Level-Dependent Functional MRI of Early Evidences of Brain Plasticity after Hemodialysis Session by Helixone Membrane of Patients with Indices of Adrenal Deficiency.

Ann Neurosci 2017 May 12;24(2):82-89. Epub 2017 May 12.

The Clinical Neuroscience Laboratory, Faculty of Medicine of Fez, University Hospital of Fez, Fez, Morocco.

Background: Various alterations of hypothalamic-pituitary-adrenal axis function have been described in patients with chronic renal failure. Nevertheless, controversial evidences were stated about the association between adrenal function deficiency (AD) and hemodialysis (HD).

Purpose: The goal of this paper was to estimate indirect indices of the adrenal gland dysfunction which is potentially influenced by oxidative stress (OS) that still generates brain plasticity and reorganization of the functional control.

Methods: Two male patients undergoing HD by the synthetic Helixone membrane for more than 6 months at the HD Center of the University Hospital of Fez, Fez, Morocco, were recruited. They underwent identical assessment immediately before and after the full HD session; this consisted of a blood ionogram revealing rates of sodium and calcium, and brain blood oxygenation level-dependent functional MRI (BOLD-fMRI) using a motor paradigm in block design.

Results: The blood ionogram revealed hypercalcemia and hyponatremia in both patients. Both biological assessment and BOLD-fMRI study results revealed a high level of OS that induced activation of a significantly large brain volume area suggesting the occurrence of possible brain plasticity and functional control reorganization induced by free radicals and enhanced by AD.

Conclusion: The occurrence of brain plasticity and functional control reorganization was demonstrated in both patients studied who were undergoing HD by BOLD-fMRI with a notable sensitivity; this plasticity is induced by elevated OS occasioned by HD technique itself and probably amplified by AD. Similar results were found in a previous study performed on the same patients undergoing HD by a polysulfone membrane.
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http://dx.doi.org/10.1159/000475897DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5448452PMC
May 2017

Indices of adrenal deficiency involved in brain plasticity and functional control reorganization in hemodialysis patients with polysulfone membrane: BOLD-fMRI study.

J Integr Neurosci 2016 Jun 14;15(2):191-203. Epub 2016 Jun 14.

§ Department of Nephrology, University Hospital of Fez, Fez, Morocco.

This work purpose was to estimate the implication of suspected adrenal function deficiencies, which was influenced by oxidative stress (OS) that are generating brain plasticity, and reorganization of the functional control. This phenomenon was revealed in two-hemodialysis patients described in this paper. Blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) revealed a significant activation of the motor cortex. Hemodialysis seems to originate an inflammatory state of the cerebral tissue reflected by increased OS, while expected to decrease since hemodialysis eliminates free radicals responsible for OS. Considering adrenal function deficiencies, sensitivity to OS and assessed hyponatremia and hypercalcemia, adrenal function deficiencies is strongly suspected in both patients. This probably contributes to amplify brain plasticity and a reorganization of functional control after hemodialysis that is compared to earlier reported studies. Brain plasticity and functional control reorganization was revealed by BOLD-fMRI with a remarkable sensitivity. Brain plastic changes are originated by elevated OS associating indices of adrenal function deficiencies. These results raise important issues about adrenal functional deficiencies impact on brain plasticity in chronic hemodialysis-patients. This motivates more global studies of plasticity induced factors in this category of patients including adrenal functional deficiencies and OS.
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http://dx.doi.org/10.1142/S0219635216500126DOI Listing
June 2016

Implications of oxidative stress in the brain plasticity originated by fasting: a BOLD-fMRI study.

Nutr Neurosci 2017 Nov 8;20(9):505-512. Epub 2016 Jun 8.

b Clinical Neuroscience Laboratory, Faculty of Medicine and Pharmacy , University of Fez , Morocco.

Objectives: The goal of this study was assessing the intermittent fasting effect on brain plasticity and oxidative stress (OS) using blood-oxygenation-level dependent (BOLD)-functional magnetic resonance image (fMRI) approach. Evidences of physiological and molecular phenomena involved in this process are discussed and compared to reported literature.

