Papers by Saleh S . Baeesa
Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, 2016
Background:Trigeminal neuralgia (TGN) is usually caused by arterial compression of the trigeminal... more Background:Trigeminal neuralgia (TGN) is usually caused by arterial compression of the trigeminal nerve. There are very few cases caused by intra-axial brainstem masses. Little information is therefore available regarding the response to incomplete resection of offending lesions. We present one such case, and systematically review the published in the literature.Methods:Case report and systematic review of MEDLINE and EMBASEResults:Case report: A seven year-old girl is referred with typical TGN pain. MRI revealed a cervicomedullary tumor with no abnormalities of the pons or trigeminal nerve. Subtotal resection under neurophysiologic monitoring was achieved, leaving a small residual attached near the expected location of the trigeminal spinal nucleus and tract.Patient recovered well with resolution of her TGN pain. She is asymptomatic seven years post-operatively.Literature Review:We found no other published cases in children or secondary to gliomas. Among reviewed cases, only two un...
Pathology and Oncology Research, 2022
Background: Neurotrophic tyrosine receptor kinase (NTRK) fusion has been detected in rare types o... more Background: Neurotrophic tyrosine receptor kinase (NTRK) fusion has been detected in rare types of CNS tumours, which can promote tumorigenesis. The efficacy of Trk inhibitor became a significant therapeutic interest. Our aim was to investigate whether Pan-Trk immunohistochemistry (IHC) is a reliable and efficient marker for detecting NTRK-fusion in different brain tumours.Methods: This study included 23 patients diagnosed with different types of CNS tumours. Testing for Pan-Trk IHC with monoclonal Ab (EPR17341) has been performed on all FFPE tissues. Parallelly, NTRK-rearrangements were tested using both DNA and RNA-based next-generation sequencing (NGS) assay using TruSight Onco500 platform.Results: The cohort included eight pilocytic astrocytomas, one oligodendroglioma, six IDHwildtype glioblastomas, four IDHmutant grade four astrocytomas, and one sample of each (astroblastoma, central neurocytoma, medulloblastoma, and liponeurocytoma). The mean age was 35 years; seven cases were...
Neurosciences (Riyadh, Saudi Arabia), Jul 1, 2021
Journal of neurological disorders, May 12, 2016
Objective: Malignant middle cerebral artery infarction is known to be associated with significant... more Objective: Malignant middle cerebral artery infarction is known to be associated with significant rates of mortality and morbidity. This study was undertaken to assess the immediate and one-year outcome of this intervention and to present our experience from two tertiary centers in western Saudi Arabia. Methods: The authors conducted a retrospective study to evaluate patients who underwent decompressive hemicraniectomy between November 2010-December 2015 due to clinical deterioration from space-occupying middle cerebral artery infarct. The patients were followed for at least one year after intervention using Barthel Index (BI) & modified Rankin Scale (mRS) as measures for functional independence. Results: Sex patients were included in the study. The mean age was 41.57 years and, the mean preoperative Glasgow Coma Scale (GCS) score and NIH Stroke Scale were 6.8 and 15, respectively. The mean time from stroke onset to surgery was 48.8 hours. The mean immediate postoperative GCS was 5.7. Thirty-day survival rate was 66% with mortality reaching up to 50% at one year. Among survivors, the mean mRS score of 4.6 (SD 1.53), 66% were entirely dependent (BI 0-20), 33% were partially dependent (BI 60-95) at one-year post surgery, and only one patient remained in a vegetative state. Conclusion: Survival after decompressive hemicraniectomy is better than previously reported ; this might be explained by early intervention & patients' young age in this series. Functional outcome was found to be highly variable, thus further studies with larger number of patients are encouraged to examine functional outcome predictors among survivors.
EBN باصعلأاو خلماةحارج في تاسراملما ىلع ةينبلما تاربخو براجتلا نم ةمكارتم تاونسو جذامنلاو تايرظنل... more EBN باصعلأاو خلماةحارج في تاسراملما ىلع ةينبلما تاربخو براجتلا نم ةمكارتم تاونسو جذامنلاو تايرظنلا ىلإ ةلماش ةلمح يمدقتو اهعمجب انمق ،EBN عيجشتو ثوحبلا ءارجإ عم اهتقلاعو ةيريرسلا ثاحبلأا ةيمهأ كلذك انكردأو . EBN موهفلم .يدقنلا مييقتلا موهفم انضرعتساو ةينورتكلا عجارم انمدق . EBN
Over 325 participants attended the 6th Annual Meeting of the Saudi Association of Neurological Su... more Over 325 participants attended the 6th Annual Meeting of the Saudi Association of Neurological Surgeons (SANS) held in Al-Khobar, Saudi Arabia from 3rd to 5th April, 2012. The meeting, entitled “Neurosurgery: Today, Tomorrow, and Beyond,” was hosted by Prof. Abdulrahman Alanizi, President of the meeting, and Prof. Ahmed Ammar, Chairman of the Scientific Committee. The meeting was preceded by 2 activities; the first was dedicated to public education of head and spine trauma with more than 200 attendances. The second was a neurocritical care symposium and workshop on the current management of head trauma and intracranial measurement of intracranial pressure and brain tissue oxygen monitoring, with more than 60 participants. Parallel to the main meeting, there were 2 neurological education symposiums and workshops dedicated to the 185 nurses that attended and included 20 papers. The main conference was enriched by participation of 7 renowned international speakers, including Prof. Laligam Sekhar, who presented a special lecture on skull base surgery, and Prof. Mark Bernstein who participated with 2 lectures on medical education. A special session was dedicated to the current status and future of the Neurosurgery training program in Saudi Arabia and abroad. The following highlights include selected interesting abstracts from the meeting.
Annals of Saudi Medicine, Jul 1, 2022
BACKGROUND:Vitamin D deficiency has been linked to various medical conditions such as bone loss, ... more BACKGROUND:Vitamin D deficiency has been linked to various medical conditions such as bone loss, decreased mineralization, endocrine disorders, and central nervous system disorders, including epilepsy. Vitamin D deficiency is prevalent among patients with epilepsy (PWE). However, the specific association between vitamin D levels and age in PWE is unclear.OBJECTIVES:Identify the relation between vitamin D level and age in PWE and evaluate factors that may play a role in seizure control.DESIGN:Retrospective analytical medical record reviewSETTING:Outpatient epilepsy research clinic in Saudi ArabiaPATIENTS AND METHODS:Between November 2016 and April 2020, we selected eligible PWE aged older than 14 years whose vita-min D levels were recorded at least once after reviewing 1550 patient electronic files. We analyzed data on serum vitamin D level by age and other factors, vitamin D supplement use, seizure classification, and conducted a multivariate logistic regression to assess associations with seizure control.MAIN OUTCOME MEASURES:Relationships between vitamin D levels and age and factors that might affect seizure control.SAMPLE SIZE:524 patientsRESULTS:The prevalence of low serum vitamin D levels was high (86.8%). The median vitamin D level in all patients was low (38 nmol/L), and was lower in young PWE than in adult PWE (P<.01). Only 146 patients received vitamin D supplements. High vitamin D levels were associated with a 40% seizure reduction.CONCLUSION:Vitamin D deficiency is underestimated in PWE in Saudi Arabia, and is more prevalent among young adults and patients on polytherapy than in other PWE. Patients with high vitamin D levels had good seizure control compared with those with low levels. The effect of vitamin D supplements on seizure control should be further investigated in randomized control trials.LIMITATIONS:Retrospective study and no categorization by presence of supplementation.CONFLICT OF INTEREST:None.
Journal of neurosurgery, Jun 1, 2023
OBJECTIVE Delayed cerebral ischemia (DCI) associated with vasospasm is well described in the sett... more OBJECTIVE Delayed cerebral ischemia (DCI) associated with vasospasm is well described in the setting of aneurysmal subarachnoid hemorrhage (SAH). In addition, DCI is very infrequently encountered in patients who have undergone resection of a brain tumor with unclear pathophysiology. The occurrence of DCI in the pediatric population is exceedingly rare, and outcomes in this population have, to the authors’ knowledge, never been systematically reviewed. Therefore, the authors present what is to their knowledge the largest series of pediatric patients with this complication and systematically reviewed the literature for individual participant data. METHODS The authors conducted a retrospective review of 172 sellar and suprasellar tumors in pediatric patients who underwent surgery at the Montreal Children’s Hospital between 1999 and 2017 to identify cases of vasospasm occurring after tumor resection. Descriptive statistics, including patient characteristics, intraoperative and postoperative findings, and outcome status, were collected. A systematic review was also conducted using three databases (PubMed, Web of Science, Embase) to identify reported cases available in the literature of vasospasm after tumor resection in children and collect individual participant data on these patients for further analysis. RESULTS Six patients treated at Montreal Children’s Hospital were identified, with an average age of 9.5 years (range 6–15 years). The prevalence of vasospasm after tumor resection was 3.5% (6/172). Vasospasm in all 6 patients occurred after craniotomy was performed to treat a suprasellar tumor. The average interval from surgery to symptoms was 3.25 days (range 12 hours–10 days). The most common tumor etiology was craniopharyngioma, seen in 4 cases. Extensive tumor encasement of blood vessels requiring significant operative manipulation was described in all 6 patients. A rapid decrease in serum sodium (exceeding 12 mEq/L/24 hrs or below 135 mEq/L) was seen in 4 patients. On final follow-up, 3 patients were left with significant disability, and all patients had persistent deficits. A systematic review of the literature revealed a total of 10 other patients whose characteristics and treatment were compared with those of the 6 patients treated at Montreal Children’s Hospital. CONCLUSIONS Vasospasm after tumor resection in children and youth is likely a rare entity, with a prevalence of 3.5% in this case series. Suprasellar tumor location (particularly craniopharyngioma tumor etiology), significant encasement of blood vessels by the tumor, and postoperative hyponatremia may be predictive factors. Outcome is poor, with most patients having significant persistent neurological deficits.
Journal of neurological disorders, May 12, 2016
Background: Malignant middle cerebral artery (MCA) stroke is associated with high mortality rates... more Background: Malignant middle cerebral artery (MCA) stroke is associated with high mortality rates and high levels of morbidity among survivors. Several randomized studies have now shown that decompressive craniectomy, when performed in selected patients, can be beneficial. Here we present our initial experiences implementing decompressive craniectomy procedures in patients with brain infarcts at our hospital in Saudi Arabia. Material & Methods: Between October 2008 and July 2011, four out of six patients with hemispheric brain infarcts complicated by malignant edema underwent decompressive craniectomy and duraplasty within 72 hours of symptom onset. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Clinical outcome was assessed at 12 months using the modified Rankin scale (mRS). Results: Two patients over 65 years old who were in poor medical condition were not treated surgically; both died within 4 days. Three females and one male, ranging in age from 38 to 57 years, underwent craniectomy. Of these, two died 7 and 21 days after stroke onset. One patient recovered with minor functional disability (mRS=2) while the other had a residual moderately severe functional disability (mRS=4) at final follow-up. Unexpectedly, given the small number of patients, the presence of co-morbid illness, the timeline of clinical deterioration post admission, and the lowest pre-operative GCS statistically predicted survival. Conclusions: Decompressive craniectomy rates are increasing in clinical practice, and the procedure can be life-saving. To our knowledge, our four surgical cases are among the first reported in Saudi Arabia. We call for national awareness of the management of such cases and early intervention. We also call for pre-stroke health status/co-morbidity and both the rate and extent of neurological decline post admission to be added as potential outcome predictors in future research.
Canadian Journal of Neurological Sciences, Jun 1, 2016
The Spine Journal, Oct 1, 2015
Journal of spine practice, Dec 16, 2022
Pathology and Oncology Research, 2021
The aim of this study is to investigate the relationship between isocitrate dehydrogenase-1 (IDH1... more The aim of this study is to investigate the relationship between isocitrate dehydrogenase-1 (IDH1) mutation and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation with recurrence-free interval in glioblastoma patients treated with chemoradiotherapies. Clinical data were collected from 82 patients with totally resected glioblastoma and treated with adjuvant therapies from 2014 to 2019. IDH1 mutation was assessed by immunohistochemistry and MGMT promoter methylation was assessed by different sequencing methods. IDH1 mutation was present in 32 cases and 50 cases were IDH1 wildtype; 54 and 28 patients had unmethylated and methylated MGMT promoter, respectively, Of the 82 patients, 62 patients received chemoradiotherapy while 20 patients only received radiation. Approximately, 61% of patients had a tumor recurrence after 1 year, and 39% showed a recurrence before 1 year of treatment. There was no significant relationship between IDH1 mutation and MGMT promoter methylation...
