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 NEWS
January/06/2007
Surgical treatment in
paraplegia survey:
Cross-anastamosis in paraplegia below D9 started to give
results. The last documented case operated 1 year ago in a patient from Israel came
to the clinic 3 weeks ago. ECS and EMG performed showed that there is
starting innervation of Th 11 and 12. The patient's lower limbs muscles
became bulky and he could contract the lower abdominal muscles and some
movements in the pelvic girdle. Crude sensation descended down to the
inguinal level both sides. If you are more interested in this topic,
click here!
March/08/2007
Tuberculosis of the
spine
In the last 2 years the incidence of
tuberculosis of the spinal column is becoming more frequent and having
different clinico-morphologic picture. This phenomenon is alarming sign
as the residual of the use of dirty bombs and several radioactive
materials in the surrounding dirty wars in the region. For demonstration
click here! and
here!
20-AUGUST-2007
SIEMENS Digital C-arm is implemented and
functioning in the Shmaisani hospital.
30-AUGUST-2007
The Inomed ISIS Highline neurophysiologic
navigation system start to work at the operating room.
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10.17-APRIL-2007 RAWAN
TALEB ABU-THABET 22 YEARS MALFUNCTIONING
VENTRICULO-PERITONEAL SHUNT.
Anamnesis
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The patient came to the
emergency Al-Shmaisani hospital with acute
episode of headache, blurred vision and vomiting
for 2 days. |
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The patient was operated by
me September-1998 for pinealocytoma
followed by insertion of the
ventriculo-peritoneal shunt right side, followed
by radiotherapy. She was last seen in the clinic
24-February-1999 to stop anticonvulsant
treatment. |
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MRI of the brain was
performed and confirmed the presence of acute
hydrocephalus. |
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The patient was almost blind
in both eyes with agonizing headache. Check for
reservoir function was acceptable. Plain abdomen
and skull X-ray ruled out slippage of the shunt.
Mannitol 20 gm every 6 hours started and the
patient was taken to the operating room after 7
hours. |
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The old abdominal incision
was refreshed and the shunt was pulled out of
its canal and checked directly for its function.
It was functioning perfectly and it was clean.
Inspection inside the slits was normal. The
distal part of the shunt was reinserted to the
same canal and rotated several times to prevent
possible occlusion by scar or omintum inside the
abdomen. |
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Smooth postoperative recovery
and the Mannitol was stopped and all
medications. The visual functions normalized and
the patients complains disappeared. |
Comments:
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The patient got sudden onset
hypertensive encephalic syndrome due to unknown
reasons of shunt malfunction with deteriorating
visual functions, which could lead to complete
bilateral blindness. |
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Direct check of the shunt
function is mandatory, to prevent further
escalation of the increase intracranial
pressure. |
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The cause of the malfunction
could be a debris or many countless reasons,
which could cause temporary or permanent
function loss of the shunt. |
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Despite the fact the patient
is stable for more than 12 years after surgery
for pinealoma and insertion of VPS, she was in
need for the device all the time. In other
cases, the patient could accommodate and when
the shunt start to malfunction, no clinical data
are observed and the incidence undergo
unnoticeable. |
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For more details about
pinealomas
click here! |
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