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

An Iraqi lady suffering from pseudotumor cerebri for 4 years and LP-shunt inserted one year ago, continued to complain of severe headache and blurring vision. She was kept in diamox , decadron and warfarin for 18 months. After routine investigations , malfunction of the shunt was established and removal of the shunt was performed and new one was replaced.  The patient the next day was free of her headache with no visual complains. The causes of malfunction of the first shunt were the following. The shunt was epidural in location. The insertion angle of the epidural needle was directed downward. From these two points it is highly recommended to insert the epidural needle 45-50 degrees  upward to continue observing the distal tip of the the catheter that it is functioning, after that to proceed to the insertion to the peritoneal cavity.