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.tv

Functional Neurosurgery
functionalneuro.surgery
Functionalneurosurgery.net

IOM Sites
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
neurosurgery.art
neurosurgery.me
neurosurgery.mx
skullbase.surgery

Neurosurgical Encyclopedia
neurosurgicalencyclopedia.org

Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
ependymomas.com
gliomas.info
meningiomas.org
neurooncology.me
pinealomas.com
pituitaryadenomas.com 

Neuroanatomical Sites
humanneuroanatomy.com 
microneuroanatomy.com

Neuroanesthesia Sites
neuro-anesthessia.org

Neurobiological Sites
humanneurobiology.com

Neurohistopathological
neurorhistopathology.com

Neuro ICU Site
neuroicu.info

Neuroophthalmological
neuroophthalmology.org

Neurophysiological Sites
humanneurophysiology.com

Neuroradiological Sites
neuroradiology.today

NeuroSience Sites
neuro.science

Neurovascular Sites
vascularneurosurgery.com

Personal Sites
cns.clinic

Spine Surgery Sites
spine.surgery
spondylolisthesis.info
paraplegia.today

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 .

27-MAY-2015  ABDEL-AZZIZ RFEFAN AL-ENEZI  26 YEARS RECALCITRANT WELL ENCAPSULATED ABSCESS LEFT LEFT SENSO-MOTOR STRIP.

 

Anamnesis

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The patient came to the clinic 25-May-2015 fro Saudi Arabia complaining of convulsions for 2 years with history of fever and headache with right sided hemiparesis and hypalgesia for 2 months. MRI of the brain done 19-March-2015 showing huge cystic mass left fronto-temporal area with massive edema. The patient was treated for abscess and repeat MRI done 16-April-2015 showed dramatic shrinkage of the abscess. The patient was discharged and came with fever to the clinic. 

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On examination; the patient is complaining of headache with nausea, blurred vision both eyes. The patient is left handed and has right sided hemiparesis 3/5 and hypalgesia.

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The patient was admitted and repeat MRI of the brain showed the abscess in the same region with spectroscopy excluding the tumorous nature of the lesion. The Choline is very low and the lipids 1.3 and 0.9 are high. The patient was covered with Vancomycin, Rocephine and Flagyl.

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Cardiac consultation showed that the patient has congenital defects , that G.A and hypotension will be of great risk and high mortality.

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Using RM (Riechert-Mundinger System), Inomed Planning software and intraoperative MRI with local anaesthesia, the abscess was reached fro burr hole and using ventricular end of PS Medical of shunt, the abscess was evacuated. It was yellow brown thick in consistency and sent for CXS and histologic studies. The wall of the abscess was inspected it was a swollen brain with no proper separable capsule. The cavity was irrigated with saline and the ventricular tube left in the cavity and connected to Ready-Vac drain. The wound was closed and MRI after that showed shrinkage of the cavity and the tube hanging in the upper corner of the cavity. 

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The patient was sent for ICU for 12 hours for observation.

 

 

Comments  

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The patient was operated without any sedation with local anaesthesia using Xylocain and Marcaine. The patient during surgery was in complete communication that no neurologic deficit was noted, considering that the abscess was in the left senso-motor area.

Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.


Inomed Riechert-Mundinger System, with three point fixation is the most accurate system in the market. The microdrive and its sensor gives feed back about the localization.


Inomed MER system

Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and documentation.

TRUMPF TruSystem 7500

After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014

 


Spectroscopy ruling the presence of any malignancy.


High lipid and lactate inside the abscess.


Distribution of NAA showing complete destruction of neural tissue inside the abscess cavity.


The capsule is the same as the abscess cavity.

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

 


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