Neurosurgeon, Fellowship of Neurovadcular and Neurointervention
RESEARCH, TEACHING, or OTHER INTERESTS
Medicine, Neurology (clinical), Pathophysiology
19
Scopus Publications
Scopus Publications
Report of the Outcome of 6-year Blood Blister-Like Aneurysm Treatment Using Clipping Technique: A Single-Center Experience Iman Ahrari, Abdelkarim Rahmanian, Meisam Eqbal, Mahsa Ghavipisheh, Ali Namjoo-Moghadam, Sobhan Ahrari, Ehsan Mohammad Hosseini, Mohammad Jamali Journal of Neurological Surgery Part A Central European Neurosurgery, 2025 Blood blister-like aneurysms (BBA) are rare vascular lesions with challenging treatment. While direct surgery has been the primary technique for treating BBA, there has been a shift toward endovascular methods in recent years. This article presents a retrospective case series of patients treated with direct surgery at our center over a 6-year period.Patients who underwent surgery for BBA from 2014 to 2019 were evaluated. Data on surgical procedures, complications, and clinical outcomes were obtained from patients' medical records. Additionally, patients were contacted to provide updates on their treatment outcomes.A total of 17 patients were treated for BBA during the study period. All cases presented with subarachnoid hemorrhage and were treated using the clipping method. Intraoperative rupture occurred in 11 patients. Additionally, internal carotid artery sacrificing was done in five patients due to avulsion during surgery. Of these 17 patients, 11 (64.7%) had favorable outcomes following surgery, while the mortality rate was 29.4% (5 patients).The rate of favorable outcomes and mortality associated with the direct surgery technique at our center was comparable to results from other centers. Further studies are required to determine the optimal method for treating BBA.
Outcome of Ischemic Stroke Patients Following Decompressive Craniectomy: A Cohort Study Mohammad Jamali, Mahyar Noorollahi, Ehsan Mohammad Hosseini, Abdolkarim Rahmanian, Mohammad Sayari, et al. Iranian Journal of Medical Sciences, 2025 Background: Decompressive craniectomy (DC) is effective in reducing mortality and improving outcomes in stroke patients. However, there is a need for a better understanding of the outcomes and complications of stroke, particularly in regions such as Iran, where comprehensive studies on DC outcomes are scarce. This study investigated the effects of DC in stroke patients. Methods: This cohort study was conducted at Nemazi Hospital in Shiraz, Iran, from 2018 to 2020. All patients aged over 18 years with ischemic stroke requiring DC were included using census sampling. Data on demographics, clinical history, and imaging findings were collected. Outcomes were assessed using the modified rankin scale (mRS), Glasgow outcome score extended (GOSE), and aphasia severity rating (ASR). Results: A total of 144 cerebral infarction patients underwent DC; 22 (15.3%) were lost to follow-up, and 67 (55%) of the remaining patients died either during hospitalization or within at least 6 months of follow-up. Patients over 60 years old (OR=0.152), those with a history of stroke (OR=0.227), and those with COVID-19 infection (OR=0.164) were associated with a decreased likelihood of survival. However, an increase in the Glasgow Coma Scale (GCS) score on admission was associated with an increased probability of survival (OR=1.199). The ordered logistic regression analysis showed that an increase in GCS score was associated with a higher probability of achieving better outcomes across all models: GOSE (OR=1.177), mRS (OR=0.839, with lower scores indicating better outcomes), and ASR (OR=1.354). The analysis showed that patients over 60 had a lower probability of achieving better outcomes in the GOSE model (OR=0.185) and were likely to have worse outcomes in the mRS model (OR=5.182). Conclusion: These findings underscored the critical role of comorbidities (such as COVID-19 and prior stroke) and GCS scores in predicting patient survival and functional outcomes following DC. In particular, the higher mortality rates and poorer functional outcomes observed in older patients highlighted the need for careful consideration in this age group.
