Publications by authors named "Radwa K Soliman"

8 Publications

  • Page 1 of 1

Clinical and Radiological Characteristics of Acute Cerebrovascular Diseases Among Egyptian Patients With COVID-19 in Upper Egypt.

Front Neurol 2021 22;12:635856. Epub 2021 Mar 22.

Department of Neuropsychiatry, Faculty of Medicine, Aswan University Hospital, Aswan, Egypt.

There is little information on the acute cerebrovascular complications of coronavirus disease 2019 (COVID-19) in Egypt. The aim of this study was to estimate the proportion of acute cerebrovascular disease (CVD) among COVID-19 patients and evaluate their clinical and radiological characteristics in comparison with non-COVID-19 CVD. In a retrospective study, COVID-19 patients whom presented with CVD in Assiut and Aswan University Hospitals were compared with non-COVID-19, CVD patients, admitted to Qena University Hospital, prior to the pandemic. The following data were collected: clinical history and presentation, risk factors, comorbidities, brain imaging (MRI or CT), chest CT, and some laboratory investigations. Fifty-five (12.5%) of the 439 patients with COVID-19 had acute CVD. Of them, 42 (9.6%) had ischemic stroke while 13 patients (2.9%) had hemorrhagic CVD. In the 250 cases of the non-COVID-19 group, 180 had ischemic stroke and 70 had hemorrhagic stroke. A large proportion of patients with COVID-19 who presented with ischemic stroke had large vessel occlusion (LVO), which was significantly higher than in non-COVID-19 patients with CVD (40 vs. 7.2%, < 0.001). Comorbidities were recorded in 44 (80%) cases. In COVID-19 ischemic stroke patients, risk factors [hypertension and ischemic heart disease (IHD)] and comorbidities (hepatic and renal) were significantly higher than those in non-COVID-19 patients. In addition, 23.5% had hemorrhagic CVD, and six patients with LVO developed hemorrhagic transformation. Acute CVD among patients with COVID-19 was common in our study. LVO was the commonest. Hypertension, IHD, and anemia are the most common risk factors and could contribute to the worsening of clinical presentation. Comorbidities were common among patients with CVD, although a large number had elevated liver enzymes and creatinine that were partially due to COVID-19 infection itself. The current results begin to characterize the spectrum of CVD associated with COVID-19 in patients in Upper Egypt. The ID number of this study is IRB no: 17300470.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fneur.2021.635856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019810PMC
March 2021

Surveillance Study of Acute Neurological Manifestations among 439 Egyptian Patients with COVID-19 in Assiut and Aswan University Hospitals.

Neuroepidemiology 2021 Feb 25:1-10. Epub 2021 Feb 25.

Department of Neuropsychiatry, Assiut University Hospital, Faculty of Medicine, Aswan, Egypt.

Background: COVID-19 can be accompanied by acute neurological complications of both central and peripheral nervous systems (CNS and PNS). In this study, we estimate the frequency of such complications among hospital inpatients with COVID-19 in Assiut and Aswan university hospitals.

Materials And Methods: We screened all patients with suspected COVID-19 admitted from 1 June to 10 August 2020 to the university hospitals of Assiut and Aswan in Upper Egypt. Clinical and laboratory tests, CT/MRI of the chest and brain, and neurophysiology study were performed for each patient if indicated.

Results: 439 patients had confirmed/probable COVID-19; neurological manifestations occurred in 222. Of these, 117 had acute neurological disease and the remainder had nonspecific neuropsychiatric symptoms such as headache, vertigo, and depression. The CNS was affected in 75 patients: 55 had stroke and the others had convulsions (5), encephalitis (6), hypoxic encephalopathy (4), cord myelopathy (2), relapse of multiple sclerosis (2), and meningoencephalitis (1). The PNS was affected in 42 patients: the majority had anosmia and ageusia (31) and the others had Guillain-Barré syndrome (4), peripheral neuropathy (3), myasthenia gravis (MG, 2), or myositis (2). Fever, respiratory symptoms, and headache were the most common general symptoms. Hypertension, diabetes mellitus, and ischemic heart disease were the most common comorbidities in patients with CNS affection.

Conclusion: In COVID-19, both the CNS and PNS are affected. Stroke was the most common complication for CNS, and anosmia and/or ageusia were common for PNS diseases. However, there were 6 cases of encephalitis, 2 cases of spinal cord myelopathy, 2 cases of MG, and 2 cases of myositis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000513647DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8018217PMC
February 2021

Combined therapy with conventional trans-arterial chemoembolization (cTACE) and microwave ablation (MWA) for hepatocellular carcinoma >3-<5 cm.

