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
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05-DECEMBER-2004 HANAN MUHAMED KHALIFEH 33 YEARS
HUGE FLOW CAVERNOUS HEMANGIOMA LEFT CEREBELLAR HEMISPHERE ENGULFING THE LEFT
The patient then came to the clinic
03-July-2004 complaining of unsteady gait with
ataxia and headache with left sided paresis for
several months with horizontal nystagmus when
looking to the left. The patient was operated
elsewhere 2 years ago for alleged arachnoid
cyst, but the problem persisted and a dural
pocket from the bone defect was bulging under
the skin at the bone defect area.
The patient was sent for new MRI of the brain
which was done 10-October-2004 showing the
cystic mass of huge volume extending down to the
C2 lamina level.
On examination: the patient is limping dragging
the left side of the body. Romberg unstable with
horizontal nystagmus when looking to the left.
Osteoplastic craniotomy for
the posterior fossa using the previously
performed bone defect. The dura was opened and
the cystic mass was followed and step wise
removal achieved. Going deep the mass became
more solid and vascular and it had many feeders
and engulfing the left vertebral artery. All the
feeders were coagulated and the cavernomatous
mass dissected from the artery which was
circumferentially invading it. The basilar
artery was respected and all the major arteries
in the area.
recovery. The left hemiparesis regressed.
The patient came 25-December-2013 complaining of
numbness of the right hand with LBP and left
sciatica for 2 months. There was mild atrophy of
the left side of the toque with mild weak right
upper limb and dorsiflexion left foot 4/5. MRI
of the brain done 28-December-2013 showing no
recurrence of the mass. MRI lumbar spine showed
central extrusion of L4-5 resulting in severe
segmental stenosis. She was advised to undergo
surgery for the L4-5 disc extrusion.
For more information about the cavernous
The lesion was challenging, because the
vertebral artery was engulfed by it and it had
many arterial feeders.
The arterial network after removal 0f the tumor.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .