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
The patient a known case of Ca bladder came complete sudden-onset right paraplegia more dense of the lower limb for one week. MRI demonstrated tow tiny MTS of the left cerebral hemisphere, with massive toxic
edema of the entire hemisphere. Decadron given preoperatively, gave a little effect. Considering the ease of their removal it was decided to remove them. The challenge was with the lesion located parallel to the falx cerebri . There were a lot of veins covering the area. It was decided to remove it from anterior in relation to the veins, because the posterior aspect was full of veins. The tumor had proper cleavage and both lesions were removed completely through separate two craniotomies. The patient after mild recovery within 3-4 days after surgery, showed gradual deterioration, despite the gradual improvement of his local problem . The tumor
MTS got very aggressive nature and scattered infarctions of the brain stem and subsequent deterioration of brain-stem function continued to deteriorate and the patient died 18-April-2005.
Conclusions: It is hard to predict the outcome of such cases, and operating upon them, must be considered with other paramedical factors.