Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 2 2017 04 19 55 61 EN Sima Rafiei Department of Health Management, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran Sina Abdollahzadeh Department of Surgery, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran Fariba Hashemi Department of Operating Room, School of Paramedicine, Qazvin University of Medical Sciences, Qazvin, Iran Mohammad Ranjbar Health Policy Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2016 09 10 2017 03 16 Background: The key challenge is how to encourage and retain health professionals in their work location. There is a list of policy options for this purpose but applying an appropriate and effective set of strategies requires a country level research. Our study aimed to identify retention strategies for neurosurgeons and examine both the importance and feasibility of the identified strategies using expert panels’ point of view. Methods: First of all, a literature review was conducted to identify retention strategies for physicians. Then to gain consensus on the strategies and determine their importance and feasibility an expert panel was organized and a modified Delphi process was used. Results: A total of 40 strategies were identified by the panel classified in seven categories of income and economic factors, professional/job factors, clinical infrastructure, personal/family factors, living condition and welfare, educational factors and career development, governmental regulations and management policies. Conclusion: Based on the study results, three areas of economic incentives, personal and professional factors got the greatest priority in health professional planning for retention purposes. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1134 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1134/324

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 2 2017 04 19 96 97 EN Yara Dadalti Fragoso Neuroimmunology Unit, Department of Neurology, Universidade Metropolitana de Santos, SP, Brazil Joseph Bruno Bidin Brooks Neuroimmunology Unit, Department of Neurology, Universidade Metropolitana de Santos, SP, Brazil Mateus Reghin Neto Institute of Neurological Sciences, Hospital Beneficencia Portuguesa Sao Paulo, SP, Brazil 2016 08 31 2017 04 13 The unexpected finding of a hemangioblastoma on the cerebellum of a patient undergoing treatment with natalizumab for multiple sclerosis https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1122 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1122/328

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 2 2017 04 19 83 89 EN Omidvar Rezaei Skull Base Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hossein Pakdaman Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Kurosh Gharehgozli Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Leila Simani Clinical Research Development Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Amir Vahedian-Azimi Trauma Research Center, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran Sina Asadi Clinical Research Development Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Zahra Sahraei Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammadreza Hajiesmaeili Anesthesiology Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2016 07 31 2017 03 16 After brain injuries, concentrations of some brain markers such as S100B protein in serum and cerebrospinal fluid (CSF) are correlated with the severity and outcome of brain damage. To perform an updated review of S100B roles in human neurocritical care domain, an electronic literature search was carried among articles published in English prior to March 2017. They were retrieved from PubMed, Scopus, EMBSCO, CINAHL, ISC and the Cochrane Library using keywords including “brain”, “neurobiochemical marker”, “neurocritical care”, and “S100B protein”. The integrative review included 48 studies until March 2017. S100B protein can be considered as a marker for blood brain barrier damage. The marker has an important role in the development and recovery of normal central nervous system (CNS) after injury. In addition to extra cerebral sources of S100B, the marker is principally built in the astroglial and Schwann cells. The neurobiochemical marker, S100B, has a pathognomonic role in the diagnosis of a broad spectrum of brain damage including traumatic brain injury (TBI), brain tumor, and stroke. Moreover, a potential predicting role for the neurobiochemical marker has been presumed in the efficiency of brain damage treatment and prognosis. However further animal and human studies are required before widespread routine clinical introduction of S100 protein. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1112 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1112/333

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 2 2017 04 19 100 102 EN Anis Riahi Department of Neurology, Military Hospital, Tunis, Tunisia Malek Mansour Department of Neurology, Military Hospital, Tunis, Tunisia Ines Bedoui Department of Neurology, Military Hospital, Tunis, Tunisia Hajer Derbali Department of Neurology, Military Hospital, Tunis, Tunisia Mariem Messelmani Department of Neurology, Military Hospital, Tunis, Tunisia Jamel Zaouali Department of Neurology, Military Hospital, Tunis, Tunisia Ridha Mrissa Department of Neurology, Military Hospital, Tunis, Tunisia 2016 12 24 2017 04 13 Acute beriberi neuropathy mimicking Guillain-Barré syndrome after a strict  vegetarian diet https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1193 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1193/326

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 2 2017 04 19 103 104 EN Ali Babashahi Department of Neurosurgery, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Morteza Taheri Department of Neurosurgery, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran 2016 12 16 2017 03 08 A huge and invasive skull metastasis caused by renal cell carcinoma https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1187 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1187/321

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 2 2017 04 19 105 106 EN Farnaz Sinaei Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Farzad Fatehi Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2017 02 09 2017 03 19 The third Iranian and the second joint French-Iranian neuromuscular meeting https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1242 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1242/322

