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Dr. Ali Al-Bayyati and Dr. Munir Elias

 
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-OCTOBER-2011  NORA ZAKI ISMAEEL  24 YEARS   NON-FUNCTIONING LPS DUE TO UPWARD MIGRATION.

Anamnesis

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The patient was admitted to Shmaisani hospital with clinical signs of increased ICP. The patient is a known case of pseudotumor cerebri and she went 4 surgeries for insertion of LPS, which all the time is troubleshooting.  The first surgery was in November-2009, the second  at 31-May-2011, the third at 22-July-2011 and the last in 04-August-2011.

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The patient was sent for new MRI of the brain with contrast and MRA and MRV, which all proved to be normal. CT-scan of the abdomen at the primary images gave little information about the status of the device, but when using the ORSVisual software, it became clear that the shunt was out of the peritoneal cavity with upward migration to the dorsal spine. Fundus photography showed slight signs of papilloedema both sides.

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The old incisions were refreshed and the old upward migrating LPS was removed from the back. Using Touhy needle, new LPS PSMedical Medtronic was inserted about 20 cm intradurally. The distal end was inserted intraperitoneally and both points were fixed with anchors, included in the package.

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Routine closure of the wounds.  Smooth postoperative recovery.


CT-scan data reformatted by using ORSVisual software, demonstrating the upward migrating device.

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

 

Comments

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Usually the LPS migrate downward. It could be that this case is the first to be seen that the device was migrating upward.

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Why this happened remains unknown.

 

 


Fundi both eyes demonstrating slight papilloedema.

 

 

 

 

 


Back Up!

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 .

 

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