Int J Hyperthermia 2021 ;38(1):248-256

Diagnostic Radiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Purpose: To compare safety and efficacy of combined therapy with conventional transarterial chemoembolization (cTACE)+microwave ablation (MWA) versus only TACE or MWA for treatment of hepatocellular carcinoma (HCC) >3-<5 cm.

Methods: This randomized controlled trial (NCT04721470) screened 278 patients with HCC >3-<5 cm. Patients were randomized into three groups: 90 underwent TACE (Group 1); 95 underwent MWA (Group 2); and 93 underwent combined therapy (Group 3). Patients were followed-up with contrast-enhanced CT or MRI. Images were evaluated and compared for treatment response and adverse events based on modified response evaluation criteria in solid tumor. Serum alpha-fetoprotein (AFP) concentration was measured at baseline and during every follow-up visit.

Results: Final analysis included 265 patients (154 men, 111 women; mean age = 54.5 ± 11.8 years; range = 38-76 years). Complete response was achieved by 86.5% of patients who received combined therapy compared with 54.8% with only TACE and 56.5% with only MWA ( = 0.0002). The recurrence rate after 12 months was significantly lower in Group 3 (22.47%) than Groups 1 (60.7%) and 2 (51.1%) ( = 0.0001). The overall survival rate (three years after therapy) was significantly higher in Group 3 (69.6%) than Groups 1 (54.7%) and 2 (54.3%) ( = 0.02). The mean progression-free survival was significantly higher in Group 3 than groups 1 and 2 ( < 0.001). A decrease in AFP concentration was seen in 75%, 63%, and 48% patients of Group 3, 2, and 1, respectively.

Conclusions: Combined therapy with cTACE + MWA is safe, well-tolerated, and more effective than TACE or MWA alone for treatment of HCC >3-<5 cm.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/02656736.2021.1887941DOI Listing
January 2021

Texture analysis of apparent diffusion coefficient (ADC) map for glioma grading: Analysis of whole tumoral and peri-tumoral tissue.

Diagn Interv Imaging 2021 Jan 5. Epub 2021 Jan 5.

Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.

Purpose: To prospectively investigate the capabilities of texture analysis (TA) based on apparent diffusion coefficient (ADC) map of the entire tumor volume and the whole volume of peri-tumoral edema, in discriminating between high-grade glioma (HGG) and low-grade glioma (LGG).

Materials And Methods: A total of 33 patients with histopathological proven glioma were prospectively included. There were 20 men and 13 women with a mean age of 54.5±14.7 (standard deviation [SD]) years (range: 34-75years). TA parameters of whole tumor and peri-tumoral edema were extracted from the ADC map obtained with diffusion-weighted spin-echo echo-planar magnetic resonance imaging at 1.5-T. TA variables of HGG were compared to those of LGG. The optimum cut-off values of TA variables and their corresponding sensitivity, specificity and accuracy for differentiating between LGG and HGG were calculated using receiver operating characteristic curve analysis.

Results: Mean and median tumoral ADC of HGG were significantly lower than those of LGG, at 1.23×10 mm/s and 1.21×10 mm/s cut-off values, yielding 70% sensitivity each (95% CI: 59-82% and 61-80%, respectively), 80% (95% CI: 79-98%) and 90% (95% CI: 82-97%) specificity, and 73% (95% CI: 66-91%) and 76% (95% CI: 72-90%) accuracy, respectively. Significant differences in tumoral and peri-tumoral kurtosis were found between HGG and LGG at 1.60 and 0.314 cut-off values yielding sensitivities of 74% (95% CI: 58-83%) and 70% (95% CI: 59-84%), specificities of 90% (95% CI: 80-95%) and 70% (95% CI: 64-83%) and accuracies of 79% (95% CI: 69-89%) and 70% (95% CI: 64-77%), respectively.

Conclusion: Measurements of whole tumoral and peri-tumoral TA, based on ADC maps, provide useful information that helps distinguish between HGG and LGG.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.diii.2020.12.001DOI Listing
January 2021

Case Report: Acute Spinal Cord Myelopathy in Patients With COVID-19.

Front Neurol 2020 22;11:610648. Epub 2020 Dec 22.

Department of Radiology, Assiut University Hospitals, Assiut, Egypt.

COVID-19 is typically associated with fever and severe respiratory symptoms including dry cough and dyspnea. However, COVID-19 may also affect both central and peripheral nervous systems. To date, the incidence rate of spinal cord involvement in COVID-19 is not known and the pathogenesis is still not fully understood. We report here two female patients admitted to Assiut University Hospitals/Egypt during the period from first of July to August 10, 2020. Both presented with a positive SARS-CoV-2 polymerase chain reaction (PCR) nasopharyngeal swab, elevated serum d-dimer and ferritin levels, and bilateral ground glass appearance in a CT chest scan. The first was a 60-year-old female with acute onset of flaccid paraplegia 10 days after flu-like symptoms, in whom MRI revealed transverse myelitis. The second was a 21-year-old female with symptoms of acute quadriplegia, fever, headache, and anosmia in whom an MRI scan revealed long cervico-thoracic myelopathy. Anterior spinal artery occlusion and possibly transverse myelitis were considered as differential diagnosis of long segment myelopathy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fneur.2020.610648DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7784375PMC
December 2020

Chondroma of the falx cerebri: A case report and review of literature.

