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J. Donald McQueen and Kazem Abbassioun

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Ronald Brisman and Kazem Abbassioun

✓ Six cases of intracranial aneurysms are described in three families: two sisters, identical twins, and a mother and daughter. The cases suggest a hereditary basis for some intracranial aneurysms.

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Abbass Amirjamshidi, Hamid Rahmat, and Kazem Abbassioun

✓ In the early days of the war between Iran and Iraq, reports of the sudden deaths of soldiers who previously had survived a penetrating head injury suggested the possibility that a late complication, traumatic aneurysm (TA), could be the cause of this catastrophe. In response, the authors planned a prospective study to perform cerebral angiography in victims with penetrating head traumas, especially in those who had artillery shells or bone fragments passing through areas of dense vasculature. Thirty-one TAs and arteriovenous fistulas were documented. Not all of the lesions, however, were deemed appropriate for surgical intervention. Six aneurysms (19.4%) healed spontaneously and shrank or disappeared on repeated serial angiograms. The authors present their cases and discuss the incidence of TAs, their natural course and behavior, and the special problems encountered in managing these interesting and potentially fatal complications of penetrating head injuries.

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Hamid Rahmat, Kazem Abbassioun, and Abbass Amirjamshidi

✓ A case of pulsating unilateral exophthalmos is presented. It was caused by a traumatic aneurysm of the intraorbital ophthalmic artery, secondary to missile injury. Evolution of the aneurysm was observed clinically, by angiography, and by computerized tomography. The differential diagnosis of pulsating exophthalmos and the pathogenesis of such aneurysms are briefly discussed.

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Abbas Amirjamshidi, Seyyed Mahmood Ramak Hashemi, and Kazem Abbassioun

The authors report the clinical features, imaging and surgical findings, and follow-up of 5 rare cases of schwannoma of the middle fossa with possible origin from the greater superficial petrosal nerve (GSPN). All patients presented to a single neurosurgical institution. The study design was a prospective follow-up of 5 cases of schwannomas of the middle fossa that most likely originated from the GSPN. The presenting features were burning pain in the eyes in 2 cases, epilepsy and behavioral changes in 2 cases, and headache in 1 case. Imaging studies showed a subtemporal mass on the anterosuperior aspect of the petrous bone in all cases. An enhancing tail on the MR images was highly suggestive of the origin of the tumor from the GSPN. All tumors were removed through a subtemporal extra- or intradural approach.

Partial to complete peripheral facial nerve palsy was encountered after surgery in 3 cases, which recovered completely. Dry eye was the long-term permanent deficit in all cases. Mid- to long-term follow-up of the cases has not revealed any tumor recurrence. The 5 cases of schwannoma of the middle fossa with possible origin from GSPN were managed successfully, and their clinical presentation, differential diagnosis, and management are discussed.

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Abbas Amirjamshidi, Mahmoud R. Khalatbari, and Kazem Abbassioun

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Abbas Amirjamshidi, Rouzbeh Shams Amiri, Maysam Alimohamadi, and Kazem Abbassioun

Multiple primary brain tumors are commonly observed in patients with a history of brain radiation therapy or neurofibromatosis. The concomitant presence of 2 different types of brain tumors in a single location or chamber is a very rare clinical presentation in the absence of such a predisposing factor. The authors report on the case of a 16-year-old boy presenting with different types of brain tumors in 2 ventricular chambers concomitantly. This boy had a medium-sized colloid cyst of the third ventricle and a large fibrillary astrocytoma fungating from the brainstem into the floor of the fourth ventricle. The lesions were successfully excised in 2 separate surgeries. Radiotherapy was used as the adjuvant mode of therapy. There has been no sign of tumor recurrence after 16 months of follow-up. Clinical awareness and recognition of such a combination of tumors is important because they will dictate special treatment strategies depending on the individual biological aggressiveness of each tumor.

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Familial acromegaly with pituitary adenoma

Report of three affected siblings

Kazem Abbassioun, Vahab Fatourehchi, Abbass Amirjamshidi, and Nemotallah Aghai Meibodi

✓ The authors report the cases of three brothers with pituitary adenomas who had classical findings of acromegaly and gigantism. Two had irreducibly elevated growth hormone (GH) values and underwent transsphenoidal microsurgical extirpation of their tumors. The third acromegalic brother had a normal GH value and evidence of panhypopituitarism; he had a small intrasellar tumor and a partially empty sella. The pattern of inheritance was probably autosomal recessive. A review of literature indicated that familial incidence of isolated acromegaly with pituitary adenomas is rare.

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Kazem Abbassioun, Hamid Rahmat, Nosrat O. Ameli, and Mansour Tafazoli

✓ From among 1500 patients who underwent computerized tomography (CT) during an 18-month period, five cases of hydatid disease of the brain were diagnosed. The preoperative diagnosis is of paramount importance as the cyst has to be removed unruptured. The CT features of this condition are practically pathognomonic. The authors discuss the CT findings in these cases and differential diagnosis with other cystic lesions of the brain. The help that this safe and sure method of investigation gives to attain preoperative diagnosis is emphasized.