Method: Six fully healthy male non-smokers volunteered in this study. All volunteers were right handed, and have an equilibrated, consistent and healthy daily nutritional habit, and a healthy lifestyle. Participants were allowed consuming food during evening and night time while fasting with self-prohibiting food and liquids during 14 hours/day from sunrise to sunset. All participants underwent identical brain BOLD-fMRI protocol. The images were acquired in the Department of Radiology and Clinical Imaging of the University Hospital of Fez, Fez, Morocco. The anatomical brain and BOLD-fMRIs were acquired using a 1.5-Tesla scanner (Signa, General Electric, Milwaukee, United States). BOLD-fMRI image acquisition was done using single-shot gradient echo echo-planer imaging sequence. BOLD-fMRI paradigm consisted of the motor task where volunteers were asked to perform finger taping of the right hand. Two BOLD-fMRI scan sessions were performed, the first one between the 5th and 10th days preceding the start of fasting and the second between days 25th and 28th of the fasting month. All sessions were performed between 3:30 PM and 5:30 PM. Although individual maps were originated from different individual participants, they cover the same anatomic area in each case. Image processing and statistical analysis were conducted with Statistical Parameter Mapping version 8 (2008, Welcome Department of Cognitive Neurology, London UK).

Results And Discussion: The maximal BOLD signal changes were calculated for each subject in the motor area M1; Activation maps were calculated and overlaid on the anatomical images. Group analysis of the data was performed, and the average volume and the maximum intensity of BOLD signal in the activated area M1 was determined for all studied volunteers. The current study allowed measuring regional brain volumes and neural network activity before and during an extended period of fasting using BOLD-fMRI. This demonstrated and confirmed the impact of fasting on human brain structure and function. Further studies are required to elucidate mechanisms and enable direct inference of a diet-induced OS effect on the brain.
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http://dx.doi.org/10.1080/1028415X.2016.1191165DOI Listing
November 2017

Prevalence of IDH1/2 Mutations in Different Subtypes of Glioma in the North-East Population of Morocco.

Asian Pac J Cancer Prev 2016 ;17(5):2649-53

Groupe Hospitalier Pitie-Salpetriere, Laboratoire de Neuropathologie R Escourolle, Paris, France E-mail :

Background: Genetic alterations in gliomas have increasing importance for classification purposes. Thus, we are especially interested in studying IDH mutations which may feature potential roles in diagnosis, prognosis and response to treatment. Our aim was to investigate IDH mutations in diffuse glioma patients diagnosed in university hospital centre of Fez in Morocco.

Materials And Methods: IDH1 codon 132 and IDH2 codon 172 were direct-sequenced in 117 diffuse glioma samples diagnosed and treated in University Hospital Hassan II between 2010 and 2014.

Results: The R132H IDH1 mutation was identified in 43/117 tumor samples and R172K IDH2 mutation was detected in only one anaplastic oligodendroglioma. IDH mutations were observed in 63.2% of astrocytomas, 73.3% of diffuse oligodendrogliomas and 12.90% of glioblastomas.

Conclusions: Our results confirmed other studies published earlier for other populations with some small discrepancies.
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February 2017

A rare location of sacral tuberculosis: A report of three cases.

Eur J Rheumatol 2014 Jun 1;1(2):78-80. Epub 2014 Jun 1.

Department of Rheumatology, CHU Hassan II University Hospital, Fez, Morocco.

Tuberculosis remains one of the most common infectious diseases in the world. Vertebral tuberculosis is the commonest form of bone and joint tuberculosis; however, isolated sacral tuberculosis is rare. This atypical presentation may lead to a delay in diagnosis and treatment. We report three cases of sacral tuberculosis diagnosed in young women, aged 30, 23, and 35 years old, respectively. Lombosciatic pain was the main symptom in all cases. All patients had a biological assessment, plain radiographs, and CT scan. However, magnetic resonance imaging was done in only two cases. All patients underwent surgical sacral biopsy, and the diagnosis of tuberculosis was confirmed by histology in all cases. The evolution was satisfactory with the adjunction of antituberculous chemotherapy in all cases. Spinal tuberculosis should be the first and foremost differential diagnosis in the presence of atypical clinical and radiological features of a sacral lesion, particularly in developing countries. Early diagnosis and treatment could prevent or minimize the neurological morbidity in such cases.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042283PMC
http://dx.doi.org/10.5152/eurjrheumatol.2014.014DOI Listing
June 2014

Spontaneous pneumorrhachis and transverse myelitis complicating purulent meningitis.

