Farideh Nejat

Imam Khomeini International University, Kazvin, Qazvīn, Iran

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Publications (115)157 Total impact

  • Zohreh Habibi, Farideh Nejat
    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. 09/2014;
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    ABSTRACT: Background: In general, it seems that both genetic and environmental factors play important roles in the induction of neural tube defects. Lipomyelomeningocele (LipoMMC) is a rather common type of closed neural tube defect, but only limited studies have investigated the potential risk factors of this anomaly. Therefore, the purpose of this case-control study was to investigate the risk factors involved in LipoMMC formation. Material and Method: Various risk factors were evaluated in 35 children between 1 month and 10 years of age with LipoMMC in a hospital-based case-control study. The 2 control arms consisted of 35 children with myelomeningocele (MMC group) and 35 children with congenital anomalies other than central nervous system problems (control group). All groups were matched for age and visited the same hospital. A structured questionnaire was used for the collection of all data, including the mothers' weight and height during pregnancy, education, reproductive history, previous abortions, and socioeconomic status, as well as the parents' consanguinity and family history of the same anomalies. Results: Univariate analysis of the children with LipoMMC compared to the control group showed that the use of periconceptional folic acid supplementation was significantly lower in the MMC and LipoMMC groups compared to the control group. In addition, comparison of the MMC and control groups revealed statistically significant differences regarding the use of folic acid and maternal obesity. In multivariate analysis, use of folic acid in the periconceptional period and during the first trimester was an independent risk factor for LipoMMC and MMC. Furthermore, maternal obesity was a significantly positive risk factor for MMC. Conclusion: The probable risk factors for LipoMMC were investigated in this case-control study. Consumption of folic acid in the periconceptional period and during the first trimester is an independent protective factor against LipoMMC. It seems that larger studies are needed to examine other possible risk factors. © 2014 S. Karger AG, Basel.
    Pediatric Neurosurgery 06/2014; · 0.42 Impact Factor
  • Mahdi Arjipour, Farideh Nejat, Zohreh Habibi
    Journal of Neurosurgery Pediatrics 05/2014; · 1.63 Impact Factor
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    ABSTRACT: Objective: Exophytic gliomas of the medulla are rare childhood tumors that mostly are pilocytic astrocytomas. Here we report our experience in 11 ‑children with this rare tumor. Methods: A retrospective study was performed using the records of children with exophytic gliomas of the medulla at Children's Hospital Medical Center in Tehran, Iran, from 2002 through 2013. The general, clinical, and radiological data and follow-up of all patients were reviewed. Results: The patients mostly were male aged from 11 months to 7 years. Swallowing problems, failure to thrive and nausea and vomiting were the most common symptoms. The time span between the onset of symptoms and the diagnosis was 2-24 months. Gross total resection of tumor was possible in 8 patients. Most tumors were pilocytic astrocytomas. Patients were followed for 2 months to 11 years (mean = 3.6 years). There was no intraoperative mortality. Recurrence occurred in 1 child with fibrillary astrocytoma. Conclusion: Gross total resection of symptomatic dorsal exophytic medullary glioma is recommended. Most tumors are pilocytic astrocytomas. The attachment of these tumors to important brainstem structures usually inhibits total resection. Electrophysiological monitoring of sensorimotor pathways and cranial nerves can be helpful to preserve surrounding neural tissue during tumor resection and to minimize complications. Regular follow-up of patients with clinical examination and brain MRI is mandatory. Repeated surgery, radiation therapy and chemotherapy are suggested in cases with tumor recurrence or progression. © 2014 S. Karger AG, Basel.
    Pediatric Neurosurgery 05/2014; · 0.42 Impact Factor
  • Iranian Journal of Pediatrics 12/2013; 23(6):721-2. · 0.26 Impact Factor
  • Journal of Neurosurgery Pediatrics 09/2013; · 1.63 Impact Factor
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    ABSTRACT: Lipomyelomeningocele, a closed neural tube defect, usually occurs in lumbosacral area as a single lesion but can be associated with other spinal dysraphism. We report an infant with a very rare presentation of tandem lumbosacral lipomyelomeningoceles, thick filum terminale and split cord malformation.
    Journal of Pediatric Neurosciences 09/2013; 8(3):204-6.
  • Pediatric Neurosurgery 08/2013; · 0.42 Impact Factor
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    ABSTRACT: Myelomeningocele is a complex central nervous system malformation mostly associated with other neural and extraneural anomalies. A rare special feature of the forehead and skull was observed in myelomeningocele. Here, we present several patients with myelomeningocele, severe hydrocephalus, and interfrontal encephalocele accompanied by metopic suture widening and abnormally shaped frontal bones. Five children with this feature were enrolled in this series. The age, sex, location of myelomeningocele sac, neurological deficits, hydrocephalus and history of shunt surgery, and follow-up period were evaluated. Patients were aged from 1 to 12 months (mean, 6 months). All patients were male. Most sacs were located in lumbar and lumbosacral areas. Neurological deficits varying from only sphincter problem to paraplegia were found in all patients. Hydrocephalus was found in all children that needed a shunt procedure. Asymptomatic Chiari malformation, interfrontal encephalocele, and corpus callosum agenesis were evident in five, five, and three patients, respectively. Anterior fontanel anomalies known as interfrontal encephalocele associated with myelomeningocele have been reported before. The patients have an open metopic suture extending widely to the nasal radix producing hypertelorism accompanied by interfrontal herniation of frontal lobes. The associated hydrocephalus exaggerates the anomaly. Treatment of accompanying hydrocephalus is advised to decrease the severity of frontal lobe herniation. Some patients may need frontal bone reconstruction surgery to provide cosmetic correction at the place of the midline frontal bone defect.
    Child s Nervous System 08/2013; 29(8):1349-52. · 1.24 Impact Factor
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    ABSTRACT: Objective: There are controversies about seizure risk factors in shunted hydrocephalic patients which can be due to having merged two different types of seizure (preshunt and postshunt seizures) in previous studies. Also, it is not known whether a considerable change in ventricular size after shunting can be a risk factor of postshunt seizures. Methods: 150 hydrocephalic patients who underwent shunting from 2006 to 2011 in the Children's Hospital Medical Center in Tehran, Iran, were visited at least 1 year after shunting to assess risk factors of preshunt and postshunt seizures. Ventricular size was assessed by using a radiologic index of bifrontal ratio (BFR). Results: Preshunt seizures were higher in patients with postinfectious hydrocephalus and intraventricular hemorrhage. Early shunting, history of shunt complications and shunt infection, and a high number of shunt revisions were significant risk factors for developing postshunt seizures. The change in BFR after shunting was not a significant risk factor of postshunt seizures. Conclusion: The difference between risk factors of preshunt seizures and postshunt seizures shows that they are two different types of seizures with different natures. Preshunt seizures are hard to prevent as they are related to the underlying disease of the brain or the etiology of hydrocephalus. However, postshunt seizures are related to the shunt and might be decreased by preventing shunt complications.
    Pediatric Neurosurgery 06/2013; · 0.42 Impact Factor
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    Iranian Journal of Pediatrics 04/2013; 23(2):241-2. · 0.26 Impact Factor
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    ABSTRACT: Background: Craniosynostosis is a relatively common congenital abnormality. The underlying etiology and most probable risk factors of nonsyndromic craniosynostosis are unknown. We conducted a study to identify the risk factors for craniosynostosis. Materials and Methods: In this case-control project, 70 children with craniosynostosis (syndromic or nonsyndromic) hospitalized at the Children's Hospital Medical Center from September 2010 to 2011 were studied for the potential risk factors. At the same time, 70 age- and sex-matched children hospitalized with other congenital anomalies were reviewed. Information from case and control groups was obtained via personal interviews with parents of patients and a prepared checklist was filled out for each child. Results: The mean (±SE) age at admission time in the case-control group was 13 ± 1.95 (1.5-96) months, and almost half of them were boys (n = 37 or 53%). The most frequent sutures involved in craniosynostosis were coronal (n = 30 or 42.9%) and then metopic sutures (n = 16 or 22.9%), multiple (n = 12 or 17.1%), sagittal (n = 11 or 15.7%) and lambdoid (n = 1 or 1.4%). In the case group, maternal diabetes mellitus and thyroid disease were found in 8 (11.6%) and 6 (8.6%) patients, respectively. The most frequent medication used by mothers (n = 66 or 94%) in the case group during pregnancy were vitamins (including iron supplements, omega 3, folic acid and multivitamins). Conclusion: A positive family history of craniosynostosis [odds ratio (OR) 19.01 and 95% confidence interval (CI) 2.24-160.7] and using clomiphene citrate for infertility (OR 12.71 and 95% CI 1.42-113.6) were the strongest independent risk factors for craniosynostosis. More comprehensive studies with a larger sample size are required to confirm the role of environmental factors in order to decrease the occurrence of craniosynostosis.
    Pediatric Neurosurgery 02/2013; · 0.42 Impact Factor
  • Farideh Nejat, Mostafa El Khashab
    Surgical Neurology International 01/2013; 4:56. · 1.18 Impact Factor
  • Farideh Nejat, Mostafa El Khashab
    Journal of Nippon Medical School 01/2013; 80(1):83.
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    ABSTRACT: Brain abscess in young infants is extremely rare and usually associated with a previous history of bacterial meningitis or septicemia. Here we report a cerebellar abscess mimicking brain tumor with atypical clinical and paraclinical presentations. A two-month old previously well-baby boy was referred to us with persistent vomiting, strabismus and developmental regression. The brain imaging showed a right cerebellar mass with multiple small cysts inside the lesion. Elevated serum alfa-fetoprotein associated with cystic and solid posterior fossa mass proposed the preoperative diagnosis of teratoma but tumor cells were not found inside the pathology specimen. The culture of the sample was positive for staphylococcus aureus. The interest of this case lies in the atypical features of clinical and radiological evaluations in a young infant associated with an abnormal alfa-fetoprotein level of serum.
    Iranian Journal of Pediatrics 12/2012; 22(4):539-42. · 0.26 Impact Factor
  • Farideh Nejat, Mostafa El Khashab
    Journal of Neurosurgery Pediatrics 11/2012; · 1.63 Impact Factor
  • Farideh Nejat, Mostafa El Khashab
    Journal of Neurosurgery Pediatrics 11/2012; · 1.63 Impact Factor
  • Farideh Nejat
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    ABSTRACT: Anterior encephalocele is a rare pathologic condition in pediatric neurosurgery. Most of encephaloceles are located in the occipital region. The present study reports a series of 15 children with anterior encephaloceles. This was a descriptive retrospective survey conducted on the medical recordings of encephalocele patients underwent a neurosurgery during a 12-year period. A total of 83 cases of neurosurgery performed in a pediatric hospital (Children Hospital Medical Center, Tehran, Iran) were reviewed. The demographic, surgical approach and follow up data and recordings of these patients were collected and then analyzed. A total of 83 patients with encephalocele were operated, of which 15 have anterior encephalocele. They were classified as fronto-orbital, frontonasal, frontoethmoidal, transsphenoidal, and interfrontal. They were aged from 3 days to 7 years at the time of operation. All surgeries were performed with craniotomy or endoscopic repair of the lesion. A 1 to12-year period follow-up showed that all cases are alive and all of them except for one case have normal neurodevelopmental status. Anterior encephalocele is a rare condition in congenital central nervous system. Most of patients with anterior encephalocele encounter with face deformity because of mass or hypertelorism or orbital disfiguration. Some of them have serious complications of meningitis due to CSF leakage. In time surgical management with precious correction of cranial bone defect are necessary to prevent more complicated consequences and to reduce the need for surgery in the future. Anterior encephalocele, surgery, skull defect.
    Journal of injury & violence research 11/2012; 4(3 Suppl 1).
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    ABSTRACT: INTRODUCTION: Positioned anatomically between the spinal epidural space and the intramedullary compartment, the spinal subdural space remains the least common area of localized infection in the central nervous system. Infectious processes of the subdural spinal space include subdural spinal empyema, subdural spinal abscess, infected spinal subdural cyst, and infectious spinal subdural cyst. To date, there has been no systematic review of these entities in children, with the cumulative knowledge of the pathophysiologic, microbiologic, and demographic characteristics of these infections relegated solely to few small series and case reports. METHODS: A series of 11 recent cases culled from the collaboration of international authors are presented. In addition, an exhaustive MEDLINE search and manual review of the international literature was performed, identifying a total of 73 cases of spinal subdural infections in patients under the age of 21. Data of interest include the age, sex, signs, and symptoms at presentation, spinal location of infection, presence of spinal dysraphism, and other comorbidities, offending organism, treatment, outcome, and follow-up. RESULTS: Patients ages ranged from 4 weeks to 20 years (mean, 6.5 years). Males outnumbered females by a ratio of 2:1. Over half (53 %) of spinal subdural infections in children were associated with spinal dysraphism or other congenital abnormalities of the spine. The commonest organism to infect the spinal subdural space in children is mycobacterium tuberculosis and the thoracic spinal region was most commonly infected. CONCLUSIONS: The disease is usually treated surgically, although a more expectant approach consisting of antibiotics and observation has also been proposed.
    Child s Nervous System 09/2012; · 1.24 Impact Factor
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    ABSTRACT: Objective: Cranial dermal sinus is a very rare anomaly mostly found in the midline occipital area, presenting with diverse clinical features from asymptomatic dermal sinus to symptomatic situations including meningitis, dermoid tumor or abscess. Methods: Medical records of 18 patients with 19 cranial dermal sinuses operated at the Children's Hospital Medical Center in Tehran from 1999 to 2011 were retrospectively studied. Their presentations, accompanying anomalies, radiological and surgical findings were evaluated. Results: Patients were aged 1 month to 6 years and were followed for 2-12 years. Most sinuses were located in the midline occipital region. Infection was the most common reason for referral (50%) followed by skin dimple (33.3%). Creamy white discharge was found in 50% of patients. Posterior fossa abscess, hydrocephalus and meningitis were observed in 38.9, 38.9 and 22.2% of children, respectively. All sinus tracts with associated dermoid tumors or abscesses were removed en bloc to decrease the risk of recurrence. Conclusion: The sinus tracts are a portal of entry for pathogens which result in serious complications of meningitis or abscess. In this series, 67% of children presented with serious symptoms; therefore, we recommend prophylactic surgery in all cranial dermal sinuses. The exact time of surgery is not obvious as the natural course of the disease is unknown. If any symptom is observed surgery should be done as soon as possible. For asymptomatic sinuses identified by the pediatrician during a regular visit prophylactic surgery is recommended as soon as the child can tolerate operation.
    Pediatric Neurosurgery 09/2012; · 0.42 Impact Factor

Publication Stats

353 Citations
157.00 Total Impact Points


  • 2010–2013
    • Imam Khomeini International University
      Kazvin, Qazvīn, Iran
  • 2009–2013
    • Hackensack University Medical Center
      Hackensack, New Jersey, United States
  • 2002–2013
    • Tehran University of Medical Sciences
      • Department of Neurosurgery
      Tehrān, Ostan-e Tehran, Iran
  • 2012
    • Shariati Hospital
      Teheran, Tehrān, Iran
    • Kerman University of Medical Sciences
      Carmana, Kermān, Iran
  • 2009–2010
    • Sina Hospital
      Mashad, Razavi Khorasan, Iran
  • 2006–2008
    • University of Tehran
      Teheran, Tehrān, Iran