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
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Multigen RF lesion generator
24-NOVEMBER-2014 HASAN ALI AHMAD AL-MASOODI 75
YEARS HUGE CHRONIC SUBDURAL HEMATOMA LEFT CONVEXITY.
The patient was operated by me
10-September-1999 for ICH with
AVM right parieto-occipital region and was doing
well. The patient then came to the clinic from
YAR 23-November-2014 with his relatives in wheelchair, telling
that he suffered minor trauma to the head 2
months ago. he last 10 days got rapid
deterioration of his condition with right sided
weakness and gross memory deficit and difficult
talking. He is in wheelchair for a week with
Foley's catheter for one day. MRI of the brain
performed in YAR 18-November-2014 bad quality
and incomplete study. but showing huge chronic
subdural hematoma left convexity and CT-scan the
same day showing the same data. The patient is
diabetic the last 5 years with controlled
arterial hypertension before the first surgery.
On examination, the patient is in wheelchair
with severe weak right upper and both lower
limbs, with better power of the left distal
muscles. The patient respond to verbal commands
with difficulty and can count to 4 with
difficulty. The relatives telling that he has
severe memory impairment. Sensation was
preserved all over. Babinski positive in the
right side without clonus.
The patient was sent for MRI of the brain with
contrast with MRA of the brain and carotids. The
area of the previous surgery in the right
parieto-occipital area is sclerotic without
evidence of new vascular malformation. There is
huge chronic subdural hematoma occupying the
entire left hemisphere with major shift of the
mid structures to the right and subfalcine
herniation. There are mild to moderate stenosis
of the right ICA just above the bifurcation from
the CCA and the right MCA segments.
Left fronto-parietal osteoplastic craniotomy
with reflection of the flap to the left ear. The
dura was opened in AP direction and the hematoma
was evacuated and the cavity was washed
meticulously to seek for active bleeding sites.
There are several veins still bridging between
the collapsed brain and dura under the dural
incision. They were preserved. Ready vac drain
was inserted to the most inferior point of the
cavity and the dural was closed using nylon 4
zero. Routine closure of the wound.
Smooth postoperative recovery. The patient was
sent to the ICU for 24 hour observation.
Dramatic improvement of his neurological
The patient has profound neurological
deficit due to major shift of the brain and distortion of
the anatomical structures, which will suffer even without
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
Inomed MER system
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 .