J Glob Infect Dis 2013 Oct;5(4):179-82

Department of Intensive Care, University Hospital of Fez, Fez, Morocco.

Pneumorrhachis is the presence of air in the spinal canal; mostly, it has an iatrogenic origin. The association of this entity with spontaneous pneumomediastinum without any pneumothorax is rarely reported in the literature. The spontaneous resorption is the usual evolution. The association to acute transverse myelitis is discussed by the authors. The patient is a 21-year-old male with pneumorrhachis associated to a spontaneous pneumomediastinum was admitted at the emergency department for bacterial meningitis. The antibiotherapy has marked the clinical profile by disappearance of the meningeal signs in the 48 h after admission. In contrast, the neurological symptoms were of marked aggravation by appearance of a tetraparesis with a respiratory distress syndrome having required artificial ventilation. The computed tomography (CT) scan showed a typical hypodensity corresponding to paramedullary air extending to several thoracic segments. The spinal magnetic resonance imaging (MRI) showed a high cervical medullary edema without signs of compression. The patient died within 15 days with a profile of vasoparalysis resistant to vasoactive drugs. Pneumomediastinum associated to pneumorrhachis and transverse myelitis complicating purulent meningitis is a rare entity. Although the usual evolution is favorable, the occurrence of serious complications is possible.
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http://dx.doi.org/10.4103/0974-777X.122019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3958990PMC
October 2013

Multisystem Sarcoidosis in a Patient on Interferon-α Therapy for Chronic Hepatitis C.

J Glob Infect Dis 2012 Apr;4(2):128-31

Department of Hepatogastroenterology, University Hospital of Fez, Morocco.

Sarcoidosis is a chronic multisystemic granulomatous disease that is triggered by an autoimmune process. Nowadays, this pathology represents a well-recognized but uncommon complication for antiviral treatment in hepatitis C virus (HCV) infection. Herein, we report a remarkable case of 47-year-old woman treated for chronic HCV infection; the patient has developed interferon alfa-induced sarcoidosis involving the central nervous system. The evolution was fatal despite disrupting the antiviral therapy and initiating a high-dose corticotherapy. This complication of interferon alfa treatment was reported in the literature in only one case. Through this case and a review of the literature, we aim to underline the importance of screening for sarcoidosis before and during the follow-up of HCV patients undergoing antiviral therapy.
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http://dx.doi.org/10.4103/0974-777X.96779DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3385203PMC
April 2012

Hemorrhagic papillary glioneuronal tumor mimicking cavernoma: two case reports.

Clin Neurol Neurosurg 2013 Feb 18;115(2):200-3. Epub 2012 Jun 18.

Department of Neurosurgery, Hôpital de la Salpêtrière, Paris, France.

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http://dx.doi.org/10.1016/j.clineuro.2012.04.021DOI Listing
February 2013

Atypical radiological findings in cerebral hydatid disease.

Neurosciences (Riyadh) 2011 Jul;16(3):263-6

Department of Neurosurgery, University Hospital Hassan II, Fez, Morocco.

Cerebral hydatid disease is very rare, representing only 2% of all cerebral space occupying lesions. The diagnosis is usually based on a pathognomonic CT pattern. Exceptionally, the image is atypical raising suspicion of many differential diagnoses such as intracerebral infectious, vascular lesions, or tumors. We report 2 atypical cases of cerebral hydatid cysts diagnosed in a 21, and a 24-year-old woman. The CT scan results suggest oligodendroglioma in the first case and brain abscess in the second. An MRI was helpful in the diagnosis of the 2 cases. Both patients underwent successful surgery with a good outcome. The hydatid nature of the cyst was confirmed by histology in both cases.
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July 2011

Dermoid cyst of the posterior fossa.

Neurosciences (Riyadh) 2011 Apr;16(2):153-5

Department of Neurosurgery, University Hospital Hassan II, Fez, Morocco.

