Inomed Stockert Neuro N50. A versatile
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Multigen RF lesion generator .
06-OCTOBER-2004 MAYMUNA MUHAMED AL-AMERI 63
YEARS ARNOLD-CHIARI MALFORMATION.
Anamnesis
The patient came to the
clinic 02-October-2004 complaining of headache
for 5 years, increasing with cough in the
occipital region. She has bronchial asthma for 7
years. Beside medications for bronchial asthma
she was in Diamox 250 mg once daily. MRI of the
brain done 23-September-2004 showing
Arnold-Chiari malformation grade II.
On examination, the patient
in agonizing headache and when walking has
tendency to fall foreword. Swallowing difficulty
for 5 years. There hemiparesis and hypalgesia
below the chin right side.
The patient was sent for
investigations and fundoscopy ruled out presence
of papilloedema.
Midline posterior occipital
approach with skeletonization of C1 and C2.
Decompression of the posterior rim of foramen
magnum and laminectomy C1 and 2. The dura was
opened and elliptical dural graft was applied to
the constricted area. Water-tight closure of the
graft and the wound. Smooth postoperative recovery. The power of the
right upper and lower limbs dramatically improved.
FOLLOW UP
The patient
came to the clinic 16-October-2004 with clean wound
and neurologically free. swallowing improved.
MRI of the
brain done 06-December-2004 showing wide space at
the cranio-vertebral junction.
The last time
she came 13-October-2016 with MRI of the brain
showing scattered infarctions behind the posterior
horns with bulge disci C5-6 and C7-D1. She was
treated conservatively.
Comments
The best was to
decompress the Arnold-Chiari malformation is to
apply wide graft after bone decompression.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
Inomed Riechert-Mundinger System, with three point
fixation is the most accurate system in the market. The microdrive and
its sensor gives feed back about the localization.
Inomed MER system
Leica HM500
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
documentation.
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
LooksCam II Xenosys in the run starting from 14-March-2021 with
SheerVision TTL x4 magnification.
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 .
