Correlation Between Pre-treatment Collateral Status and Short-Term Functional Outcome in Patients With Mild to Moderate Stroke After Reperfusion Therapy in a Local Primary Stroke Center in the Southwestern Part of Saudi Arabia.

Background Stroke is a substantial cause of disability and mortality worldwide and is characterized by the sudden onset of acute neurological deficit. During acute ischemia, cerebral collateral circulations are crucial in preserving blood supply to the ischemic region. Recombinant tissue plasminogen activator (r-tPA) and endovascular mechanical thrombectomy (MT) are the primary standards of care for acute recanalization therapy. Methodology From August 2019 through December 2021, we enrolled patients treated in our local primary stroke center with anterior circulation acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) with or without MT. Only patients diagnosed with mild to moderate anterior ischemic stroke, as measured by the National Institutes of Health Stroke Scale (NIHSS), were included in the study. The candidate patients underwent non-contrast CT scanning (NCCT) and CT angiography (CTA) at admission. The modified Rankin scale (mRS) was used to assess the functional outcome of the stroke. The modified Tan scale, graded on a scale of 0-3, was used to determine the collateral status. Results This study comprised a total of 38 patients who had anterior circulation ischemic strokes. The mean age was 34. 8±13. All patients received IVT; eight patients (21.1%) underwent MT following r-tPA. In 26.3% of cases, hemorrhagic transformation (HT), both symptomatic and asymptomatic, was evident. Thirty-three participants (86.8%) had a moderate stroke, whereas five participants (13.2%) had a minor stroke. With a P-value of 0.003, a poor collateral status on the modified Tan score is substantially associated with a short, poor functional outcome. Conclusion In our study, patients with mild to moderate AIS with good collateral scores at admission had better short-term outcomes. Patients with poor collaterals tend to present with a disturbed level of consciousness more than patients with good collaterals.

Clinical and neurophysiological risk factors of learning disabilities in different types of idiopathic focal epilepsy.

Objectives: Academic difficulties are common in epileptic children. A learning disability (LD) is a reduction in the learning capacity of children or the intellectual ability of adults, which is different from mental retardation or dementia. Materials & Methods: The participants were 56 patients, of whom 35 were males (62.5%), and 21 were females (37.5%). The participants attended the Neurology Outpatient Clinic, the Sohag University Hospital, between December 2016 and May 2017. Children with chronological age between 7 and 16 years with idiopathic focal and normal mental and motor developmental history were enrolled in this cross-sectional study. The Revised Quick Neurological Screening Test was used to assess different types of LD. Results: LDs were present in 67.9% of our participants with a statistically significant association between LDs in one arm and younger age, earlier age of onset of epilepsy, frequent seizures, and seizure semiology, particularly of temporal lobe origin, in the other arm. In addition, left epileptic focus on EEG, prolonged treatment duration with antiepileptic drugs (AED), and polytherapy were significantly correlated with LDs. Conclusion: Many factors are significantly correlated with LDs in children with idiopathic focal epilepsy, like age of the patient, age of epilepsy onset, seizure semiology, prolonged AED treatment, and polytherapy.

Risk factors of multiple sclerosis in Aseer region, Kingdom of Saudi Arabia A case-control study.

OBJECTIVES: To investigate socio-demographic and environmental risk factors of multiple sclerosis (MS) in Aseer region, Kingdom of Saudi Arabia (KSA). METHODS: This was a retrospective, record, and interview based matched case control study completed in the neurology clinics at tertiary hospitals in Aseer, KSA. It included 82 MS cases and 82 controls. The study used a structured questionnaire to collect information on key socio-demographic and environmental exposures. The main outcome measure was a statistically significant relationship of key socio-demographic and environmental risk factors with MS. RESULTS: A total of 82 registered patients, 50 were females, resulting in a female to male ratio of 1.56:1. Various risk factors were found to have a statistically significant association with MS which included female (OR=3.01, 95% CI [1.59:5.69]; p<0.001), family history of MS (OR=2.1, 95%CI [2.4:1.7] p=0.04), low exposure to sunlight (OR=2.02, 95%CI [2.53: 9.9] p<0.001), only fed breast milk in childhood (OR=0.46, 95%CI [0.55:0.39]; p<0.001), parental consanguinity (OR=2.17 95%CI [4.11:1.14] p=0.017), history of chickenpox (OR=15.59 95% CI [68.7:3.55]; p<0.01). On using multiple logistic regression, chicken pox infection (AOR=0.045, 95%CI [0.015-0.135]; p=0.001)and low sun-exposure (AOR=.271, 95%CI [.121-.609]; p<0.05) were deduced as the predictors of MS in this region. CONCLUSION: This study offers unique insights into the risk factors of MS. Low sun exposure and childhood chickenpox are significantly related to the development of MS in the Aseer region.

Clinical and epidemiological profile of cerebral venous thrombosis. A Multicenter retrospective study in Aseer Region Saudi Arabi.

OBJECTIVE: To assess the epidemiological pattern and correlates with the clinical outcome of Cerebral venous thrombosis (CVT) in Abha, Kingdom of Saudi Arabia. METHODS: A retrospective record_based cohort design was conducted including all patients admitted with diagnosis of CVT in 2 main tertiary hospitals in Aseer Region between 2015 to the end of 2018. The study hospitals were Aseer Central Hospital and Armed Forces Hospitals Southern Region. The data were collected by structured data sheets, including sociodemographic data. Assessment of known risk factors for CVT, clinical presentation, treatment received, and clinical outcome after treatment were extracted. RESULTS: The study included 119 patients with CVT, whose ages ranged from 15 to 97 years, with a mean age of 35.5-/+14.1 years. Majority of the patients were females (81.5%). Headache was the most presenting (82.4%) symptom, followed by vomiting (30.3%) and a decreased level of consciousness. Thirty_three cases (27.7%) had complications, and recanalization was recorded among 92 cases (94.8%) based on follow up vascular imaging. CONCLUSION: The study revealed that most of the cases of CVT had favorable clinical outcome and recanalization, especially those who had a shorter duration untildiagnosis. Young females were the most affected group.