Mohamed Hamdy Ibrahim
United Arab Emirates
Mohamed Hamdy Ibrahim graduated from Faculty of Medicine, Ain Shams University, Cairo, Egypt. He joined the neuropsychiatry residency at Ain Shams University Cairo, Egypt from 2001 till 2003. He finished his MD in Neurology and got his Doctorate by 2008. He has been assigned as Lecturer of Neurology and his main concern was in the field of Neurovascular Interventional Radiology. He finished his fellowship in interventional neurology at Zurich University, Switzerland as F.I.N.R. by 2013. Currently he is an Assistant Clinical Professor of Neurology, GMU University, Ajman, United Arab of Emirates (UAE) since 2010. He has published many journals as Open Journal of Medical Imaging (OJMI), The Egyptian Journal of Radiology and Nuclear Medicine, The European Journal of Neurology, Neurology of India. In addition he is now a member of World Federation of Interventional and therapeutic Neuroradiology (WFITN), Member of ESMINT (European Society of Minimal Invasive Neurological Therapy) & Member of European Society of Neuroradiology Diagnostic and Interventional (ESNR)
Objectives: To study the prevalence of intracranial venous stenosis in pseudotumor cerebri patients.
Patients & Methods: Thirty patients were diagnosed having PTC according to Dandy criteria. All underwent general and neurological assessment. Radiological assessment included CT scan brain ±MRI brain without contrast, MRV. All underwent digital subtraction angiography (DSA) (venous phase) to confirm the validity of filling gaps seen at the level of MRV.
Results: MRV brain showed that 24 patients (80%) showed filling gaps. Digital subtraction cerebral angiography (venous phase) showed 9 patients (30%) had stenosis in their dural sinuses. MRV showed to be a good screening tool since it had 100% sensitivity and negative predictive value. However, since it has a moderate specificity (62%) with a positive predictive value (PPV) of only 35%, then lesions detected should be confirmed with digital subtraction cerebral angiography (venous phase) particularly those involving the transverse and sigmoid sinus.
Conclusion: Studying the intracranial venous system in patients with PTC is an important step in understanding the pathophysiology of the disease. Detection of venous sinus stenosis opens the way to a novel therapeutic option for refractory patients like venous sinus stenting.
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