Feasibility and Data Quality of the National Spinal Cord Injury Registry of Iran (NSCIR-IR): A Pilot Study.

BACKGROUND: Spinal cord injury (SCI) is one of the most disabling consequences of trauma with unparalleled economic, social, and personal burden. Any attempt aimed at improving quality of care should be based on comprehensive and reliable data. This pilot investigation studied the feasibility of implementing the National Spinal Cord and Column Injury Registry of Iran (NSCIR-IR) and scrutinized the quality of the registered data. METHODS: From October 2015 to May 2016, over an 8-month period, 65 eligible trauma patients who were admitted to hospitals in three academic centers in mainland Iran were included in this pilot study. Certified registered nurses and neurosurgeons were in charge of data collection, quality verification, and registration. RESULTS: Sixty-five patients with vertebral column fracture dislocations were registered in the study, of whom 14 (21.5%) patients had evidence of SCI. Mechanisms of injury included mechanical falls in 30 patients (46.2%) and motor vehicle accidents in 29 (44.6%). The case identification rate i.e. clinical and radiographic confirmation of spine and SCI, ranged from 10.0% to 88.9% in different registry centers. The completion rate of all data items was 100%, except for five data elements in patients who could not provide clinical information because of their medical status. Consistency i.e. identification of the same elements by all the registrars, was 100% and accuracy of identification of the same pathology ranged from 66.6% to 100%. CONCLUSIONS: Our pilot study showed both the feasibility and acceptable data quality of the NSCIR-IR. However, effective and successful implementation of NSCIR-IR data use requires some modifications such as presence of a dedicated registrar in each center, verification of data by a neurosurgeon, and continuous assessment of patients' neurological status and complications.

Intradiploic dermoid cyst: a rare cause of intracranial hypertension.

In this study, we report a rare case of intradiploic dermoid cyst in a patient who developed rapid symptoms of intracranial hypertension (ICH) that mimicked Pseudotumor cerebri syndrome clinically. A 25-year-old female presented with a history of headache, nausea, vertigo and blurred vision in the past 4 months. Images revealed a small supratentorial extradural intradiploic tumor. A midline occipital craniotomy was performed and total removal of the dermoid cyst was accomplished. Present case demonstrated that dermoid cysts can be considered an exceptionally rare basic cause of ICH.

Variations in the Anatomy of the Willis' circle: A 3-year cross-sectional study from Iran (2006-2009). Are the distributions of variations of circle of Willis different in different populations? Result of an anatomical study and review of literature.

BACKGROUND: It is not well known whether the distributions of variations of circle of Willis (CW) are different in different populations. Previous studies have indicated: (a) The variations of the structure of the CW in different populations and ethnic and (b) some correlation between those congenital anatomical variations and possible cerebrovascular diseases. The frequency of such anatomical variations has not been evaluated sufficiently in the Iranian population. The aim of this study is to find the variations of the anatomy of the vessels in the CW in sample population of Iranian people and compare it with other available studies in the literature, providing a new grouping for variations. METHODS: Samples were obtained from 200 autopsies in different ages, all retrieved in the department of Forensic Medicine, Tehran university of Medical Sciences after achieving permission from the Department of Ethics and Medico-legal Sciences. The CW was examined directly, using magnification, at the base of the brain. The cerebral vessels were observed for their configuration and their calibers were measured directly. Variations were noted and grouped into different categories. RESULTS: Out of the 200 specimens examined, 69 (34.5%) were compatible with the typical anatomy of the CW. In the remaining 65.5% of the specimens, there were variations in the CW. Hypoplasia of the posterior communicating arteries was the most common variation in our study. One of the autopsies showed the presence of an aneurysm (0.5%). CONCLUSION: The anatomical variations found in our study were not significantly different from those reported in the literature. Based on the available data; (a) there is no evidence that the distribution of the variations of the anatomy of the CW is different in various societies and (b) the prevalence of the congenital aneurysmal changes in this region is not low in the Iranian population.