Intracranial dermoid tumors represent a rare clinical entity accounting for 0.1-0.7% of all intracranial tumors. Their location in the posterior fossa is uncommon. We report a 16-year-old male patient who presented with clinical signs of increased intracranial pressure and cerebellar symptoms. The CT scan revealed a median cystic lesion of the fourth ventricle causing an active triventicular hydrocephalus. The MRI showed a median well shaped cystic lesion, of low signal intensity compared to the CSF, with capsular contrast enhancement. He underwent endoscopic third ventriculostomy before subtotal removal of the lesion. The postoperative course was uneventful, and the histological diagnosis was a dermoid cyst. Through this observation, we aim to discuss the clinical, and radiological aspects of the posterior fossa dermoid cyst, and to review the therapeutic strategies.
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April 2011

Pott's disease in children.

Surg Neurol Int 2011 Jan 11;2. Epub 2011 Jan 11.

Department of Neurosurgery, University Hospital Hassan II, Fez- Morocco, Faculty of Medicine and Pharmacy of Fez, Morocco.

Background: The incidence of tuberculosis is increasing, and skeletal tuberculosis accounts for 10-20% of all extrapulmonary cases. Spinal tuberculosis occurs mostly in children and young adults. It causes bone destruction, spinal deformity and neural complications.

Materials And Methods: Our study includes 37 children (below 15 years of age) with spinal tuberculosis treated in our department in the last 6 years. The demographic data, clinical profile, surgical intervention and outcome of these children are reported.

Results: The mean age ranged from 4 to 15 years, with an average of 9.1 years, and the male/female ratio was 1.8. Thirty patients (81%) had progressive inflammatory rachialgia and only six patients (16.2%) had neurological symptoms. The lumbar spine was mostly affected (23 cases). All patients have benefited from antituberculous chemotherapy (Regimen 2SRHZ/10RH) associated with spinal immobilization during 3 months. The surgical treatment was indicated in seven patients because of the presence of large bilateral abscess of the psoas muscle in one patient and the presence of severe neurological symptoms in the six remaining patients. The evolution was favorable in all cases, including those with neurological symptoms. There was no case of death and the length of follow-up for these patients ranged between 1 and 4 years.

Conclusion: Spinal tuberculosis is still a prevalent disease in developing countries, mainly occurring in children. Complications of the disease can be devastating because of its ability to cause bone destruction, spinal deformity and paraplegia. Therefore, an early diagnosis and establishment of treatment are necessary to expect a good outcome.
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http://dx.doi.org/10.4103/2152-7806.75459DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031051PMC
January 2011

Spontaneous bilateral subacute subdural hematoma revealing intracranial hypotension.

Neurosciences (Riyadh) 2009 Oct;14(4):384-5

Department of Neurology, University Hospital Hassan II Fez, Morocco.

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October 2009

Arachnoid cyst of the posterior fossa.

Neurosciences (Riyadh) 2010 Oct;15(4):277-9

Department of Neurosurgery, University Hospital of Fez, Fez, Morocco.

Arachnoid cysts of the posterior fossa are uncommon. Our case of a 49-year-old man presented with a 2 month history of headaches, nausea, and vertigo associated with walking instability. An MRI revealed a median well-circumscribed cystic lesion of the posterior fossa, with similar signal characteristics to CSF, and without connection to the fourth ventricle. This aspect suggested either arachnoid or hydatid cysts. Direct open surgery was performed allowing complete removal of the cyst wall, with a good outcome.
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October 2010

Primary spinal epidural hydatid cyst with intrathoracic extension.

Neurosciences (Riyadh) 2009 Jan;14(1):81-3

Department of Neurosurgery, University Hospital Hassan II, Fez, Morocco. Tel. +212 (61) 297297. Fax. +212 (35) 944789. E-mail:

Spinal epidural localization of hydatid cyst is quite rare. We report a case of a 33-year-old patient who experienced paraparesis over 2 years, with an umbilical sensitive level. A CT scan and MRI showed an intrathoracic multilobar lesion, probably of intra-spinal origin. An anterolateral transpleural surgical approach confirmed the hydatic character of the observed lesion and enabled total spinal cord decompression. No osseous involvement was noted. We report a case of spinal epidural hydatid cyst successfully managed by an anterior approach, and we discuss epidemiological, diagnosis, and therapeutical features of this rare localization of hydatid cyst.
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January 2009
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