Background & Objective: Migraine is one of the chronic and Common Kinds of headache. Among important treatments which are advised for improvement of acute migraine attack, there are tryp tans and Ergot Alkaloids Because of side effects of Ergot Alkaloids Like nausea, vomiting, lack of appetite, Peripheral vessel contractions and induced headache and its limited consumption and patients age limitation, the patients face some difficulties using Ergot Alkaloid. On the other hand Tryp tans are Consumed as a monotherapeutic regimen but Ergot Alkaloids must be used with metoclopramide in order to prevent nausea and also they should be used in the acute phase of migraine so we decided to Compare the two groups of drugs so that if they have positive effectiveness in favor of Tryp tans, using them would be advised.

 Methods: The range of age for patients was 20- 40 years who suffered from classic and common migraine according to IHS criteria, were randomly placed in two groups. One group (36) was treated in the acute phase of disease by sumatryptan and the other (39) by a combination of 3 dihydroergotamine and naproxen and metoclopramide, and therapeutic effectiveness was studied by three Criteria of intensity, attack and frequency of attack. After the treatment, they were analyzed through chi square.

 Results: In terms of intensity, duration and frequency of the headache after the treatment, there was no significant difference between two groups and the results in both group were the same.

 Conclusion: As there were no significant statistical difference between the effect of two drugs on attack intensity, headache duration and frequency in patients of classic and common migraine, and because of the complications of Ergot Alkaloids like vomiting it should be consumed with metoclopramide and because of vessels contractions which may result in the organs gangrene and induced headache, and its maximum dose is 6 mg per week, sumatryptan is advised as the monotherapeutic.

Background & Objectives:�Stroke is the third most common cause of death after heart disease &cancer and the most common disabling neurological disorder. The incidence increases with age, and is somewhat higher in male than in female. The main risk factor of stroke is hypertension. In last years incidence of stroke has decreased due to improvement of hypertension treatment but due to occurrence of cerebrovascular accident with normal blood pressure, in many patients with stroke. This study aimed to evaluate the frequency of mortality and morbidity in stroke patients with hypertension & normal blood pressure.

Methods:�This descriptive retrospective study, evaluated 8121 patients with stroke who were admitted at hospital (1997-2006). The inclusion and exclusion criteria were defined. Data was gathered through check list and analyzed by SPSS soft ware 10 edition and the results were compared with each other.

Results: The total mortality and morbidity rate of stroke was 13.59% who 19.3% of patients with high mean blood pressure and 10.2% of patients with normal mean blood pressure were expired due to stroke. The mortality based on age in two groups was similar and more frequent in 65 to 74 year olds. The rate of mortality and morbidity in patients with high mean blood pressure in male and female were similar but in normal mean blood pressure cases were more frequent in male than in female. Hemorrhagic stroke was the most common type of stroke in hypertensive patients (59.55%) and in normotensive patients, ischemic stroke was more frequent (37.7%). The duration from admission to death was similar in two groups and the death was highest within 72 hrs after admission.

Conclusion:�Since mortality and morbidity according to age had no significant difference in both groups. It seems other risk factors are effective in evaluating cerebrovascular accidents (prognosis).

Background: Spinal dural arteriovenous fistula (SDAVF) is a known cause of nontraumatic slow progressive araparesia and is frequently overlooked because its clinical features overlap with more common causes of myelopathy and also neuroimaging may be normal.

Case Report: A 53 year-old man with developed weakness of both lower limbs had symptoms begun spontaneously 3.5 month before admission and progressed from 1 month ago with bowel and bladder incontinence. The patient's physical examination was normal and neurologic testing revealed lower extremity motor strength of 3/5. Deep tendon reflexes were decreased and superficial abdominal reflexes were absent. Sensation of pinprick and temperature was absent distal to the T4-T5 level. Vibration and proprioception were decreased to the ankle and saddle anesthesia and the patient was non ambulatory. Laboratory routine and specific tests for vitamin B12 level, hepatitis, HIV, HTLV_{1, 2} were negative. MRI of spine with and without contrast raised the possibility of dural arteriovenous malformation extended from T3 level to conus medullaris which was confirmed by angiography. The patient referred to neurosurgeon for deciding route of treatment.

Conclusion: SDAVF can be a significant non traumatic slowly progressive cause of myelopathy. The majority of the affected patients are males older than 50 years of age. Rapid diagnosis in these patients leads to significant improvement.