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Browsing by Author "Al-Jehani, Hosam"

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    Cerebral venous sinus thrombosis
    (2019) Al-Jehani, Hosam
    Abstract Not Available(Editorial)
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    Familial intracranial aneurysms in Saudi Arabia: What do we need to do?
    (2016) Shiekh, Bassem; Al-Jehani, Hosam; Yamani, MahmoudOrz, Yasser
    Aneurysmal subarachnoid hemorrhage (SAH) is a devastating event with significant morbidity and mortality. The incidence of SAH might be influenced by environmental factors but genetic predisposition is evolving as an important effector in the risk of development of intracranial aneurysms and rupture of aneurysms. This requires strategies for effective screening of family members at risk of developing such a phenotype, in order to deliver preventive treatment to these target lesions. We discuss the potential for implementing these strategies in the Saudi Arabian health system and the future implications on our care for such a vulnerable group of subjects.
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    Spinal muscular atrophy and ependymoma
    (2017) Albakr, Aishah; Abbas, Faisal; Al-Jehani, Hosam; Ammar, Ahmed
    Spinal muscular atrophy (SMA) is an autosomal recessive disorder, characterized by a progressive degeneration of anterior horn cells of the spinal cord resulting in hypotonia, skeletal muscle atrophy and weakness. We report the case of a 33-year-old female with SMA type IV (SMA4) who presented with symptoms of spinal cord lesion that was initially missed. Further evaluation resulted in the diagnosis of ependymoma. To the best of our knowledge, this is the first time that the coexistence of SMA4 and ependymoma has been reported.
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    “Thrombectomy and Back:” A novel approach for treating patients with large vessel occlusion in the Eastern Province of Saudi Arabia
    (2021) Al-Jehani, Hosam; AlHamid, May; Hudhiah, Kawthar; Al-Bakr, Aisha; Bunayan, ReemAlAbbas, Faisal
    Background: Timely access to comprehensive stroke centers for patients suffering from acute ischemic stroke due to large vessel occlusion (LVO) remains a commonly encountered obstacle worldwide, especially in areas with no comprehensive stroke or thrombectomy-capable stroke centers. Objective: To present our novel experience with a “thrombectomy-and-back” model implemented in the Eastern Province of Saudi Arabia. Methods: King Fahd Hospital of the University (KFHU), a 600-bed hospital located in Al Khobar with an open-access emergency department, was designated as a comprehensive stroke center in the Eastern Province. “Thrombectomy-and-back” was designed such that the neurologist in the referring hospital directly communicates with the attending neurovascular team at KFHU for their anticipation of the case, and subsequently confirms LVO presence through urgent acquisition of a CT and a CT angiogram. Once LVO was confirmed, the patients were timely transferred to KFHU for mechanical thrombectomy. Upon procedure completion, the patients returned to the referring hospital with the same medical and EMS team. The safety of transfer and peri-procedural complications were analyzed. Results: From December 2017 to December 2019, 20 thrombectomy-and-back codes were activated, of which 10 were deactivated on negative LVO and 10 remained activated. Of these 10 patients, 2 required admission to our hospital's Neuro-ICU: one was because the middle cerebral artery reoccluded during the procedure and the other was due to hemodynamic instability upon arrival; this first patient passed away 2 months later due to the complications of the malignant left middle cerebral artery stroke. Conclusions: The novel Thrombectomy-and-Back model in the Eastern Province of Saudi Arabia has proved to be a safe and efficient approach for patients presenting with LVO to receive timely interventional therapy and minimizing futile transfers.
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    The use of transcranial doppler pulsatility index to guide intracranial pressure monitoring in intoxicated traumatic brain injury patients
    (2014) Al-Jehani, Hosam
    Introduction: Management of intracranial pressure (ICP) represents a cornerstone in the care of traumatic brain injury (TBI) patients. On occasions, intoxicated TBI represent a clinical challenge since their initial imaging is not significantly correlating with elevated ICP yet their neurological exam concerns toward that possibility. Materials and Methods: We present an initial series of intoxicated TBI patients in which the trans-cranial Doppler (TCD) were conducted to noninvasively judge the ICP and correlate those with the clinical findings. Results: A total of four patients is reported in this series. About 50% of the patients had evidence of elevated ICP based on TCD parameters confirmed by ICP monitors. Conclusion: From our series, TCD screening examinations were helpful in expediting an objective guided decision for intracranial pressure monitoring.