Neurosurgery.tv Home Search neurosurgery.tv drelias@go.com.jo
Home
JANUARY
FEBRUARY
MARCH
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
 

RELATED WEBSITES

neurosurgery.fr neurosurgery.guru
neurosurgery.me
microneuroanatomy.com
ioperativemonitoring.com
diencephalon.info
mesencephalon.org
medullaoblongata.info neurophysiology.ws
humanneurophysiology.com
e-neuroradiology.com
onconeurosurgery.com
schwannomas.com
acousticschwannoma.com
pituitaryadenoma.net
meningiomas.org
craniopharyngiomas.com
craniopharyngiomas.net
pinealomas.com
glioma.ws
ependymoma.info
spinesurgeries.org
spondylolisthesis.info
paraplegia.co
vascularneurosurgery.org
Neurosurgical Encyclopedia
cns-clinic.net
munir.ws

 
 
 
 

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.

28-November-2013

Magnetom Skyra 3 tesla with all clinical applications start to run.

 

 
 
 
 

07.  08-NOVEMBER-2007  NASER MAHMOUD AL-HAMAWY  39 YEARS CSF LEAK AFTER THE SECOND OPERATION PERFORMED 01-NOVEMBER-2007.

 

 
 

Anamnesis

bullet

The patient was operated by me 01-November-2007 for remnant of the tumor . The patient was doing well and the wound was clean, until the third postoperative day after 2 days of ambulation, suddenly progressed CSF leak. The patient was put in mannitol without help. The next day diamox was administered 4 times a day  and the third day Lasix 40 mg twice daily with putting the patient in the head down position with strict bed rest, without results. 

bullet

Considering the huge amount of CSF leak with these measurements, it was decided to explore the wound.

bullet

Debridement of all the old scarous tissues was performed. and the dura was seen open at the middle of the field, about 7 mm length. The stitches at this defect were slipped. It was possible to see the spinal cord which regained a normal appearance running inside the dura with good pulsation of the xanthochromic CSF.

bullet

The dura was closed tightly and check with elevation of the head and Valsalva maneuver, showed no CSF leak. For more security, a piece of muscle with histocryl glue was impacted over the the upper part of the dural incision.

bullet

Tight layer by layer closure of the wound with water-tight closure of all layers.

bullet

Smooth postoperative recovery.

Comments:

bullet

CSF leak is one of the usual complications after spinal or cranial surgeries. Usually conservative treatment can resolve the problem in more than 70% of cases. If the CSF fail to show decline in its production and leak, it is better to explore the wound and close the defect. 4 Zero nylon was used and hermetic closure was achieved and further aid with muscle and glue were used for assurance of CSF leak closure.

bullet

The dural defect was 7 mm length and it was unlikely, that conservative measures will resolve the problem.

bullet

It was striking, that the spinal cord regained normal appearance in comparison to the previous surgery.

 
     
 

Copyright [2007] [CNS Clinic]. All rights reserved