Publications by authors named "Salman Abbasi Fard"

14 Publications

  • Page 1 of 1

Fulminant and Diffuse Cerebral Toxoplasmosis as the First Manifestation of HIV Infection: A Case Presentation and Review of the Literature.

Am J Case Rep 2020 Jan 26;21:e919624. Epub 2020 Jan 26.

Department of Neurosurgery, National Skull Base Foundation, Thousand Oaks, CA, USA.

BACKGROUND One of the most common causes of central nervous system (CNS) opportunistic infections in immunocompromised patients is toxoplasmosis. It can cause focal or disseminated brain lesions leading to neurological deficit, coma, and death. Prompt management with optimal antibiotics is vital. However, the diagnosis of cerebral toxoplasmosis is challenging in infected individuals with human immunodeficiency virus (HIV). The possible diagnosis is based on clinical presentation, imaging, and specific serologic investigations. The diagnosis can be confirmed by histopathological examination and/or by finding nucleic material in the spinal cerebrospinal fluid (CSF) examination. CASE REPORT We present a review of the literature with a rare illustrative case of diffuse CNS toxoplasmosis as the first manifestation of HIV infection in a young patient. Brain MRI showed diffuse, ring-enhancing lesions, and significant midline shift. Decompressive hemicraniectomy for control of intracranial pressure and anti-infectious therapy were performed. CONCLUSIONS This should raise awareness that cerebral toxoplasmosis can occur in pediatric patients with HIV infection, and, more importantly, as the first manifestation of AIDS. Although the prognosis is often poor, early diagnosis and immediate treatment of this life-threatening opportunistic infection can improve outcomes.
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http://dx.doi.org/10.12659/AJCR.919624DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6998800PMC
January 2020

Instability in Thoracolumbar Trauma: Is a New Definition Warranted?

Clin Spine Surg 2017 Oct;30(8):E1046-E1049

Division of Neurosurgery, University of Arizona, Tucson, AZ.

Study Design: Review of the articles.

Objective: The objective of this study was to review all articles related to spinal instability to determine a consensus statement for a contemporary, practical definition applicable to thoracolumbar injuries.

Summary Of Background Data: Traumatic fractures of the thoracolumbar spine are common. These injuries can result in neurological deficits, disability, deformity, pain, and represent a great economic burden to society. The determination of spinal instability is an important task for spine surgeons, as treatment strategies rely heavily on this assessment. However, a clinically applicable definition of spinal stability remains elusive.

Materials And Methods: A review of the Medline database between 1930 and 2014 was performed limited to papers in English. Spinal instability, thoracolumbar, and spinal stability were used as search terms. Case reports were excluded. We reviewed listed references from pertinent search results and located relevant manuscripts from these lists as well.

Results: The search produced a total of 694 published articles. Twenty-five articles were eligible after abstract screening and underwent full review. A definition for spinal instability was described in only 4 of them. Definitions were primarily based on biomechanical and classification studies. No definitive parameters were outlined to define stability.

Conclusions: Thirty-six years after White and Panjabi's original definition of instability, and many classification schemes later, there remains no practical and meaningful definition for spinal instability in thoracolumbar trauma. Surgeon expertise and experience remains an important factor in stability determination. We propose that, at an initial assessment, a distinction should be made between immediate and delayed instability. This designation should better guide surgeons in decision making and patient counseling.
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http://dx.doi.org/10.1097/BSD.0000000000000314DOI Listing
October 2017

Prognostic factors in traumatic atlanto-occipital dislocation.

J Clin Neurosci 2016 Nov 21;33:63-68. Epub 2016 Aug 21.

Weill Cornell Brain and Spine Center, 525 East 68 Street, Box 99, New York, NY 10065, USA.

Traumatic atlanto-occipital dislocation (AOD) is an ominous injury with high mortality and morbidity in trauma patients. Improved survival has been observed with advancements in pre-hospital and hospital care. Furthermore, high quality imaging studies are accessible at most trauma centers; these are crucial for prompt diagnosis of AOD. The objective of this study is to perform a comprehensive literature review of traumatic AOD, with specific emphasis on identifying prognostic factors for survival. A review of the literature was performed using the Medline database for all traumatic atlanto-occipital articles published between March 1959 and June 2015; 141 patients from 60 total studies met eligibility criteria for study inclusion. A binary logistic regression model was utilized to identify prognostic factors. The analysis assessed age, sex, spinal cord injury (SCI), traumatic brain injury (TBI), polytrauma injury (PI), and Traynelis AOD Classification. Only TBI was statistically significantly associated with death (OR 8.05 p<0.05); SCI did not reach statistical significance for predicting mortality in AOD patients (OR 1.25 p>0.05). Age, sex, PI, and Traynelis AOD Classification did not meet significance to predict mortality in AOD patients. We found that patients with TBI are eight times more likely to die than patients without TBI. A high degree of suspicion for AOD during pre-hospital care, as well as, prompt diagnosis and management in the trauma center play a key role in the treatment of this devastating injury. The relationship between survival and factors such as TBI and SCI should be further explored.
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http://dx.doi.org/10.1016/j.jocn.2016.05.021DOI Listing
November 2016

Anatomic considerations of the anterior upper cervical spine during decompression and instrumentation: a cadaveric based study.

