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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator
30-JUNE-2013 ALI YAHIYA AL-QUFAILY 65 YEARS
TUMOUR OF THE RIGHT CEREBELLAR HEMISPHERE WITH HYPERTENSIVE ENCEPHALIC SYNDROME.
The patient came
to the clinic 27-June-2013 complaining of severe
headache for 2 weeks with blurred vision. For 2
months having ataxic gait with memory
disturbances. The patient suffered bullet injury
to the abdomen 1993 for what he underwent
several surgeries for the abdomen, the last was
done 2 months ago for intraperitoneal scar. He
is diabetic. Subgalial lipoma resection
occipital left side performed 1996.
MRI of the brain done 24-June-2013 showing a
huge mass in the right cerebellar hemisphere
pushing the third ventricle and causing
secondary hydrocephalus with subependymal
On examination: The patient
was limping with shuffling gait. The patient
walk with help of 2 persons. Horizontal
nystagmus when looking to both sides, more to
the right. Right sided hemiparesis more
pronounced in the upper limb.
It was explained to the sons
of the patient that the tumor mostly a malignant
clinically and morphologically. MTS could not be
ruled out, despite the fact he was investigated
thoroughly by the general surgeon.
Setting position was avoided
to escape air embolism in such patient with such
age. Supine position with Mayfield fixing the
head to bring the right occipital area upper
most. Midline incision with dissection
more to the right. The bone defect was created
over the right cerebellar hemisphere. Incision
of the dura parallel to the transverse sinus.
The tumor is involving the dura and it was
abnormally bleeding. The tumor was highly
vascular and it had no proper borders. Fresh
frozen biopsy was that of highly malignant
glioma. The tumor was followed to all directions
until the tentorium was seen and the right side
of vermis and right tonsil were identified. The
lateral pole of the right cerebellum was also
seen and the CS came fro the cisterna magna and
pontocerebellar cistern. A wide cavity was
created and proper heamostasis was achieved and
surgicele was applied to the tumor bed. Lyodura
patch was applied to gain water-tight closure.
Routine closure of the wound.
Smooth postoperative recovery. The patient sent
to the ICU.
The patient has a malignant tumor. This is by
clinical and radiologic studies. Only final
widened histologic studies can bring the proper
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision.
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 .