Biography:

Muhammad Awais Khan, MD has completed his Residency and Fellowship from University of Arizona, Tucson, USA. He completed his Medical School from Aga Khan University, Pakistan. He is double Board Certified in General Neuropathy and Clinical Neurophysiology.

Abstract:

Biography:

Carlos Alberto Diaz Pacheco earned his Medical Degree from the University of Antioquia (UdeA), Medellin, Colombia, followed by Radiology Residency at the same university. He subsequently completed a Interventional Neuroradiology Fellowship at SILAN (Ibero Latin American Society of Neurointervention) in Barcelona (Spain). He has extensive expertise in the minimally invasive treatment of cerebrovascular diseases including cerebral aneurysms, AVM and stroke as well as in the interventional treatment of craniofacial vascular malformations and chemosurgery for the treatment of retinoblastoma. He has several national and international publications, review articles and book chapters to his credit. He is an active Lecturer and serves as a Reviewer for scientific journals. He is a Member of the Colombian Association of Radiology and Member of its scientific committee. He served as the Director of Radiology- Faculty of Medicine at UdeA.

Abstract:

Introduction: Prompt recanalization of occluded brain arteries in patients with stroke requires the use of multiple strategies. We report a retrospectively collected clinical experience in Medellin – Colombia using a combination of a direct first pass technique with Sofia 6 Plus (Micro Vention-Terumo, Inc., Tustin, CA) Reperfusion Catheter in combination with Solitaire™ FR (SFR) (ev3 Inc, Irvine, California, USA) in the treatment of AIS (acute ischemic stroke). Materials & Methodology: Between March 2016 and Nov 2017 data from 32 patients treated with “SOFITAIRE” approach within 8 h of AIS symptom onset were selected. Procedural data including TICI score (Thrombolysis in cerebral infarction), timing, adverse events and outcome were analyzed. Results: SOFITAIRE approach was successful in achieving complete recanalization in 24 patients (75%) with a final score of 3 according to the TICI. A partial recanalization (TICI 1 -2a) was obtained in four patients (12.5%). Treatment failure was observed in four cases. 80.6% of strokes were in anterior circulation. Five cases were presented with tandem lesions involving cervical ICA. Median time from groin puncture to revascularization was 39 minutes. None adverse events were recorded. Two patients, not re-vascularized died during the hospitalization due to massive MCA infarction. Marked improvement of National Institutes of Health Stroke Scale from baseline to 24 h after recanalization were obtained in all survivals. Conclusions: SOFITAIRE approach was effective and fast in achieving a high rate of complete artery recanalization with a low rate of complications. The combined use of reperfusion catheters with retrievers may be considered as a promising tool for endovascular revascularization.

Biography:

Eduardo Flores Alvarez pursued his Master´s Degree from National Autonomous University of Mexico (UNAM) School of Medicine, Mexico with focus on the application of advanced magnetic resonance in glioblastomas. He completed his neurosurgical training program from General Hospital of Mexico of the UNAM and is the Head of Endoscopic NeuroSurgery Department. His area of research include: the advanced analysis of magnetic resonance.

Abstract:

Introduction: The Diffusion tensor image (DTI) is leading the analysis of brain lesions, and its derived biomarker the fractional anisotropy (FA) can be related to invasion, infiltration, and extension of brain neoplasms. Aim: We aim to evaluate FA values in three tumor regions of patients with glioblastoma (GB) and its association with intervals of overall survival (OS) using survival and correspondence analyses. Methodology: A retrospective study in 36 patients with GB: 23 (63.9%) males, 4614 y; and 13 (36.1%) females, 5313 y. Patients were followed up for 36 months. We measured DTI-derived FA at edema, enhancing rim and necrosis. To account for the tumor location, we used a four-level MRI-based classification based on the GB involvement of the subventricular zone and cortex. Kaplan-Meier method and the Log-Rank test assessed the survival curves between four subgroups based on tumor location. Correspondence analysis evaluated the association between OS (grouped in 7 six-month intervals) and FA measurements in the tumor regions. Results: Median FA values were higher in the normal brain regions (0.351), followed by peritumoral edema (0.190), enhancing ring (0.116) and necrosis (0.071). Comparisons among FA values among tumor regions showed a significant difference, p<.001. The Kaplan–Meier estimates indicated that the median OS for all patients was 19.3 months; the Log-Rank test to compare differences in the OS curves among subgroups was significant χ2 (3)=8.48, p=0.037. Correspondence analysis showed that a positive association between FA values in the edema region and the survival intervals was significant χ2 (18)=30.996, p=0.029. Conclusions: The alternative multivariate assessment of correspondence analysis might supplement the traditional survival analysis in patients with GB. A close follow-up of the variability of FA in the peritumoral edema region is predictive of the OS within specific six-month interval subgroup. Further studies should focus on a predictive model combining surgical and DTI biomarkers

Biography:

Rinat Esenaliev pursued his PhD in Applied Biophysics at the Institute of Spectroscopy, Russian Academy of Sciences and is currently the Professor in the Department of Neuroscience, Cell Biology and Anatomy and Director of Laboratory for Optical Sensing and Monitoring at the University of Texas Medical Branch, USA. He has more than 28 years of experience in biomedical optoacoustics, optoacoustic instrumentation and applications in monitoring, sensing and imaging. He has pioneered a number of optoacoustic applications in biomedical imaging, sensing and monitoring as well as in opto acoustic therapy and theranostics.

