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
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03-JULY-2013 ALI YAHIYA AL-QUFAILY 65 YEARS
TUMOUR OF THE RIGHT CEREBELLAR HEMISPHERE WITH POSTOPERATIVE PERSISTING HYPERTENSIVE ENCEPHALIC SYNDROME.
The patient was operated by me
30-June-2013 for high grade glioma. The
patient was doing well in the ICU. Control
CT-scan done 8 hours after the surgery. The
tumor bed was acceptable, but the hydrocephalus
still persisting. The patient walked the next
day, but still complaining of bifrontal
headache. Considering that the hypertensive
Encephalic syndrome still persisting, Torkildsen
procedure was an option to provide the most
possible best outcome to the patient.
The incision was reopened and
extended up in setting position. The bone defect
also widened to have more lateral and near the
foramen magnum. The dural incision was also
widened. All the suspected tissues were removed
until a healthy cerebellar tissue was seen.
Insertion of Torkildsen shunt was performed from
the right posterior horn, down to the cisterna
magna down to the foramen magnum.
Routine closure of the wound.
Smooth postoperative recovery.
The patient was sent to the ICU.
Control CT-scan after the first operation. The
hydrocephalus still persisting.
Control CT-scan after second surgery. Notice that the
shunt was unintentionally inserted to the quadrigeminal
cistern and it was functioning.
The patient after the second surgery got the
histologic result of benign hemagioblastoma.
Total resection was achieved at the second
surgery and shunting was performed.
The prognosis is excellent in this case.
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