Browsing by Author "Naghavi, Erfan"

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    Review
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    Comparative Efficacy and Safety of Therapeutic Strategies for Mirror Aneurysms: a Systematic Review and Meta-Analysis
    (Springer, 2024) Sheıkhvatan, Mehrdad; Bahadori, Amir Reza; Naghavi, Erfan; Kashan, Azadeh Imeni; Davari, Afshan; Sheikhvatan, Mehrdad; Ranji, Sara; Tıbbi Biyoloji Anabilim Dalı / Department of Medical Biology
    Mirror aneurysms are rare and pose therapeutic challenges, with both endovascular and microsurgical options available. Single-stage and two-stage procedures are employed, but the optimal strategy remains unclear. This systematic review and meta-analysis evaluate the efficacy and safety of different therapeutic strategies for managing mirror aneurysms. The study adhered to PRISMA guidelines and comprehensively analyzed data from multiple databases, including Pubmed, Scopus, Embase, Web of Science, and the Cochrane Library, up to 30th September 2024. Statistical analysis utilized the Comprehensive Meta-analysis (CMA) software version 3.0. This systematic review encompasses 42 studies, with 11 studies undergoing meta-analysis. The meta-analysis included 629 participants. Both microsurgical clipping and endovascular interventions achieved high rates of complete occlusion (RROC 1) (ES = 0.896; 95% CI: 0.840 to 0.931; P < 0.001) with low to moderate heterogeneity (I-2 = 46.46%). Favorable neurological outcomes (mRS <= 2) were significantly achieved among all patients (ES = 0.924; 95% CI: 0.891 to 0.948; P < 0.001) with low heterogeneity (I-2 = 15.52%). Subgroup analysis revealed that microsurgical clipping demonstrated superior occlusion rates and more consistent neurological outcomes compared to endovascular treatment. Also, complications were reported in seven studies (n = 492) and included cerebral infarction, hydrocephalus, and vasospasm. As well, mortality and recurrence were rare. Both microsurgical clipping and endovascular interventions are effective and safe for treating mirror aneurysms, with clipping showing superior occlusion rates and consistent outcomes. Single-stage procedures and unilateral craniotomy are associated with better neurological outcomes when feasible.
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    Article
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    Late-onset drug-resistant epilepsy in pyridoxamine 5′-phosphate oxidase deficiency: a case report
    (Bmc, 2024) Naghavi, Erfan; Davari, Afshan; Bahadori, Amir Reza; Razmafrooz, Mohammad; AmiriFard, Hamed; Sabzgolin, Iman; Ranji, Sara
    Background Pyridoxamine 5 '-phosphate oxidase deficiency is a rare inborn error of vitamin B6 metabolism that presents with drug-resistant epileptic seizures. However, the condition is responsive to supplementation with the active vitamin B6 metabolite pyridoxal 5 '-phosphate and, in some cases, pyridoxine. Case presentation In this case report, a 10-year-old Iranian male of Fars ethnicity came to a regional hospital in Tehran, Iran with a chief complaint of tic-like movement. He had a history of unintentional, repetitive, and stereotypic movements of both arms since the age of 4 years. The physical examination depicted facial dimorphism. During admission, the patient experienced habitual hypermotor seizures and generalized tonic-clonic seizures. Ictal electroencephalography demonstrated a generalized background attenuation and bursts of generalized, predominantly left-sided, biphasic spike-wave complexes. Whole-genome sequencing revealed a pyridoxamine 5 '-phosphate oxidase deficiency as the underlying cause of the drug-resistant seizures, resulting in a low serum level of pyridoxal 5 '-phosphate. The patient underwent pyridoxine supplementation therapy, which ultimately resolved his seizures. At 6 months, he was seizure free. Conclusion Physicians ought to be aware of manifestations of vitamin B6 deficiency such as mimicking tic and consider it in the differential for drug-resistant epilepsy.