neurophysiology.ws
neurosurgery.fr
e-neuroradiology.com
onconeurosurgery.com
craniopharyngiomas.com
pituitaryadenoma.net
meningiomas.org
munir.ws

Dr. Ali Al-Bayyati and Dr. Munir Elias

Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit  neurosurgery.fr

Functional Neurosurgery
functionalneuro.surgery
Functionalneurosurgery.net

IOM Sites
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
cns-online.com
cns.surgery
cns.today
e-neurosurgery.com
neurosurgery.ag
neurosurgery.bz
neurosurgery.co
neurosurgery.cz
neurosurgery.fr
neurosurgery.gallery
neurosurgeryvideo.gallery
neurosurgicalvideo.gallery
neurosurgery.guru
neurosurgery.me
neurosurgery.mx
neurosurgery.photos
neurosurgery.tips
neurosurgery.tv
neurosurgery.tw
neurosurgeryspine.org

Neurosurgical Encyclopedia
neurosurgicalencyclopedia.com
neurosurgicalencyclopedia.net
neurosurgicalencyclopedia.org

Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
craniopharyngiomas.net
ependymomas.com
ependymomas.net
glioma.co
gliomas.info
glioma.ws
meningiomas.info
meningiomas.org
neurooncology.me
neurooncology.tv
neurooncology.ws
onconeurosurgery.com
pinealomas.com
pituitaryadenomas.com
pituitaryadenoma.net
schwannomas.com
theneuro-oncology.com

Neuroanatomical Sites
diencephalon.info
diencephalon.org
humanneuroanatomy.com
medullaoblongata.info
mesencephalon.org
microneuroanatomy.com

Neuroanesthesia Sites
neuroanesthesia.info

Neuroendocrinologiacl Site
humanneuroendocrinology.com

Neurobiological Sites
humanneurobiology.com

Neurohistopathological
neurorhistopathology.com

Neuro ICU Site
neuroicu.info

Neuroophthalmological
neuroophthalmology.org

Neurophysiological Sites
humanneurophysiology.com
neurophysiology.ws

Neuroradiological Sites
e-neuroradiology.com
neuroradiology.ws

Neurovascular Sites
vascularneurosurgery.com
vascularneurosurgery.net

Personal Sites
cns-clinic.net
cnsclinic.org
munirelias.com
munir.ws

Spine Surgery Sites
spinesurgeries.org
spinesurgery.ws
spondylolisthesis.info
paraplegia.co
paraplegia.ws

Stem Cell Therapy Site
neurostemcell.com


Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


Multigen RF lesion generator .

26-NOVEMEBR-2012  ILHAM AHMAD JURIYE  63 YEARS  LEFT PTERIONAL MENINGIOMA WITH INTRAORBITAL AND EXTRA-INTRACRANIAL EXTENSION.

 

Anamnesis

bullet

The patient start to notice slight exophthalmus of the left eye for 2 years with elevation of the left temporal region for 6 months and temporal anopia left eye for 3 months. The patient has arterial hypertension for 15 years, diabetes mellitus for 3 years and using glasses for 10 years for reading. She had clinical manifestations of PLD L4-5 with right sciatica 6 years ago.

bullet

MRI of the brain with contrast done 06-November-2012 showing huge meningioma occupying the left middle fossa floor , pushing the sylvian cistern up, abutting the left optic nerve and the ICA, but not involving it intracranially. The mass has hyperostosis of the great wing reaching the pterional area  with soft component extending to the lateral wall of the left orbit reaching the optic nerve in the intraocular segment. The mass also has extracranial component pushing the temporal muscle and reaching the left sphenoid fossa. 

bullet

On examination: the patient has slight exophthalmus left eye with slight edema of the eyelids. The visual acuity is normal with glasses of both eyes and the fundi are normal. There is considerable scatoma of the temporal field left eye. The weakness of dorsiflexion right foot 4/5 is due to the old PLD L4-5. Otherwise the patient is neurologically free.

bullet

Left pterional approach was done with removal of the bone flap which was invaded by the meningioma. It was sent for boiling for 15 min to kill the tumor cells within the bone. The meningioma part invading the temporalis muscle was resected. The left zygomatic arch was bisected and reflected down. Drilling of the pterion which was actually the intraossal part of the meningioma was drilled out down to the subtemporal fossa. The affected lateral and superior wall of the left orbit were drilled out. Most of the lesser wing was also frilled out. Opening of the dura parallel to wide matrix which was reaching the foramen spinosum and the superior orbital fissure and anterior 5 mm lateral to the optic nerve. The meningioma with its wide carpet was removed and sent to biopsy which confirmed the meningioma pathology. The annulus of Zinn was inspected after exposure of the left optic nerve inside its canal. The pathological involvement was removed. The periorbital fascia was inspected and opened to so as not to miss any mass under the ocular muscles. The periorbital fascia was closed and using large piece of lyodura and wide dural defect was closed water-tightly with stitches running from the foramen spinosum to the superior orbital fissure and the dura covering the lesser wing then all around. The zygoma then was returned back and stitched and bone flap returned back.

bullet

Routine closure of the wound. Smooth postoperative recovery.

 

 

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

Comments

bullet

The patient has wide based pterional meningioma with intraossal, intracranial, extracranial and extension to the left orbit. Practical radical removal was achieved.

bullet

Such a meningioma with massive intraossal and invasion even the overlying muscle must have aggressive behavior  and radiotherapy is recommended even with such radical excision.

bullet

For more details about sphenoid wing meningiomas, please click here!

Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision.


Back Up!

Notice: Not all operative activities can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also escaped from the plan .

  

 

 

 

 

 

 

 

 

 

 

 

 

WELCOME TO AL-SHMAISANI HOSPITAL

 

 

 

[2012] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved