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Article
Recurrent Embolic Stoke In Children Due To Giant Congenital Cardiac Diverticulum

Authors: Hayder Kadhum Hassoun --- Ali Hussein AL-Moussawi --- Zuhair Salih Allebban
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 3 Pages: 433-436
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:One of the great challenges we face in clinical neurology practice is stroke among children, which is considered to be among the ten top causes of death in the United States. The cardiac diseases are the most common causes of strokes among children; But a recurrent embolic stroke among children is rarely reported to be due to giant cardiac diverticulum originating from the left cardiac chamber as presented in this paper

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Article
Vertebrobasilar Dolichoectasia: Clinical Neuroimaging Correlation

Authors: Hayder Kadhum Hassoun --- Haider Najim Aubaid --- Amina Mohammed Abass Zwain***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 3 Pages: 362-369
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Vertebro-basilar dolichoectasia (VBD) is an uncommon vasculopathy of unclear origin affecting the arterial wall of vertebral artery (VA) and basilar artery (BA). A variety of clinical syndromes and neuroimaging features have been associated with VBD. OBJECTIVE: This cross sectional study is conducted to shed a light on the neuroimaging signs of VBD and explore the association between the clinical presentation and imaging parameters of VBD in patients clinically suspected to have VBD with neuroimaging diagnosis. MATERIAL AND METHODS: This randomized cross sectional study was performed in Middle Euphrates Neuroscience Centre in Annajaf city between April 2012 to December 2012,A 34 patients with neuroimaging diagnosis of VBD (18 patients by MRI and 16 patients by MDCT) were included, VBD were assessed by studying the basilar artery width (BAW), bending length (BL) and level of basilar artery bifurcation according to Dan Deng et al criteria. The findings were correlated with patient clinical presentation.RESULTS: Thirty four patients, (24 males & 10 females) with age range between 25-81 years and mean of 57.9 year were included in this study. Among all presenting symptoms, only headache showed statistically significant association (p value <0.05) with the width of the basilar artery. There was higher prevalence of single cranial nerve involvement (SCNI) in patients with more tortuous basilar artery (55.5% of those with BL more or equal to 10 mm versus 16% of those less than 10 mm) with statistically significant association (p value <0.05), suprasellar extension was seen in 26.4% of cases and showed significant association with headache and visual symptoms. CONCLUSION: VBD is an important clinical entity and could be associated with or responsible for many serious clinical presentations, special attention is needed for VBD diagnosis and it's parameter during evaluation of brain imaging especially in patients with un-explained or vague presentation.


Article
Evaluation of Brain Computerized Tomography Scan in Patients with Acute Ischemic stroke
تقييم مشاهدات مفراس الدماغ في حالات الصدمة الدماغية الأحتشائية الحادة .

Authors: Hayder Kadhum Hassoun --- Haider Najim Aubaid --- Azhar Abdul-Latief Khalil
Journal: journal of kerbala university مجلة جامعة كربلاء ISSN: 18130410 Year: 2015 Volume: 13 Issue: 3 Pages: 259-267
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background: Stroke remains one of the leading cause of the death in the world and despite the advance in neuroimaging, computerized tomography (CT) is still widely used in evaluation of patients with ischemic stroke in emergency unit which should be done before giving thrombolytic therapy in the first 3-4.5 hour of stroke onset .Aim of this study is to evaluate early brain CT findings among ischemic stroke which is of great help in deciding early stroke management. Patients and methods: A cross-sectional descriptive study was done at Middle Euphrates Neuroscience center; AL-Sadder Medical City at Annajaf city – Iraq, in the period from may 2012 to December 2014. A total of 108 patients whom clinically diagnosed as stroke were referred for CT scan of brain within 48 hours of the stroke onset. Twelve patients with intracranial hemorrhages were excluded and the remaining 96 patients were studied for early brain CT findings. Results: The prevalence of ischemic infarction was 85%, with slight male predominance (male: female ratio=1.25:1) and most affected patients with ischemic type were in range of 60-69 years. The sensitivity of CT scan in detection of the ischemic changes increased linearly with time from onset of stroke. The prevalence of the hyperacute signs of middle cerebral artery infarction (insular- ribbon sign and hypodense basal ganglia) in acute ischemic stroke were seen in 33.3%, no case reported to show hyper dense middle cerebral artery sign in our study. Conclusion: CT remains the initial imaging modality of choice for the early diagnosis and management of acute stroke especially in making the diagnosis within the therapeutic window for thrombolytic therapy where the time is crucial for detectability. Specific signs of hyperacute infarction should be carefully scrutinized for early detection.