J Clin Neurosci 2015 Nov 16;22(11):1810-5. Epub 2015 Jul 16.

Division of Neurosurgery, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724 USA. Electronic address:

We evaluated the anatomical considerations specific to the high anterior retropharyngeal approach to the cervical spine. Surgical exposure of the anterior upper cervical spine can sometimes be challenging due to the surrounding neurovascular structures. Using three adult cadavers, we performed high anterior retropharyngeal cervical dissection of the left and right side for a total of six approaches (six sides). During the dissection, all important neurovascular elements were noted and photographed, and anatomical relationships to the spinal vertebral bodies and disc spaces were analyzed. There are certain anatomic considerations that are unique to the high anterior cervical spine. The unique structures include the hypoglossal nerve and the superior thyroid artery/nerve. Only the superior thyroid artery in this region has numerous anatomical variations. Awareness of other structures, including the carotid artery, recurrent laryngeal nerve, and esophagus also remains important. Awareness of the anatomical structures in the anterior upper cervical spine is essential for performing safe anterior upper cervical spinal surgery, avoiding serious complications.
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http://dx.doi.org/10.1016/j.jocn.2015.05.012DOI Listing
November 2015

Peribrachiocephalic approaches to the anterior cervicothoracic spine.

J Clin Neurosci 2015 Nov 9;22(11):1822-6. Epub 2015 Jul 9.

Division of Neurosurgery, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724, USA. Electronic address:

This cadaveric study aims to reexamine the corridors to the anterior cervicothoracic junction, relative to the left brachiocephalic vein, and to present these working corridors as either supra- or infra-brachiocephalic. The anterior cervicothoracic junction incorporates the seventh cervical vertebrae through the fourth thoracic vertebrae (C7-T4) and involves critical anatomical structures. Operative approaches to this area are well described in the literature, with the predominant implementation of three surgical corridors. We used three embalmed, human, cadaveric specimens for this study. No pathology involving the cervicothoracic junction was noted. While dissecting, we tried to imitate the actual surgery. For each surgical step, photographs were taken, drawing attention to the critical structures and highlighting the different corridors to the spine relative to the left brachiocephalic vein. It is possible to access the cervicothoracic junction relative to the brachiocephalic vein from the left. The supra-brachiocephalic approach gives access to the C7-T4 vertebrae, whereas if T4-T5 is the goal, the infra-brachiocephalic approach may be utilized. In the supra-brachiocephalic approach, the brachiocephalic artery can be either medialized or lateralized as needed. A re-examination of the anterior cervicothoracic junction anatomy has allowed us to classify approaches relative to the left brachiocephalic vein. Identifying and understanding the approaches relative to this structure will assist in safe and effective spinal surgery in this area.
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http://dx.doi.org/10.1016/j.jocn.2015.05.028DOI Listing
November 2015

Mini Nutritional Assessment (MNA) is Rather a Reliable and Valid Instrument to Assess Nutritional Status in Iranian Healthy Adults and Elderly with a Chronic Disease.

Ecol Food Nutr 2015 25;54(4):342-57. Epub 2015 Feb 25.

a Department of Nutrition and Dietetics , Monash University , Notting Hill , Victoria , Australia.

This study aimed to evaluate the usefulness of the Mini Nutritional Assessment (MNA) to assess nutritional status of Iranian population and to compare its psychometric properties between patients suffering from a chronic disease, healthy elderly and younger adults. As a group of elderly with a chronic disease, 143 Parkinson's disease (PD) patients and as the control group, 467 healthy persons were enrolled. The Persian-translated version of MNA was filled-up through interviews together with anthropometric measurements. Cronbach's α coefficient of entire MNA was 0.66 and 0.70 in healthy individuals and PD patients, respectively. The total MNA score could significantly discriminate the ones with BMI ≥ 24kg/m(2) in both groups. In general, MNA was a valid and reliable tool for nutritional assessment. We acknowledge study limitations including lack of serum measurements and a selection bias towards mild-to-moderate PD. MNA is a more reliable tool in older healthy individuals and rather younger elderly with PD.
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http://dx.doi.org/10.1080/03670244.2014.994743DOI Listing
March 2016

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

Analyzing the effects of intra-operation video-clip display on hemodynamic and satisfaction of patients during lumbar discectomy under spinal anesthesia.

