www.neurosurgery.tv 
   

neurophysiology.ws
neurosurgery.fr
e-neuroradiology.com
onconeurosurgery.com
craniopharyngiomas.com
pituitaryadenoma.net
meningiomas.org
munir.ws

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.fr

Functional Neurosurgery
functionalneuro.surgery
Functionalneurosurgery.net

IOM Sites
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
cns-online.com
cns.surgery
cns.today
e-neurosurgery.com
neurosurgery.ag
neurosurgery.bz
neurosurgery.co
neurosurgery.cz
neurosurgery.fr
neurosurgery.gallery
neurosurgeryvideo.gallery
neurosurgicalvideo.gallery
neurosurgery.guru
neurosurgery.me
neurosurgery.mx
neurosurgery.photos
neurosurgery.tips
neurosurgery.tv
neurosurgery.tw
neurosurgeryspine.org

Neurosurgical Encyclopedia
neurosurgicalencyclopedia.com
neurosurgicalencyclopedia.net
neurosurgicalencyclopedia.org

Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
craniopharyngiomas.net
ependymomas.com
ependymomas.net
glioma.co
gliomas.info
glioma.ws
meningiomas.info
meningiomas.org
neurooncology.me
neurooncology.tv
neurooncology.ws
onconeurosurgery.com
pinealomas.com
pituitaryadenomas.com
pituitaryadenoma.net
schwannomas.com
theneuro-oncology.com

Neuroanatomical Sites
diencephalon.info
diencephalon.org
humanneuroanatomy.com
medullaoblongata.info
mesencephalon.org
microneuroanatomy.com

Neuroanesthesia Sites
neuroanesthesia.info

Neuroendocrinologiacl Site
humanneuroendocrinology.com

Neurobiological Sites
humanneurobiology.com

Neurohistopathological
neurorhistopathology.com

Neuro ICU Site
neuroicu.info

Neuroophthalmological
neuroophthalmology.org

Neurophysiological Sites
humanneurophysiology.com
neurophysiology.ws

Neuroradiological Sites
e-neuroradiology.com
neuroradiology.ws

Neurovascular Sites
vascularneurosurgery.com
vascularneurosurgery.net

Personal Sites
cns-clinic.net
cnsclinic.org
munirelias.com
munir.ws

Spine Surgery Sites
spinesurgeries.org
spinesurgery.ws
spondylolisthesis.info
paraplegia.co
paraplegia.ws

Stem Cell Therapy Site
neurostemcell.com


Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


Multigen RF lesion generator .

15-JANUARY-2012  ABDEL-SATTAR MUHAMED MISLEH  33 YEARS  HUGE INFRA-SUPRASELLAR CHROMOPHOBE PITUITARY ADENOMA.

Anamnesis

bullet

The patient came to the clinic 03-January-2012 complaining of visual disturbances for 18 months with bitemporal hemianopia with decrease visual acuity, more the left  with bifrontal headache. The headache decreased after dramatic deterioration of visual functions.

bullet

MRI of the brain done 25-December-2011 showing huge pituitary adenoma with supra and infrasellar extension more to the left. There is also left maxillary polyp with sinusitis.

bullet

On examination, the patient visual acuity is 0.63 in the right and 0.03 in the left with bitemporal anopia more dense in the left. Hormonal studies performed showing decreased levels of LH, FSH, testosterone and GH. Prolactine was 21.8 ng/ml.

bullet

The patient was given antibiotics to resolve the infectious process in the sinuses, to avoid possible postoperative inflammatory complications.

bullet

Using C-arm, transsphenoidal approach achieved from the left nostril. The tumor was seen destroying the pituitary floor in the left side. Generous bony opening of the floor to expose most of the infrasellar extension. All the sellar and infrasellar parts were removed. Several fragments sent for histologic studies and the tumor mass was soft, but suckable with difficulty. he pituitary gland, which is actually the tumor wall was preserved. Using the endoscopic facilities with straight and 30 degree endoscopes, the suprasellar was removed with caution, so as not to violate the neural structures and not to allow CSF leak. Using Valsalva maneuver and putting the head of the patient head down below the heart level , the suprasellar part was pushed down and removed. Check for CSF leak was negative. The cavity of the resected tumor was filled with contrast and checked with the image-intensifier.

bullet

Routine closure of the wounds. Smooth postoperative recovery with improvement of the vision of the left eye.


 

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

Comments

bullet

The patient have a huge tumor with rounded shape and with infrasellar growth. There are no signs of cavernous sinus invasion. In this case the transsphenoidal approach is justified.

bullet

It is possible through this approach to see the most posterior parts of the suprasellar component of the tumor. The anterior parts are not seen and only the feeling by the curette and guising of the neurosurgeon remain to weight between radical resection and avoidance of CSF leak.

 

 


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 .

Postoperative MRI showing dramatic reduction of the tumor mass and the tumor wall is actually the pituitary gland with pituitary stalk are preserved.
 

  WELCOME TO AL-SHMAISANI HOSPITAL

 

 

  

[2012] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved