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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.

28-November-2013

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

 

 
 
 
 

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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