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 2 2017 09 25 1415 1415 Iranian journal of neurology Iranian journal of neurology Official journal of Iranian Neurological Association 2017 09 25 Iranian journal of neurology Iranian journal of neurology https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1415 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1415/347

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 2 2017 04 19 62 71 EN Shima Shahjouei Department of Neurosurgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Reza Bavarsad-Shahripour Department of Neurology, University of Alabama, Birmingham, Alabama, USA Farhad Assarzadegan Department of Neurology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Reza Rikhtegar Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Masoud Mehrpour Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Babak Zamani Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Georgios Tsivgoulis Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA Second Department of Neurology, Attikon University Hospital, School of Medicine, University of Athens, Athens, Greece Andrei Alexandrov Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA Anne Alexandrov Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA Ramin Zand Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA Department of Neurology, Geisinger Health System, Danville, Pennsylvania, USA 2016 10 19 2017 02 24 Background: Stroke is among the leading causes of mortality and permanent disability in the world. Iran is located in the stroke belt and has a high age-adjusted stroke incidence rate. In this multistep prospective qualitative study, we aimed at investigating the status and challenges of stroke management in Iran and explore possible solutions. Methods: In the first and second phase, we attempted to define the status of stroke management in Iran by searching the relevant literature and conducting semi-structured interviews with health-care providers in thirteen hospitals located in seven large cities in Iran. In the third phase, we tried to recommend possible solutions based on international standards and experience, as well as interviews with stroke experts in Iran and the United States. Results: Little public awareness of stroke symptoms and its urgency, low prioritization for stroke management, and an inadequate number of stroke-ready hospitals are some of the major obstacles toward timely treatment of stroke in Iran. Every hospital in our pool except two hospitals had guideline-based algorithms for the administration of intravenous thrombolysis. However, there was no single call activation system for stroke alert. Data from some of the centers showed that hospital arrival of stroke patients to final decision-making took 116-160 minutes. Although there were four endovascular programs in our target areas, there was no center with 24-hour coverage. Conclusion: There are many challenges as well as potentials for improvement of stroke care in Iran. Improving public knowledge of stroke and establishing an organized and comprehensive stroke program in the hospitals will improve acute stroke management in Iran. The Iranian ministry of health should define and advocate the establishment of stroke centers, track the rate of death and disability from stroke, introduce pathways to improve the quality of stroke care through national data monitoring systems, and eliminate disparities in stroke care. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/1148 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/1148/325

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 16 2 2017 04 19 98 99 EN Omid Aryani Department of Medical Genetics, Special Medical Center, Tehran, Iran Mohammadreza Akbari Department of Neuro-Ophthalmology, Eye and Strabismus Research Center, Farabi Eye Hospitalrsity of Medical Sciences, Tehran, Iran. Ahmad Aoude Department of Neurosurgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Soheil Naderi Department of Neurosurgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Zeynab Najafi Department of Pediatrics, School of Medicine AND Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Morteza Faghih-Jouibari Department of Neurosurgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: Distinction between radiation necrosis and recurrence of intraparenchymal tumors is necessary to select the appropriate treatment, but it is often difficult based on imaging features alone. We developed an algorithm for analyzing magnetic resonance spectroscopy (MRS) findings and studied its accuracy in differentiation between radiation necrosis and tumor recurrence. Methods:   Thirty-three   patients   with   a   history   of intraparenchymal brain tumor resection and radiotherapy, which had developed new enhancing lesion were evaluated by MRS and subsequently underwent reoperation. Lesions with Choline (Cho)/N- acetyl aspartate (NAA) > 1.8 or Cho/Lipid > 1 were considered as tumor recurrence and the remaining as radiation necrosis. Finally, pre-perative MRS diagnoses were compared with histopathological report. Results: The histological diagnosis was recurrence in 25 patients and necrosis in 8 patients. Mean Cho/NAA in  recurrent  tumors  was  2.72,  but  it  was  1.46  in radiation necrosis (P < 0.01). Furthermore, Cho/Lipid was significantly higher in recurrent tumors (P < 0.01) with the mean of 2.78 in recurrent tumors and 0.6 in radiation     necrosis.    Sensitivity,    specificity,    and diagnostic accuracy of the algorithm for detecting tumor recurrence were 84%, 75% and 81%, respectively. Conclusion: MRS is a safe and informative tool for differentiating    between   tumor   recurrence   and radiation necrosis. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/576 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/576/226