Journal of King Abdulaziz University-medical Sciences, 2006
Plasma cell granulomas of the central nervous system are rare benign forms of inflammatory pseudo... more Plasma cell granulomas of the central nervous system are rare benign forms of inflammatory pseudotumor of unknown etiology. They are often characterized by nonneoplastic proliferation of plasma cells and mimicking neoplastic processes. The author describes the management of six patients with histological proven plasma cell granulomas presented primarily with headache. Three were males with their age ranged from 9 to 43 years and a mean follow up of 40 months. The preoperative imaging studies revealed 3 cases located in the cerebral convexity and 3 were located in the posterior fossa region. Craniotomy was performed in 5 patients and in three patients complete resection was achieved. The resection was subtotal in 2 patients and they received postoperative steroids and radiation therapy. Complete resolution of the residual lesion was observed in one, and in another, the residual lesion remained stable during follow-up. One patient with infiltrating petroclival lesions had image-guided trans-nasal biopsy followed by radiation therapy with partial response. The author reviewed the literature of this rare entity and identified 46 reported cases of plasma cell granulomas. The clinicopathological and radiological findings, and the differential diagnoses were discussed and the management was outlined.
Research Square (Research Square), Mar 10, 2021
Background The Wilms tumor 1 (WT1) gene has recently been shown to play a role in gliomagenesis, ... more Background The Wilms tumor 1 (WT1) gene has recently been shown to play a role in gliomagenesis, making it a potential immunotherapy target in glioblastomas. We aimed to investigate the most sensitive method to detect WT1 expression in glioblastoma and explore relationship between WT1 expression and isocitrate dehydrogenase-1 (IDH1) mutation. Methods Clinical and biological data were collected from 44 patients with totally resected glioblastomas, treated with adjuvant therapies, in the period between 2015 and 2019. WT1 protein expression was assessed in all cases using IHC while its gene expression was assessed in 13 clustered samples using quantitative polymerase chain reaction (qPCR). IDH1 mutation was assessed using immunohistochemistry (IHC). McNemar test was used to compare the sensitivity between IHC and RT-qPCR for WT1 gene expression detection. Kaplan Meier curves were used to compare the distribution of recurrence-free interval (RFI) between IDH1 and WT1 expression groups. Results The mean age was 54-years, with a male to female ratio 1.45. IDH1-wildtype was found in 26 cases (59.1%) and the remining 18 cases (40.9%) were IDH1-mutant. Through IHC, WT1 was overexpressed in 32 cases (72.7%), partially expressed in 9 cases (20.5%) and not expressed in only three cases (6.8%). For the 13 cases tested by qPCR, 6 cases showed WT1 gene up-regulation and 7 cases showed WT1 downregulation. There was no signi cant difference in WT1 expression among cases with different RNA concentrations regardless the testing method (P-value < 0.05). However, the difference between IHC and qPCR revealed 83% sensitivity, 28.5% speci city and 53% accuracy. IDH1-mutant cases with WT1 overexpression showed signi cant difference in recurrence interval (P-value < 0.048). This signi cance was not seen among IDH1-mutant cases with WT1 partial or no expression (P-value = 0.56). There was also no signi cant difference in recurrence interval among IDH1-wildtype cases with WT1 partial or overexpression (P-value = 0.83). Conclusions Parallel testing for WT1 expression using IHC and qPCR is not reliable. However, IHC provides more accurate results than does qPCR, which runs on fragmented tissue with indeterminant RNA concentrations. Moreover, IDH1-mutant glioblastomas with WT1 overexpression are associated with slow recurrence interval particularly if temozolomide with additional chemotherapies are used.
Journal of Biomolecular Structure & Dynamics, Jul 5, 2022
PubMed, Sep 1, 2000
Trauma is the most common cause of death in childhood and non-accidental injury is the leading ca... more Trauma is the most common cause of death in childhood and non-accidental injury is the leading cause of death in infants between one month and one year of life. This is a newly emerging entity in Saudi Arabia. However, there is little available literature on the extent of child maltreatment in Saudi Arabia and other Arab countries. In this review, we will discuss various aspects of the central nervous system insults resulting from the inflicted trauma of child abuse. We aim to raise awareness in the region as the tragic loss of life and function is unequalled in childhood beyond the perinatal period.
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Papers by Saleh S . Baeesa