Mohammed Radhi Radeef Al-dulaimi

ABSTRACT Venous thromboembolism(VTE) it refer to all forms of pathologic thrombosis , occurring on the venous side of the circulation and when it effect thedeep veins it is referred to as deep venous thrombosis (DVT).Many of acute stroke patient develop pulmonary embolism in the absence of symptomatic DVT (silent DVT), the clinical significance of silent DVT in relation to acute stroke is unclear at present. It remains to be seen whether silent DVT is a common complication among patient with acute stroke. Objective: The aim of this study was to help clarify occurrence of DVT based on a screening DUS in patient with acute stroke (ischemic & hemorrhagic) and risk factors for its development. Methods: This cross-sectional study carried out in the period between January and September 2015 in Middle Euphrates neuroscience center at Annajaf city. Ninety tow patients with acute stroke show no clinical evidence of DVT enrolled in the study .36 were female and 56 were male, their ages ranged from 42 to 70 years old. We classified study group into subgroups for purposes of statistical analysis. Results: silent DVT was found in sixpatients with acute stroke (6.52%, n=92). Patients with silent DVT tended to be older as they had mean age of 66.33.While patients without silent DVT had mean age of 58 (P value =0.002),Silent DVT effect age group older than 70 years(p value (0.002).Patient with silent DVTtended to have higher NIHSS score than those without silent DVT (mean 14 vs 7.39, p value=0.003).Silent DVT significantly affectPatients with severe stroke (P value=0.002) and those with sever lower limbs disability (P value =0.006). Conclusion: Our study shows significant presence of silent DVT in patient with acute stroke; hemorrhagic stroke subtype, old age, sever stroke, and sever lower limbs disability were the independent risk factors of its development. Keywards: Silent DVT, stroke type, age, gender, severity of stroke, lower limbs disability.

In December 2019, a novel coronavirus outbreak with multiple system involvement started initially in Wuhan City, Hubei Province of China. Coronavirus disease 2019 (COVID-19) infection is a systemic disorder typically presenting with fever, fatigue, and upper and lower respiratory symptoms, although neurological manifestations are increasingly reported, but pathological mechanisms have yet to be established. The symptoms of infection with COVID-19 are dependent on the patient’s age and underlying medical illness, and on the condition of the immune system. Neurotropic and neuroinvasive capabilities of coronaviruses have been described in humans. We herein report a patient infected with COVID-19 who developed pneumonia associated with acute progressive myelopathy. Neurological examination revealed progressive flaccid areflexic paralysis of lower limbs over 3 days with retention of urine and sensory level at 10th spinal thoracic segment (T10). The patient had a positive nasopharyngeal swab for COVID-19 at the onset of the neurological symptoms. This case of acute progressive myelopathy adds further evidence of the complications of severe COVID-19 infection, and we are dealing with a virus of unpredictable behavior. Since this virus neurotropism is not clear yet, further investigations should be conducted on the mechanism of possible neurological infection in patients with COVID-19.

ABSTRACT Background: migraine, the second most common cause of headache, and the most common headache-related disability in the world, it affect two third of women and one third of men. It is an episodic headache associated with certain features such as sensitivity to light, sound, nausea and vomiting often accompany the headache. Important description of migraine is a recurring syndrome of headache associated with other symptoms of neurologic dysfunction in varying admixtures. Aims of study: to assessment of prevalence and factors associated with misdiagnosis of migraine Study design: cross-sectional study Methods: a total 363 patients attending middle Euphrates neuroscience center in al najaf city. female 277(76.31%) and male 86(23.69%) of migraine. mean age (SD) was 32.02 (8.404). fulfilling criteria of diagnosis of the international headache society (ICHD-3Β) for migraine headache were chosen for study. for severity MIDAS was used. diagnosis was considered as “appropriate” if patient’s headache fulfilling ICHD3B criteria for migraine headache otherwise labeled as “inappropriate.” Statistical analysis: factors tested by chi-square for categorical data. Logistic regression analysis was used to identifying independent factors affected with inappropriate diagnosis by SPSS program. Results: “inappropriate” diagnosis in 144(39.7%) patients vs appropriate diagnosis 219(60.3%) patients. Gender , oral contraceptive pills use , education, frequency ,location ,pain type ,aura symptoms ,associated symptoms ,previous testing ,types of migraine ,previous diagnosis ,previous consultation and headache relief by medications where all of it significant on misdiagnosis of migraine.