ماتزال الجلطة الدماغية من الأسباب الرئيسية للموت في العالم وهو من الأمراض السريرية الشائعة التي يستخدم فيها فحص المفراس الدماغي بصورة كبيرة لغرض تقييم المرض بالرغم من التطور الكبير لأنواع الفحوص المستخدمة حديثا.َ الغاية من هذه الدراسة هو لتقييم الدور الذي يلعبه المفراس الدماغي في الكشف المبكر عن حالات الجلطة الدماغية الاحتشائية الحادة. المرضى و طريقة العمل : من بين 108 مريض ( 60 ذكر, 48 أنثى ), مشخصين بالجلطة الدماغية تشخيصاَ سريرياً, كانو قد أحيلو إلى شعبة المفراس في مركزالفرات للعلوم العصبية في مستشفى الصدر التعليمي في النجف خلال اليومين الأولى من تاريخ الإصابة بالجلطة الدماغية, تم استبعاد 12 مريض مصابين بالنزف الدماغي و تم اجراء الدراسة علي العدد المتبقي (96 مريض) .النتائج :بالنسبة للعمر,فإن أعلى فئة عمرية كانت متعرضة للإصابة بالاحتشاء الدماغي هو العقد السادس من العمر وزيادة طفيفة في الذكور على الاناث. تزايدت حساسية المفراس في الكشف عن الجلطة بشكل خطي مع زيادة المدة الزمنية من تاريخ الاصابة. العلامات الحادة لمرضى الجلطة الدماغية بسبب إصابة الشريان الدماغي الوسطي متمثلةً بعلامة الشريط الدماغي العازل و علامة قلة وضوح العقدة القاعدية للدماغ ( في المفراز الدماغي ) شكلت نسبة 33,3% بينما لم تظهر أي حالة في الدراسة علامة ازدياد كثافة الشريان الدماغي الوسطي.الإستنتاج : يبقى المفراس الدماغي وسيلة فعالة ومهمة للتشخيص الأولي للمرضى المصابين بالجلطة الدماغية الاحتشائية. بالرغم من ندرتها , فانه بالبحث الدقيق عن علامات الجلطة الحادة المعروفة بالمفراس يمكن الكشف المبكر عن الجلطة الاحتشائية


Article
C-Reactive Protein Profile Among Acute Stroke Patients

Authors: Hayder Kadhum Hassoun --- Husain Salih Abass --- Taki Tiraihi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 1 Pages: 7-12
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND:C-reactive protein (CRP) is an inflammation marker, which has been implicated in stroke severity, response to stroke, or a mixture of both. OBJECTIVE:This study has been conducted in order to clarify early CRP essay in relation to the type of acute stroke (ischemic and hemorrhagic), onset duration, severity, stroke disability and carotid stenosis. METHODS: A cross sectional randomized study included 50 patients with stroke (23 male and 27 females: mean age 54.7 + 10.3 years). They were classified into having ischemic or hemorrhagic strokes, deficit in less or more than 12hrs (within 24 hrs), large or small size infarction, severe or non-severe disability and severe or non-severe carotid stenosis. RESULTS:There is more significant association of C-reactive protein with the ischemic (82.4%) than the hemorrhagic types (56.3%).There is significant association of CRP positivity in relation to the late onset duration of the deficit (> 12 hrs: 85.2%) in comparison to the early onset (≤ 12hrs: 60.9%). C-reactive protein level showed statistically significant association with the size of infarction (CRP is positive in 91.3% of the large size versus 63.6% of the small size). There is significant association of CRP level in relation to carotid stenosis (68.8% in severe stenosis versus 31.2% in non-severe ones). The short-term disability was significantly associated with CRP level (CRP is positive in 83.8% with severe disability versus 57.8% with the non-severe one). CONCLUSION: High CRP level at the admission of the acute stroke patient is more associated with the ischemic type, the late onset, the large size infarction, severe disability and severe carotid stenosis.

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