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
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26-JULY-2015
RAMZI GEORGE ISSA RECURRENT HUGE LEFT CONVEXITAL SUBACUTE SUBDURAL HEMATOMA WITH
RIGHT SIDED PLEGIA.
Anamnesis
The patient was operated by me for subacute huge
subdural hematoma left convexity
15-July-2015 and was discharged with good
recovery of his neurologic deficit. The patient
then came 25-July-2015 telling that 2 days ago
started to deteriorate with the progressive
plegia took place back. The patient was sent for
new CT-scan of the brain which was done
confirming accumulation of the hematoma as
before the surgery.
Using the old incisions, a wide flap was created
and reflected inferior. The dura was opened and
the hematoma was evacuated and the thick capsule
was reaching from the tentorium posteriorly up
to the mediobasal frontal lobe anterior. It was
resected and the remnants were coagulated.
Lateral it was reaching the lesser wing. All the
draining veins and cortex were preserved and
were untouched. The dura was closed with ready
vac drain left under the dura. Routine closure
of the wound.
Smooth postoperative recovery.
The power of the left side immediately improved
after recovery. The patient was sent to the ICU
for 24 hour observation.
Comments
The patient was advised in the first
surgery, that 50% he could achieve the goal of recovery, or
he could accumulate the hematoma and at this case a wide
craniotomy with removal all the elements of the hematoma and
its capsule to be removed.
The thick capsule could provoke the
recurrence. MRI investigations done before and failed
to predict to whom to suggest a direct craniotomy or double
burr hole.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
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Inomed MER system
Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
documentation.
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
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 .