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 14 1 2015 03 15 35 40 Siamak Abdi Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shahram Oveis-Gharan Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farnaz Sinaei Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Askar Ghorbani Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: Serum troponin elevation, characteristic of ischemic myocardial injury, has been observed in some acute ischemic stroke (AIS) patients. Its cause and significance are still controversial. The purpose of this study is to find determinants of troponin elevation and its relationship with stroke severity and location. Methods:Between January 2013 and August 2013, 114 consecutive AIS patients confirmed by diffusion- weighted magnetic resonance imaging were recruited in this study. Serum troponin T level was measured as part of routine laboratory testing on admission. Ten lead     standard     electrocardiogram    (ECG)     was performed and stoke severity was assessed based on National Institutes of Health Stroke Scale (NIHSS). Results: Troponin T was elevated in 20 (17.6%) of 114 patients. Patients with elevated troponin were more   likely   to   have   higher   age,   higher   serum creatinine  and  ischemic  ECG  changes.  Troponin levels were higher in patients with more severe stroke measured  by  NIHSS  [7.96  (6.49-9.78)  vs.  13.59 (10.28-18.00)].  There  was  no  association  between troponin and locations of stroke and atrial fibrillation. There were 6 (5%) patients with elevated troponin in the presence of normal creatinine and ECG. Conclusion:  Stroke  severity,  not  its  location,  was associated   with   higher   troponin   levels.   Abnormal troponin levels are more likely, but not exclusively, to be due to cardiac and renal causes than cerebral ones. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/575 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/575/227

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 14 1 2015 03 15 41 46 Saeid Khosrawi Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Parisa Taheri Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Seyed Hasan Hashemi Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 2015 10 14 Background: H-reflex is a valuable electrophysiological technique for assessing nerve conduction through entire length of afferent and efferent pathways, especially nerve roots and proximal segments of peripheral nerves. The aim of this study was to investigate the relation between normal values of flexor carpi radialis (FCR) H-reflex latency, upper limb length and age in normal subjects, and to determine whether there is any regression equation between them. Methods: By considering the criteria of inclusion and exclusion, 120 upper limbs of 69 normal volunteers (68 hands of 39 men and 52 hands of 30 women) with the mean age of 39.8 ± 11.2 years participated in this study. FCR H-reflex was obtained by standard electrodiagnostic  techniques,  and  its  onset  latency was recorded. Upper limb length and arm length weremeasured   in   defined   position. The   degree   of association between these variables was determined with  Pearson correlation and  linear  regression was used for obtaining the proposed relaions. Results: Mean FCR H-reflex latency was found to be 15.88 ± 1.27 ms. There was a direct linear correlation between FCR H-reflex latency and upper limb length (r = 0.647) and also arm length (r = 0.574), but there was no significant correlation between age and FCR H-reflex latency (P = 0.260). Finally, based on our findings, we tried to formulate these relations by statistical methods. Conclusion: We found that upper limb length and arm length are good predictive values for estimation of normal FCR H-reflex latency but age, in the range of 20-60 years old, has no correlation with its latency. This estimation could have practical indications in pathologic conditions. https://ijnl.tums.ac.ir/index.php/ijnl/article/view/574 https://ijnl.tums.ac.ir/index.php/ijnl/article/download/574/228

Tehran University of Medical Sciences Current Journal of Neurology 2717-011X 14 1 2015 03 15 47 49 Fahmi Nasrallah Department of Biology, School of Medicine, Laboratory of Biochemistry, Rabta Hospital, Jebbari, 1007 Tunis, Tunisia. Hanene Benrhouma Department of Child and Adolescent Neurology, School of Medicine, Mongi Ben Hmida Institute of Neurology, 1700 Tunis, Tunisia. Ichraf Kraoua Department of Child and Adolescent Neurology, School of Medicine, Mongi Ben Hmida Institute of Neurology, 1700 Tunis, Tunisia. Gilbert Briand Department of Biochemistry and Molecular Biology, School of Medicine, Laboratory of Endocrinology, Metabolism-Nutrition, Oncology, Biology Pathology Center CHRU, 57039 Lille, France. Souheil Omar Department of Biology, School of Medicine, Mongi Ben Hmida Institute of Neurology, 1700 Tunis, Tunisia. Ilhem Turki Ben Youssef Department of Child and Adolescent Neurology, School of Medicine, Mongi Ben Hmida Institute of Neurology, 1700 Tunis, Tunisia. Naziha Kaabachi Department of Biology, School of Medicine, Laboratory of Biochemistry, Rabta Hospital, Jebbari, 1007 Tunis, Tunisia. 2015 10 14 Background: H-reflex is a valuable electrophysiological tech