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

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.gallery
neurosurgeryvideo.gallery
neurosurgicalvideo.gallery
neurosurgery.guru
neurosurgery.me
neurosurgery.mx
neurosurgery.photos
neurosurgery.tips
neurosurgery.tw
neurosurgeryspine.org
skullbase.surgery

Neurosurgical Encyclopedia
neurosurgicalencyclopedia.com
neurosurgicalencyclopedia.net
neurosurgicalencyclopedia.org

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

Neuroanatomical Sites
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
neuroradiology.ws

NeuroSience Sites
neuro.science

Neurovascular Sites
vascularneurosurgery.com
vascularneurosurgery.net

Personal Sites
cns.clinic
cnsclinic.org
munirelias.com

Spine Surgery Sites
spine.surgery
spinesurgeries.org
spondylolisthesis.info
paraplegia.ws

Stem Cell Therapy Site
neurostemcell.com


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Multigen RF lesion generator .

 

Anamnesis

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The patient  came to the clinic 17-April-2002 from Egypt complaining of bilateral sciatica, more the right. She had fracture med third right tibia with subsequent plate fixation 12 years ago. Exacerbation of LBP the last 3 years with ataxic gait for 2 months. She had diabetes mellitus for 1 year in diamicron and glucophage. Arterial hypertension for 6 years in hypoten 50 mg once daily. She had also hypercholesterolemia.

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On examination, she had unstable Romberg swaying to all directions. Mild bilateral lagophthalm was noted. SLRS was 90 degrees both sides with Babinski positive left side. Hypalgesia with numbness both feet  with weak muscles both feet more the left.

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Considering these data, the patient was sent to perform MRI of the brain with MRA of the brain and carotids  with MRI of the lumbar spine.

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The patient showed postoperative medullary signs with left sided hemiparesis which persisted for several days, with complete resolution of the signs over 10-14 days.

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The patient  came back to the clinic 23-April-2002 with MRI of the brain, showing giant tentorial edge meningioma with mild spondylolisthesis L5-S1. The patient was advised to undergo surgery for the meningioma, and she was surprised, that she was claiming of LBP and why, she must be operated for her brain tumor. It was explained for her, that most of her complains were due to the tumor.

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Follow Up

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The patient came to the clinic 25-May-2002 with ataxic gait. She was in glucophage twice daily, Amaryl 2 mg once daily and hypoten 50 mg once daily. She received trental, tapering doses of Epanutin, Gincosan and L-thyroxin 100 microgram once daily.
She was sent for follow-up MRI and lab investigations and came 30-June-2002. MRI done 30-June-2002 showing residual of the mass 2x2 mm at the sinus recti junction. Thyroid functions were within normal limits. She was advised to decrease the L-thyroxin and to be followed by endocrinologist and come back after one year.
The patient came back 27-December-2003 with the recurrence 3x3 mm. Romberg was stable the walking improved considerably. She had hypalgesia of the index left hand, weak dorsiflexion big toe right foot with hypalgesia of right L5 territory. She improved dramatically and no lagophthalm and she was advised in case of considerable enlargement of the tumor, to undergo radiotherapy.

 

 

Comments

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The trilateral approach has several advantages to visually control all aspects of the tumor with different angles, making practical resection of such huge tumor feasible.

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Such surgery must have difficult postoperative course, which must be considered with great caution.

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For more information about the trilateral approach, please click here!

 

Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.

Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision.


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 .

  

 

 

 

 

 

 

 

 

 

 

 

 

WELCOME TO AL-SHMAISANI HOSPITAL

 

 

 

[2002] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved