Fathi Mahmoud Afifi Nasra

Chairman Of Neurology Departmentof Al-Azhar University



Biography

Fathi Mahmoud Afifi Nasra has started his career in 1976
and completed his Master’s degree in 1979 and PhD in
1984, respectively. He was promoted to Associate Professor
of Neurology in Al-Azhar University in 1989. Then, he was
promoted to Professor of Neurology inthe same University
in 1994..He was elected as the Editor in Chief of Journal of
Egyptian stroke, board of the Journal of Neurology, Psychiatry
and Neurosurgery and board of Al-Azhar medical journal, in
1999. He was awarded the annual National Research Academy
Award for Neurology (Osama Elwan).In 2003; he was promoted
to a Chairman Of Neurology Departmentof Al-Azhar University
and Secretary of Permanent Scientific Commite to promote
professor and assistant professor in Neurology. He established
the Neurocritical Care Unit and Interventional unit in Al-Azhar
university Hospitals in 2004. Now, he is the President of
Egyptian Stroke Society.

Abstract

Many aspects of stroke have been extensively studied; the prognosis of
acute ischemic stroke is one of these aspects. Also many studies directed to
early spontaneous or induced (artificial) recanalization by using thrombolytic
therapy, relay on early restoring of blood flow.
Aim of the study: To evaluate the prognostic value of recanalization in acute
ischemic stroke by using cerebral angiography in correlation with clinical
outcome and brain C T scan findings.
Subjects & Methods: This study was conducted on 16 patients out of 50
patients, who came to the emergency department of Al-Azher university
hospitals from Mar’ 2003 to Mar’ 2005. All patients included in the study, came
within 6-8 hours from ischemic stroke onset and age greater than 18 years
(thrombolytic therapy may be needed). All selected patients were subjected to
the following: history taking, general and neurological examination including
National Institute of Health Stroke Scale (NIHSS). CT scan of brain was
performed at the time of admission to exclude cerebral haemorrhage, mass
lesion and was repeated when needed. Laboratory investigation, cerebral
angiography was performed at the first 6-8 hrs of admission, to detect the site
of occlusion and recombinant tissue plasminogen activator (rtPA) injection in
appropriate cases and repeated after 24 hrs, to detect early recanalization.
Results: There was statistically significant difference in angiographic findings
as regard outcome, higher frequency of recanalization level among good
outcome group (P<0.05), statistically significant difference in D M distribution
as regard outcome, higher frequency of D M among bad outcome group
(P<0.05), statistically significant difference in time of onset distribution as
regard outcome, higher frequency of late onset among bad outcome (P<0.05).
Conclusion: Patient with stroke and no documented angiographic occlusion
(spontaneous recanalization) must be withdrawn from thrombolytic therapy
.Cerebral angiography can be done for ischemic stroke patients, who are
candidates for thrombolytic therapy.