Microsurgical Clipping of Blood Blister-like Anterior Communicating Artery Aneurysm in a Patient with Total Occlusion of Left Internal Carotid Artery Aneurysm Ehsan Mohammad Hosseini, Susan Andalibi, Reza Taheri, Saba Zanganeh World Neurosurgery, 2025 Blister-like aneurysms represent a rare subtype characterized by a wide neck and dissecting appearance, predisposing them to perioperative rebleeding due to fragile walls. These aneurysms predominantly occur at non-branching sites of the internal carotid artery (ICA). Still, they may also manifest at atypical locations, including the anterior communicating artery (AComA), anterior cerebral artery, middle cerebral artery, posterior cerebral artery, and basilar artery. 1 Treatment of blister-like aneurysms typically involves a combination of microsurgery and endovascular procedures, with no universally established optimal therapeutic approach. Because of the total occlusion of the left ICA and both cerebral hemispheres supply from the right ICA through the anterior communicating artery, we choose microsurgery to avoid thrombotic endovascular complications. Andaluz et al. presented a case series of 5 patients with blister AComA aneurysms who underwent microsurgical intervention. 2 We present a challenging case of a 64-year-old man with thick subarachnoid hemorrhage and total and chronic thrombosis of the left ICA that came with a blister-like AComA aneurysm. This patient underwent microsurgical clipping of an aneurysm ( Video 1 ). In our center, lateral supraorbital craniotomy, described by Hernesniemi et al. 3 is the preferred surgical approach for most anterior circulation aneurysms. Under general anesthesia and in a supine position, the head was fixed using Sugita then the head and shoulder were elevated above to the cardiac level, rotated 30° to the contralateral side, and tilted slightly with some degree of flexion or extension depending on surgical preferences. A curvilinear frontotemporal skin incision behind the hairline was performed. Preserving facial nerve branches, a myocutaneous flap was reflected anteriorly to the superior orbital rim. One bur hole was set below the posterior extension of the superior temporal line and a modified 4 x 4 cm craniotomy was performed using a conventional craniotomy. The sphenoid ridge was drilled off using a diamond bur maximizing the surgical corridor. Dura was opened in a semilunar fashion and reflected anterolaterally. Dissection was started in the basal frontal surface and arachnoid dissection along the optic nerve and the optic-carotid triangle proceeded. We routinely dissected and opened the lamina terminalis posterior to optic chiasma for further cerebrospinal fluid drainage. Wide Sylvian fissure dissection was performed to minimize brain retraction. Sharp arachnoid dissection over the right A1 to AComA complex and optic chiasma was carried out and then proximal control is achieved with a temporary clip. During aneurysm surgery, an intraoperative rupture occurred that was controlled with a temporary clip. Sharp aneurysm dissection and then aneurysm clipping is made under the temporary clip. Six days after the operation, the patient was discharged home without any neurologic deficit.
Hybrid endovascular and open surgical management of retained stab wounds: illustrative case Ehsan Mohammad Hosseini, Seyed Hossein Aghamiri, Mohsen Koosha, Mohammad Hasanpour, MohammadAmin Farajzadeh Journal of Neurosurgery Case Lessons, 2025 BACKGROUND Penetrating brain injuries (PBIs) are rare cases of traumatic brain injuries and are associated with high mortality. Initial management for PBIs focuses on airway, circulation, and cranial imaging evaluation. In the next step, physical examinations are essential, including understanding the mechanism of injury, conducting a thorough neurological assessment, and reviewing medications. Imaging techniques such as CT and CT angiography are essential for assessing the extent of the injury and predicting outcomes. OBSERVATIONS A 30-year-old male presented with a PBI in the left eye. A CT scan revealed that a knife had penetrated into the frontal lobe, causing contusions and subarachnoid hemorrhage. Angiography showed that the knife was close to the anterior cerebral artery (A1–A2 junction), which increased the risk of hemorrhage and complications during removal of the knife. A hybrid approach using angiographic guidance and balloon/stent catheters was used. Incremental removal of the knife was performed with real-time angiographic monitoring. The patient underwent successful skull base repair and enucleation, with follow-up showing no complications. LESSONS Traditional acute management typically involves craniotomy for foreign object removal; however, this case report highlights the successful application of endovascular techniques alongside the classic method for hybrid management of these patients. https://thejns.org/doi/10.3171/CASE24692
