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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
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Multigen RF lesion generator
26-MAY-2014 BILAL WADDAH WISHAH 27 YEARS
PROGRESSING ARACHNOID CYST LEFT SYLVIAN WITH LEFT TEMPORAL LOBE EPILEPSY.
The patient came to the clinic 24-April-2013
complaining of headache for 1 year with fainting
attacks. The patient suffered partial seizures
with secondary generalization 5 times during the
last 2 months. The headache increasing during
night with nausea and right upper limb numbness.
CT-scan of the brain done 12-March-2013 showing
a huge arachnoid cyst left sylvian cistern. He
was operated for this cyst 15 years ago. The
patient has lazy right eye. He is blind at this
eye and has panophthalmoplegia right eye.
The patient was sent for investigations and
given Tegretol 400 CR twice a day, but he came
back 12-May-2014 with new MRI done 20-April-2014
showing a huge arachnoid cyst left sylvian
cistern. The patient telling that he got 2
convulsions during the last 45 days. EEG done
13-April-2014 confirming epi activity over the
left temporal region. The patient was not using
medications and it was explained to him the
importance of that.
The patient then came 22-May-2014 telling that
his condition is deteriorating and he got 2
attacks and the headache is increasing. Kotral
500 mg twice a day was added, but the patient
then came 24-May-2014 to the Emergency of
Shmaisani hospital with fainting attacks and
headache. He was admitted to the hospital and
continuous EEG recording was done over 12 hours
confirming the presence epi activity with in the
left cerebral hemisphere.
The old incision in the left pterional region
refreshed and the bone flap reflected to the
ear. The dura was opened and the arachnoid sac
followed down until the left ICA and left optic
nerve and dissection of the arachnoidal layers
was performed meticulously. The left M1 and its
branches are running along the field. It was
preserved and mechanically untouched to avoid
possible spasm. Resection of the left temporal
pole and left hippocampectomy was done. A thin
layer of cortex was left near the course of the
left M1 to avoid possible spasm. Strict
hemostasis with routine closure of the wound.
Smooth postoperative recovery. The patient was
sent to the ward. There is no further neurologic
The patient has 2 problems, need to be
resolved: The mass effect of the growing arachnoid cyst and
the epi activity. Both goal were achieved during surgery.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
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 .