Neuropathology 2019 Dec 4;39(6):461-466. Epub 2019 Oct 4.

Department of Radiology, Faculty of Medicine, Asyut University, Asyut, Egypt.

Chondroma is a benign cartilage-forming tumor which usually occurs in small bones of extremities but occasionally occurs in the brain. Usually, intracranial chondromas originate from skull base; however, chondroma of the falx cerebri is a very rare condition. We here report a rare case of falcine chondroma in a 19-year-old man who had normal physical examination without signs of any syndromic disorder. The neuroimaging findings were inconclusive, and the diagnosis was based on histopathological examination. The purpose of this paper is to raise attention about intracranial chondromas and suggest that chondroma must be ruled out in any patient presenting with masses arising from the falx.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/neup.12598DOI Listing
December 2019

Preoperative Grading of Glioma Using Dynamic Susceptibility Contrast MRI: Relative Cerebral Blood Volume Analysis of Intra-tumoural and Peri-tumoural Tissue.

Clin Neurol Neurosurg 2018 04 8;167:86-92. Epub 2018 Jan 8.

Diagnostic Radiology Department, Faculty of Medicine, Asyut University, Assiut, Egypt.

Objectives: To assess the usefulness of intra-tumor and peri-tumoral relative cerebral blood volume (rCBV) in preoperative glioma grading.

Patients And Methods: 21 patients with histopathologically confirmed glioma were included. Imaging was achieved on a 1.5T MRI scanner. Dynamic susceptibility contrast (DSC) MRI was performed using T2* weighted gradient echo-planner imaging (EPI). Multiple regions of interest (ROIs) have been drawn in the hotspots regions, the highest ROI has been selected to represent the rCBV of each intra-tumoral and peri-tumoral regions. Based on histopathology, tumors were subdivided into low grade and high grade. Receiver operating characteristic analysis (ROC) of rCBV, of both intra-tumoral and peri-tumoral regions, was performed to find cut-off values between high and low-grade tumors. The resulting sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated.

Results: Based on the histopathology, high-grade glioma (HGG) represented 76.2% whereas low-grade glioma (LGG) represented 23.8%. Both intra-tumoral and peri-tumoral rCBV of HGG were significantly higher than those of LGG. A cut-off value >2.9 for intra-tumoral rCBV provided sensitivity, specificity, and accuracy of 80%, 100%, and 85.7% respectively to differentiate between HGG and LGG. Additionally, the cut-off value >0.7 for peri-tumoral rCBV provided sensitivity, specificity, and accuracy of 100%, 66.6%, and 90.5% respectively to differentiate between HGG and LGG.

Conclusion: rCBV of each of intra-tumoral and peri-tumoral rCBV are significantly reliable for the preoperative distinction between HGG and LGG. Combined intra-tumoral and peri-tumoral rCBV provides overall better diagnostic accuracy and helps to decrease the invasive intervention for non-surgical candidates.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clineuro.2018.01.003DOI Listing
April 2018

Suprasellar pilocytic astrocytoma in an adult with hemorrhage and leptomeningeal dissemination: case report and review of literature.

Radiol Case Rep 2016 Dec 29;11(4):411-418. Epub 2016 Sep 29.

Institute of Neuro-Radiology, University of Zürich, University Hospital Zürich, FrauenKlinkstrasse 10 CH-8091, Zürich, Switzerland.

Pilocytic astrocytoma (PA) is a low-grade tumor. It has an excellent prognosis after total resection. Leptomeningeal dissemination and hemorrhage are very rare to be associated with PA and lead to unfavorable prognosis. A 35-year-old man was diagnosed with a hemorrhagic suprasellar PA in 2006. Subsequent examination in 2007 revealed another large subdural hemorrhagic lesion in the sacral region, which proved to be PA by histopathologic assessment. Other leptomeningeal foci were discovered mainly at the craniocervical junction. The patient underwent subtotal resection and received chemotherapy with disease control for 7 years. Progression of the disseminated disease has recently occurred; however, the patient is still alive with stable disease after radiotherapy. The radiological features, management, and relevant literature are also presented. Our report heightens the awareness of PA in the adult population and the importance of close surveillance for the leptomeningeal spread, especially for sellar region tumors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.radcr.2016.08.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5128392PMC
December 2016