The efficacy of pomegranate flower on the radiation-induced oral mucositis in the head and neck malignancy: a phase II clinical trial Ahmad Mosalaei, Maliheh Dayani, Mansour Ansari, Hamid Nasrolahi, Mohammad Mohammadianpanah, Shapour Omidvari, Susan Andalibi, Ehsan Mohammad Hosseini Journal of Radiotherapy in Practice, 2025 Introduction: Oral mucositis (OM) emerged in the late 1980s to describe the adverse effects of radiation therapy (RT) on the oral mucosa. OM is the most common and clinically significant acute adverse effect of radiotherapy for head and neck cancer. Symptoms of OM vary from pain and discomfort to an inability to tolerate food or fluids, and it may affect the quality of life, breaks in treatment, hospitalisation, and therefore cancer treatment and outcome. This study aimed to evaluate the pomegranate flower’s efficacy in preventing and treating radiation-induced mucositis due to antioxidant, anti-inflammatory and anti-cancer effects. Methods and materials: This phase II clinical trial was conducted on 50 patients (case and control) with head and neck malignancy. Patients in the case groups were instructed to rinse their mouths with 5 mg Pomegranate powder with 15 cc of sterile water three times a day. The patients in the control group rinsed their mouths with normal saline mouthwash, which is the most relatively accepted preventive and supportive care in this setting. The onset and degree of radiation-induced mucositis were graded during treatment, with ‘WHO mucositis grading’ and the ‘quality of life questionnaire’ (QLQ-OES18). Result: Forty-eight patients were analysed. There was a significant difference between the two groups on onset and severity of mucositis in the two groups. There were longer intervals for the incidence of different grades of mucositis in the case group, in comparison with the control groups (P value < 0·05). Also, Complaints of dysphagia in the case groups were lower than in the control. Conclusion: Pomegranate flower seems to be effective at the time of onset, and the severity of oral mucositis during head and neck radiation. It could be a simple, potent, and inexpensive agent, which is easily available.
Guardians of Sensation: Evaluating Metformin’s Power Against Chemotherapy-Induced Neuropathy Hamid Nasrolahi, Ahmad Mosalaei, Susan Andalibi, Shapour Omidvari, Mansour Ansari, Mohammad Mohammadianpanah, Niloofar Ahmadloo, Samineh Sadeghian, Afshin Karimzadeh, Ehsan Mohammad Hosseini International Journal of Breast Cancer, 2025 Background: Chemotherapy‐induced peripheral neuropathy (CIPN) is a common and debilitating complication of cancer treatment, particularly with agents like paclitaxel. Effective preventive measures for CIPN are limited. Metformin, an antihyperglycemic agent with neuroprotective properties, has shown promise in preclinical studies; however, its clinical utility in preventing CIPN remains underexplored.Objective: This study evaluates the preventive effects of metformin on paclitaxel‐induced peripheral neuropathy in breast cancer patients.Methods: A randomized, controlled study was conducted involving 60 breast cancer patients receiving paclitaxel chemotherapy. Patients were assigned to an intervention group receiving metformin (500 mg twice daily) or a control group without metformin. Peripheral nerve function was assessed using nerve conduction studies (NCSs), measuring sensory nerve action potential (SNAP) amplitude, compound muscle action potential (CMAP) amplitude, and distal latency (DL). Clinical neurological symptoms and adverse effects of metformin were monitored throughout the study.Results: Of the 60 enrolled patients, 47 completed the study (26 control and 21 intervention). The incidence of CIPN was lower in the metformin group compared to the control group, although this difference did not reach statistical significance. Metformin was well‐tolerated, with mild gastrointestinal side effects being the most common adverse events. No significant differences between the groups were observed in SNAP amplitude, CMAP amplitude, or DL.Conclusion: Metformin may modestly reduce the incidence of CIPN in patients receiving paclitaxel chemotherapy, although the observed effect was not statistically significant. Given its safety profile and potential neuroprotective benefits, metformin warrants further investigation in larger, multicenter trials to confirm its role in CIPN prevention.