Abstract:

Opto acoustics is an emerging diagnostic imaging modality. We propose to use optoacoustics for biomedical applications working on it for more than 25 years starting from idea of basic science to clinical studies. Biomedical optoacoustics is based on detection and analysis of optoacoustic waves generated in tissues via thermoelastic mechanism by short optical pulses. We proposed a number of important diagnostic, therapeutic and theranostic applications; developed and built opto acoustic systems and performed animal and clinical studies. The proposed diagnostic applications include noninvasive transcranial mapping, monitoring and imaging for management of patients with intracranial hematomas, stroke and other neurological conditions. In this paper, we present an overview of our works for these applications from idea to study of tissues in vitro and to animal and clinical studies. We developed and built optoacoustic systems for early detection of intracranial hematomas and mapping of cerebral blood oxygenation. We tested the systems in small (rats) and large (sheep) animals and then in adults (healthy volunteers and patients with traumatic brain injury) and neonates (both term and premature). The obtained data demonstrated that the optoacoustic systems can be used for early detection and characterization of hematomas as well as for measurements of cerebral venous blood oxygenation with high resolution and accuracy. Our results suggest that the optoacoustic imaging modality may be used for early detection and characterization of stroke (ischemic vs., hemorrhagic). 

Biography:

Husham Bayazed pursued his PhD from College of Medicine, University of Mosul,Iraq. He is now a Consultant at the Scientific Research Center, University of Zakho/ Kurdistan Region, Iraq. He is a Specialist and Consultant in Microbiology & Immunology and has published more than 25 papers in reputed journals and has been serving as Scientific Reviewer of many local and international medical journals. In addition, he has a Fellowship of ISC, Infection, Cancer, Immunology Advisory Board Member (EUROMDnet) (Belgium); Membership of World Stroke Organization; Membership of Metabolomics (USA) and Membership of American Association of Science & Technology with more than 20 participations in international scientific meetings all over the world to his credit.

Abstract:

Anti-phospholipid syndrome (APS) is an autoimmune disease. Cerebral ischemia associated with APS occurs at a younger age than typical atherothrombotic cerebrovascular disease is often recurrent, and is associated with high positive IgG anti-phospholipid (GPL) unit levels. This study sought to determine the frequency rates of anti-cardiolipin (aCL) dependent on the presence of β2GPI, anti-β2-glycoprotein I (aβ2-GPI) and anti-phosphatidyl serine (aPS) IgG autoantibodies among stroke patients and thus demonstrate the importance of testing for aβ2-GPI autoantibodies. Stroke patients and control subjects recruited from Mosul, Erbil and Dohuk provinces in Northern Iraq were evaluated. All cases were under 50 years of age and had no recognizable risk factors. Using ELISA to evaluate the presence of IgG isotype of aCL, aβ2-GPI, and aPS autoantibodies in their blood, the results indicated that the frequency of aβ2-GPI was 14/50 (28%), aCL was 11/50 (22%), and aPS was 9/50 (18%) among stroke patients. In contrast, aCL was detected in 2/30 (6.7%) of control subjects; each of the other anti-phospholipid antibodies (APLA) was never observed. Of all the aβ2-GPI+ cases, the incidence of stroke patients having the combined profile of aβ2GPI + aCL was 11/14 (78.6%) and of aβ2GPI + aPS was 9/14 (64.3%). Among these only 2/14 (14.3%) of these aβ2-GPI+ patients expressed aCL in the absence of aPS. The frequency of patients expressing all three markers was only 9/14 (64.3 %). In none of the APS/stroke patients were aCL or aPS expressed in the absence of the aβ2-GPI. Conversely, IgG aβ2-GPI as a sole marker was seen in 3/14 (21.4%) of these patients (i.e., in absence of either other marker). It can be concluded from these studies that the among the three major forms of APLA examined, the presence of IgG aβ2-GPI autoantibodies appeared to correlate best with stroke in patients who were concurrently suffering APS. 

Biography:

Manolya Acar Özköslü is currently a PhD student at Hacettepe University, Turkey and a Lecturer in the Phytotherapy and Rehabilitation Department, Health Science Faculty, Baskent University at the same time. She is currently working on her PhD thesis and is interested in neurological and cardiopulmonary rehabilitation. She has published 8 papers in reputed journals.

