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WCN19 Journal Posters Part 2 Revised V1 JNS-0000116542; No. of Pages 131 ARTICLE IN PRESS Journal of the Neurological Sciences (2019) xxx–xxx Contents lists available at ScienceDirect Journal of the Neurological Sciences journal homepage: www.elsevier.com/locate/jns WCN19 Journal Posters Part 2 revised_V1 WCN19-2260 WCN19-2269 Poster shift 01 - Channelopathies /neuroethics /neurooncology / Poster shift 01 - Channelopathies /neuroethics /neurooncology / pain - Part I /sleep disorders - Part I /stem cells and gene therapy - pain - Part I /sleep disorders - Part I /stem cells and gene therapy - Part I /stroke /training in neurology - Part I and traumatic brain Part I /stroke /training in neurology - Part I and traumatic brain injury injury Numb chin syndrome- The first finding in metastatic malignancy Results of surgical treatment in patients with moyamoya disease considering CT-perfusion imaging study N. Mustafayev, A. Bayrakoglu, F. Ilgen Uslu, M. Kolukısa Bezmialem University, Neurology, Istanbul, Turkey O. Harmatinaa, V. Morozb, I. Skorokhodab, I. Tyshb, N. Shahinb,R. Hanemb, U. Maliarb a Numb chin syndrome (NCS) is a sensory neuropathy of the SI «Romodanov Institute of Neurosurgery of NAMS of Ukraine», mental nerve, which is accompanied by hypoesthesia and paresthe- Neuroradiology Department, Kyiv, Ukraine b sia of the jaw and lower lip. Although being well known in neurology SI «Romodanov Institute of Neurosurgery of NAMS of Ukraine», practice, most of the physicians who have not experienced this Emergency Department of Vascular Neurosurgery, Kyiv, Ukraine phenomenon are unaware of this phenomenon since it is rare and can be confused with somatic complaints. This case report aims to Aim point out that NCS may be the first sign and symptom of metastatic To improve the results of surgical treatment of patients with cancers in patients who are not diagnosed. moyamoya disease based on the MSCT-perfusion (CTP) results. Case Material and methods We report a 52-year-old man who presented to our outpatient The retrospective analysis of surgical treatment was performed clinic with numbness on his right jaw for 1 month. He had a history patients with moyamoya disease (n = 5; m/w, 3/2; age range = 16– of renal transplantation and used immunosuppressive therapy. He 55 yrs) underwent brain CTP examination. Clinical manifestations was diagnosed as metastatic lung cancer when he was investigating were due to repeated acute ischemic stroke as a result of cerebral the etiology and died within a month. arteries occlusions (n = 4). In one case, clinical manifestations were due to hemorrhagic stroke. According to moyamoya disease classifi- Discussion cation by Suzuki, the stage 6 (n=3), the stage 3 (n = 1), the stage 4 (n Patients presenting with numb chin syndrome are diagnosed late = 1) were recorded. The ischemia lesion was imagined in the left because of being rare. 75% of the patients presenting with this middle cerebral artery (MCA) region (n = 3), the both MCAs regions complaint are due to malignant metastasis and maybe the first sign (n = 1); the hemorrhagic stroke was in the left temporal/basal of malignancy in a significant rate of them, as presented here. Many ganglion region (n = 1). CTP on basal ganglion levels was performed. malignant and metastatic neoplasms may cause this neuropathy. In Doppler ultrasonography, cerebral computed tomography angiogra- most cases, life expectancy is short and is considered as a sign of phy, cerebral digital subtraction angiography to identify the potential poor prognosis. donor artery for extracranial-intracranial microanastomosis (EICMA) in preoperative planning was carried out. In our study, it was the Conclusion superficial temporal artery (STA) with parietal (n = 3), frontal (n = Numb chin syndrome is a lesser known symptom of mental nerve 2) branches. The indications for surgical treatment were based on the neuropathy. In case dental and jaw-related pathologies cannot be anamnesis, neurological status, absence of regiones of extensive brain detected, it should be kept in mind that this may be the first sign of lessions by CT, the cerebral hypoperfusion regions by CTP. All patients malignancy and all detailed investigations should be planned for this underwent surgical treatment by EICMA(STA-MCA) overlays. purpose. Results doi:10.1016/j.jns.2019.10.758 Positive dynamics as an improved cognitive function, partial regressions of focal neurological events in all patients were observed. 