Microsurgical treatment of ophthalmic artery aneurysm, a case series of 55 patients with long-term follow-up Abdolkarim Rahmanian, Ehsan Mohammad Hosseini, Arman Sourani, Mohammad Jamali, Arash Saffarian, Keyvan Eghbal, Sanaz Taherpour, Mina Foroughi BMC Surgery, 2024 Background Ophthalmic artery aneurysm (OAA) can be secured in endovascular or microsurgical approaches. Still there are controversies in technique selection and their long term outcomes. Methods All the patients with OAA were treated microsurgically and followed. Demographic data, neurological status, physical examination findings, angiographic data, operation details, and intraoperative and postoperative events were recorded and analyzed. P < 0.05 was considered significant. Results Among 55 patients, 38 were females (69.1%). Median preoperative glasgow coma scale (GCS), Fisher Grade, and Hunt and Hess(HH) scores were 15, 1 and 1, respectively. The most common neurologic manifestation was visual problems (n = 15). The most common anatomical projection was medial (43.6%) oriented lesions. 85.5% of them only had 1 ophthalmic aneurysm while multiple aneurysms were reported in 14.6%. In 52 patients temporary clip was used. in 21 patients (38.2%) intraoperative aneurysm rupture occurred. Larger aneurysm size and preoperative hydrocephalus were associated with higher rates of aneurysm rupture (P = 0.003 and 0.031). 28.5% of the patients with visual problems had clinical improvement in the postoperative period. The mean follow-up period was 5 years. Follow-up angiography showed a 100% obliteration rate with a 0.0% recurrence rate. Median values for follow-up glasgow outcome scale and modified Rankin scale were 5 and 0, respectively. favorable neurological outcomes were associated with better primary GCS and HH scores. Conclusion OAA microsurgery is an effective and safe procedure with significant improvement in both visual and neurological status. Low recurrence rate and excellent clinical recovery are the most important advantages of microsurgery in OAA treatment.
The OptimalTime forPostoperative Magnetic Resonance Imaging of the Sella in Patients With Pituitary Adenoma Mohammad Ghorbani, Ehsan Keykhosravi, Mohammad Hasanpour, Ali Abbasian Ardakani, Ehsan Mohammad Hosseini Basic and Clinical Neuroscience, 2024 Introduction: Magnetic resonance imaging (MRI) is the preferred neuroradiologic tool for evaluating the sellar region. Pituitary adenomas account for about 15% of primary intracranial tumors. The optimal time for postoperative MRI of central nervous system neoplasms is 48 hours after surgery. Nevertheless, controversy exists regarding the timing of postoperative MRI in the sellar region. This study analyzed the sellar MRI findings of patients with pituitary adenoma at different times before and after surgery. Finally, we suggest the optimal time for postoperative sellar MRI imaging in patients with pituitary adenoma. Methods: A total of 28 patients with pituitary adenoma were evaluated. All patients did four sellar MRIs. The first MRI was done before surgery, and three were done 48 hours, two weeks, and three months after the surgery. Finally, the MRI findings at different times were compared to each other. Results: The pituitary gland and adenoma signals were constant at all time points. The signal of the packing material showed no differences in T1-weighted and T1-weighted with contrast sequences but showed changes in T2-weighted sequences. Conclusion: Contrary to other intracranial neoplasms, there were no apparent changes in MRI signal intensity during the 3 months after surgery in patients with pituitary adenoma. There was also no superiority of one time point for performing follow-up imaging.
CD68 Antigen and Cerebral Aneurysms: A Case-Control Study Abdolkarim Rahmanian, Ahmad Salehi, Eskandar Kamali-Sarvestani, Iman Ahrari, Ehsan Mohamadhoseini, Mohammad Jamali, Sulmaz Ghahramani Journal of Neurological Surgery Part A Central European Neurosurgery, 2022
Preventive Effect of Phenytoin Compared to Levatiracetam on Incidence of Seizure in Children with Shunted Hydrocephalus Journal of Mazandaran University of Medical Sciences, 2022