Abstract:

The aim of our study is to investigate the acute effects of proprioceptive neuromuscular facilitation (PNF) techniques on pain, chest expansion, vital signs and mobility in stroke patient. Thirty eight stroke patients were allocated two groups: PNF and NDT-BOBATH (Neurodevelopmental Treatment-Bobath) methods group (n=20, mean age=62.90±9.59 year) and NDTBOBATH method group (n=18, mean age=58.67±12.68 year). The upper extremity exercises to be compatible with the natural development of human mobility were applied in NDT-BOBATH method group. PNF and NDT-BOBATH methods group performed PNF exercises that include scapula, neck, upper extremity patterns by using facilitation and rhythmic initiation techniques in addition to NDT-BOBATH method. PNF and NDT-Bobath methods were applied in single session (30 minutes). The pain (Visual Analog Scale-VAS), chest expansion (measuring of the chest circumference with a tape measure axillary, epigastric, subcostal region), vital signs (heart rate, blood pressure, respiratory rate), mobility (Functional Reach Test) were evaluated before and after the intervention. The heart rate (p=0.026) and respiratory rate (p=0.024) scores were significantly increased in PNF and NDT-BOBATH methods group. The diastolic blood pressure (p=0.026), respiratory rate (p=0.049) and Functional Reach Test scores (p=0.011) were significantly increased in PNF and NDT-BOBATH methods group. There were statistically significant differences in VAS score (p=0.043) between two groups. It appears that PNF techniques have immediate effects on mobility and reducing pain in stroke patients. It is thought that PNF techniques are one of the safe and useful rehabilitation component to increase upper extremity function.

Biography:

Sami Tetri pursued his PhD at the Oulu University, Finland in 2009 and Postdoctoral studies in Neurosurgery in USA from Harvard University, USA. He is an Adjunct Professor and a Consultant Neurosurgeon in Oulu University Hospital, Finland. He has published more than 25 papers mainly concerning the treatment of intracerebral hemorrhage and is a Member of several Editorial Boards.

Abstract:

Every sixth person suffers stroke during their life. Cerebral haemorrhage is the most serious form of stroke and it has a death rate of 50%. Primary cerebral haemorrhage means spontaneous bleeding inside the cerebral tissue which is not caused by trauma, tumour or abnormalities in the cerebral veins. The incidence on cerebral haemorrhage vary depending on the source and the figures range between 23-31/100,000 people. The rate is double compared to subarachnoid haemorrhage. Cerebral hemorrhages often lead to permanent disability or death with no specific treatment options which would improve the prognosis. Surgical treatment of cerebral hemorrhage remains controversial. In his presentation the author will go through most important evidence-based data, current treatment policy and effect of surgical hematoma evacuation on outcome. Modern, minimally invasive techniques are also discussed in the presentation.

Biography:

Angela Ruban pursued her PhD from Ben-Gurion University of the Negev and Postdoctoral studies from Weizmann Institute of Science, Turkey respectively. She is curently pursuing his career as an Independent Neurobiology Researcher at Tel Aviv University, with a specific expertise in understanding mechanism of glutamate excitotoxicity and therapeutic targeting of neurodegenerative and brain metastatic diseases.

Abstract:

Background: Subarachnoid hemorrhage (SAH) is a life-threatening condition. Cumulative morbidity and mortality following SAH remain high, despite the considerable efforts of neuroclinicians worldwide. Traditionally, rebleeding and cerebral vasospasm have been regarded as the main causes of poor outcome in these cases. Several lines of evidence suggest that glutamate (Glu) and aspartate (Asp) are involved in the secondary damage of SAH. Objective: The objective of this study is to analyze the pattern of Glu and Asp concentrations in cerebra-spinal fluid (CSF) of patients with SAH and their correlation with neurological status at admission and outcome. Methods: Fifty seven CSF samples were collected from 19 patients on days 1-3, 5-7 and 14 post-SAH. Concentrations of Glu and Asp amino acids were analyzed by liquid chromatography. Patients were neurologically evaluated at admission using Glasgow Coma Scale (GCS) and at discharge with Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS). Results: We found a significant correlation between CSF Glu and Asp levels at days 1-3 and GCS at admission (p≤0.046). The Glu levels increased continuously in CSF up to day 14 (mean value at day 1-3 11.97±7.75, day 5-7 20.61±37.57, day 14 28.06±47.23). Moreover, we found a significant correlation between CSF Glu and Asp levels at 5-7 and 14 days post-SAH and mRS at discharge (p≤0.0001, p≤0.016, p≤0.023 at day 1-3, 5-7 and 14 respectively). Conclusions: Molecular markers of early neurologic deterioration in SAH may play a role in monitoring of SAH progression and severity. SAH leads to a significant long-term increase of Glu and Asp amino acids in CSF. The patterns differ between good and poor outcome cases. We found that increased excitatory amino acids are strongly indicative of neurological status at admission and outcome.