0022-510X/$ – see front matter ARTICLE IN PRESS 2 Abstracts / Journal of the Neurological Sciences (2019) xxx–xxx Conclusion WCN19-2277 CTP could be used to cerebral hypoperfusion localize and to objectively evaluate the changes in cerebral hemodynamics before and after revascularization in moyamoya disease. Poster shift 01 - Channelopathies /neuroethics /neurooncology / pain - Part I /sleep disorders - Part I /stem cells and gene therapy - doi:10.1016/j.jns.2019.10.759 Part I /stroke /training in neurology - Part I and traumatic brain injury Antidiabetic agents differentially affect the extent of neurologic WCN19-2272 deficit after stroke Poster shift 01 - Channelopathies /neuroethics /neurooncology / M.A.L. Qawasmeha, A. Alhusbanb, F. Alfwaressc, K. El-Salema,Z. pain - Part I /sleep disorders - Part I /stem cells and gene therapy - Alalwania Part I /stroke /training in neurology - Part I and traumatic brain aJordan University of Science and Technology, Neuroscience Depart- injury ment, Faculty of Medicine, Irbid, Jordan bJOrdan UNiversity of Science and Technology, Clinical Pharmacy, Faculty of Pharmacy, Irbid, Jordan Application of extracranial-intracranial bypass for surgical treat- cJordan University of Science and Technology, Rehabilitation Sciences ment of complex cerebral arterial aneurysms Department, Faculty of Applied Medical Sciences, Irbid, Jordan O. Harmatinaa, V. Morozb, I. Skorokhodab, I. Tyshb, N. Shahinb,R. Introduction Hanemb, U. Maliarb a Diabetes and acute hyperglycemia at the time of presentation has SI «Romodanov Institute of Neurosurgery of NAMS of Ukraine», been shown to increase stroke severity and worsen outcome both Neuroradiology Department, Kyiv, Ukraine b preclinical and clinical studies. Recently, the use of metformin has SI «Romodanov Institute of Neurosurgery of NAMS of Ukraine», been shown to reduce the severity of stroke in patients with type 2 Emergency Department of Vascular Neurosurgery, Kyiv, Ukraine diabetes. It’s still unknown whether other oral hypoglycemic agents would confer similar benefit. Aim To improve the results of surgical treatment of complex cerebral Objectives arterial aneurysms (CCAAs) using of modern methods and surgical To assess the effect of pretreatment with oral hypoglycemic correction. agents, insulin and their combination on stroke severity at presentation. Materials and methods The analysis of surgical treatment using microsurgical revascular- Patients and methods ization in 11 patients with CCAAs was performed. AAs localization was Patients admitted to the King Abdullah University Hospital anterior cerebral artery - anterior communicating artery (ACA-ACoA) (KAUH)-Jordan with ischemic stroke between January 2015 and (9.1%), internal carotid artery (ICA) (63.6%), middle cerebral artery December 2016 were evaluated and their comorbid diseases, (MCA) (27.3%). AAs were giant, fourth of them with severe thrombosis treatment on admission and their neurologic severity was assessed (36.4%). Hemorrhagic complications (36.4%), aneurysm mass effect using the National Institute of Health Stroke Scale (NIHSS) were exacerbation pseudotumorosis disease (54.5%), MCA occlusion in AA documented. Stroke severity was compared for non-diabetic МСА dissection (9%) were identified. Features of revascularization patients and diabetic patients treated with different antidiabetic techniques were included the imposition of intracranial-intracranial agents. microanastomosis (IICMA) between A4 of ACAs with AA detachment in AA ACA-ACoA; an overlay of high-flow microanastomosis between Results the external carotid artery and MCA(M2) with AA detachment (n = Data from 324 patients with acute stroke was documented. The 6); the overlay of the extracranial-intracranial microanastomosis median age of participants was 69 years. Diabetes was documented (EICMA) between the surface temporal artery and MCA (STA-MCA) in about 50% of the patients. Multinomial regression analysis with the AA detachment by balloon-catheter (n = 1); an EICMA (STA- identified diabetes treatment status as an independent predictor of MCA) upon MCA occlusion in AA dissection (n = 1); superimposition neurological severity of stroke (p = 0.032). Patients treated with oral of multiple IICMA between MCА(M3) and high-flow EICMA (АСА- hypoglycemic agents had a significantly lower NIHSS as compared to MCА(М2)) with АА MCА deconstruction in pseudotumorrhagic nondiabetic patients and insulin treated patients (p b 0.02). The complications; a microanastomosis between common CA and MCA positive effect of oral hypoglycemic agents was blunted by insulin (M2) with dissecting AА MCA(M1) detachment. co-treatment. Insulin did not alter the severity of stroke as compared Results was ranked by a modified Rankin scale. Satisfactory to non-diabetics. results of surgical treatment of CCAAs were recorded (81.8%); profound disability due to development of microanastomosis Conclusion thrombosis with hemispheric cerebral ischemia (n = 1); fatal Oral hypoglycemic agents may reduce the severity of outcome (n = 1). neurologic deficit of ischemic stroke and may have neuroprotective effect. Conclusions
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