Saudi J Anaesth 2013 Oct;7(4):415-9

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

Objective: Most neurosurgeons and anesthesiologists prefer the less invasive intervention for most surgeries; recently, the lumbar anesthesia is more popular method. In this study we have tried to distract the attention of the patients to their favorite video-clip instead of their surrounding operating room background to evaluate the hemodynamic as well as their satisfaction during the operation.

Methods: 80 patients who were scheduled for an elective one level discectomy under the regional spinal anesthesia enrolled in this prospective randomized clinical trial. The patients were randomized with sealed envelope method and each envelope was randomly assigned from this set of envelops to be either in case group one (video group) or control groups two (no audio and video and only head phone on their ears) group. In all patients, systolic and diastolic blood pressure, pulse rate and SPO2 were measured and recorded in the questionnaire charts.

Results: Of the 80 patients with Lumbar disk herniation, 53 patients were male and 27 female. The mean age for all patients was 44 year. Systolic and diastolic blood pressure at the end of surgery was significantly lower in video group (P=0.045 and 0.004). Systolic Blood pressure differences between 3(rd) and 5(th) and the end of the surgery with minute zero was significantly less in the video group. (P=0.025, 0.018 and 0.030). Diastolic blood pressure differences between 3(rd) and 5(th) and the end of the surgery with minute zero was significantly less in the video group.(P=0.051, 0.019 and 0.15). Pulse rate differences between first, 3(rd), 5(th) and exactly before leaving the recovery room with minute zero was significantly less in the video group. (P=0.015, 0.028, 0.030 and 0.008).

Conclusion: According to our study, by displaying patient's favorite video clip during the surgical intervention we could highly reduce the patient's attention to what is happening in operating room and therefore, decrease their anxiety and stress.
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http://dx.doi.org/10.4103/1658-354X.121058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858692PMC
October 2013

The effect of Boswellia Serrata on neurorecovery following diffuse axonal injury.

Brain Inj 2013 2;27(12):1454-60. Epub 2013 Oct 2.

Behavioral Sciences Research Center, Noor Hospital, Isfahan University of Medical Sciences , Isfahan , Iran .

Objectives: This pilot trial was conducted to establish whether Boswellia Serrata (BS), a traditional herbal medicine, could improve the outcome of patients who have diffuse axonal injury (DAI).

Methods: In total, 38 patients with pure DAI were enrolled in this 12-week, double-blind, randomized, cross-over study. The patients were randomly assigned to receive either placebo (group A, n = 20) or BS capsules (group B, n = 18) for 6 weeks and then switched to the other intervention for another 6 weeks. The disability rating scale (DRS) was used to assess the outcome at 2-, 6- and 12-weeks post-trauma.

Results: A non-significant trend for improvement of DRS total scores was observed after the use of BS. Regarding the DRS sub-scores, however, there was significant improvement in 'cognitive ability to self-care' during the second 6 weeks in group A on BS compared to an insignificant spontaneous recovery in group B during the same period on placebo. Moreover, both groups experienced a close-to-significant increase in the cognitive function-related items of the DRS during the periods they were on BS. The reported adverse events were all of mild quality and had similar frequency between the groups.

Conclusion: These results suggest that BS resin does not significantly affect general outcome, but may enhance the cognitive outcome of patients with DAI.
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http://dx.doi.org/10.3109/02699052.2013.825009DOI Listing
June 2014

A 12-year epidemiologic study on primary spinal cord tumors in Isfahan, Iran.

J Res Med Sci 2013 Jan;18(1):17-21

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

Background: Although primary spinal cord tumors (PSCTs) comprise a minority of primary central nervous system tumors, they often impose a great deal of morbidity on their victims. Few epidemiologic studies have addressed PSCTs in Iran.

Materials And Methods: We analyzed the demographic/clinical features of all primary intraspinal tumors (with a specific focus on primary intradural spinal cord tumors) identified between 1992 and 2004 in three of the major related hospitals in Isfahan, Iran. We also tracked the malignant cases until 2012.

Results: 102 patients with primary intraspinal tumors were found; 82 tumors were Intradural (36 intramedullary and 46 extramedullary) and 20 extradural. The principal intradural histological subtypes were nerve sheath tumor (33%), ependymoma (22%), astrocytoma (16%), and meningioma (15%). 20 (19%) of the tumors were malignant. Local pain (43%) and motor disabilities (36%) were the most common first-presenting symptoms in the patients. Male-to-female ratio was significant only in ependymoma (male:female ratio = 3.6, P < 0.05). The mean age in meningioma (57 years, standard error [SE]: 15.7) was significantly higher than other types (one-way ANOVA, P < 0.05).

Conclusion: Our results reflect analogous frequency of distribution for PSCTs compared with most of the previous counterpart studies worldwide. The only notable exception was the comparatively fewer frequency of spinal cord meningioma in our study.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719220PMC
January 2013

Multiple intracranial hemorrhages in a normotensive demented patient: A probable cerebral amyloid angiopathy.

J Res Med Sci 2012 Jan;17(1):101-3

Associate Professor,Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Cerebral amyloid angiopathy (CAA) is the most common cause of lobar intracerebral hemorrhage. Repeated bleeding may be presented with vascular dementia. We have reported a 68-year-old normotensive demented patient with probable CAA presented with hemiparesia, headache and vomiting. According to the experience of this case, it is recommended to consider CAA for normotensive elderly patients presented with multiple and superficial intracerebral hemorrhage.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3523427PMC
January 2012

An intracranial extramedullary hematopoiesis in a 34-year-old man with beta thalassemia: a case report.

J Med Case Rep 2011 Dec 19;5:580. Epub 2011 Dec 19.

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

Introduction: Extramedullary hematopoiesis occurs in approximately 15% of cases of thalassemia. Intracranial deposits of extramedullary hematopoiesis are an extremely rare compensatory process in intermediate and severe thalassemia.

Case Presentation: We present an unusual case of an intracranial extramedullary hematopoiesis with a choroid plexus origin in a 34-year-old Caucasian man with beta thalassemia intermedia, who presented with the complaints of chronic headache and rapid progressive visual loss.

Conclusion: An intracranial extramedullary hematopoiesis, although extremely rare, should be considered as a potential ancillary diagnosis in any thalassemic patient and therefore appropriate studies should be performed to investigate the probable intracranial ectopic marrow before any surgical intervention.
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http://dx.doi.org/10.1186/1752-1947-5-580DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285055PMC
December 2011

Primary solitary hydatid cyst in paraspinal cervical muscles: a case report and review of the literature.

Neurol Neurochir Pol 2011 Jul-Aug;45(4):387-90

Neurosurgery Department, Al-Zahra Hospital, Isfahan, Iran.

Hydatid disease caused by Echinococcus granulosus and Echinococcus multilocularis commonly presents with pulmonary and hepatic cysts. Primary paraspinal muscle cysts are a rare presentation. We report a case of hydatid cyst within paraspinal muscles presenting with cervical mass and associated pain. The hydatid disease serological test was negative. Neither hepatic nor pulmonary cystic lesions were found. Radiographic findings were unspecific for hydatid cysts. Surgical resection was planned due to the provisional diagnosis of muscular cystic neoplasm. During surgery, a cyst containing a clear liquid was found. The cyst wall was excised and the surgical field was irrigated with hypertonic saline. The patient's symptoms resolved by discharge day. Postoperative pathological examinations revealed a muscular hydatid cyst.
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http://dx.doi.org/10.1016/s0028-3843(14)60110-9DOI Listing
December 2011

The effect of aminophylline on renal colic: a randomized double blind controlled trial.

South Med J 2007 Nov;100(11):1081-4

Department of Urology, Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Objective: To evaluate the efficacy of aminophylline infusion as a painkiller compared with placebo in patients with acute renal colic.

Patients And Methods: From March to August 2005, 141 patients with clinical renal colic, who were under 60 years of age, had no history of heart or hepatic failure, asthma, theophylline or beta blocker use, reaction to methylxantines, pregnancy or breast feeding, and were not prescribed spasmolytic or analgesics, entered our study. They were randomly assigned to receive either 375 mg of aminophylline or placebo infusion under double blind conditions. Pain intensity was recorded using a visual analog scale (VAS), before drug administration and 30 and 60 minutes afterwards. The drug effectiveness was defined as > or =40% decrease in pain intensity 60 minutes after the onset of infusion, without exacerbation during the following 4 hours.

Results: Seventy patients received aminophylline; it was effective in 45 (64%; 95% confidence interval 52-75%). Alternatively, placebo was effective in 12 of 71 control patients (17%; 95% confidence interval 9-28%); (P < 0.001). Thirty and 60 minutes after administration, aminophylline reduced pain by 24% and 39% respectively, as compared with 6% and 8% pain reduction in the placebo group.

Conclusion: This prospective study provides remarkable information about the efficacy of aminophylline on pain relief and decreasing narcotic usage in symptomatic urinary calculi. It is safe, inexpensive, with minute side effects and can be considered a good alternative or additive to narcotic analgesics in the management of renal colic.
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http://dx.doi.org/10.1097/SMJ.0b013e3181585c97DOI Listing
November 2007