Medicine and Health Sciences Commons^™

Comparative Study Of Dynamic Cervical Implant Versus Cervical Interbody Cage Fusion In Management Of Degenerative Cervical Disc Disease, Salah Mohammed Mereka, Mohammed Al Sayed Saleh, Ibraheem Gameel Ewis

Al-Azhar International Medical Journal

Background: Cervical radiculopathy occurs when a herniated disc cause pressure on a nerve root, resulting in dysfunction of the sensory, motor, or reflex pathways served by that nerve root. This trial aimed to evaluate the effectiveness of a dynamic cervical implant against a cervical interbody cage fusion for the treatment of a single degenerative disc in the cervical spine. Methods: This prospective randomized trial was carried out on 30 patients aged from 30 to 50 years old, both sexes, suffering from single degenerative cervical discs who were surgically treated by anterior cervical discectomy, intervertebral disc herniation from C3 to C7. …

Endoscopic Lumbar Stenosis Decompression Through Uniportal Bilateral Approach, Yosouf Barakat, Magdy Asaad El-Hawary, Usama Mohamed El Shokhaiby, Ahmed Kamal Abdel-Aaty Abdou

Al-Azhar International Medical Journal

Background: Percutaneous endoscopic stenosis lumbar decompression (PESLD) is regarded as a noteworthy therapeutic option for lumber spinal stenosis (LSS), particularly on the contralateral side, in a satisfactory manner. Objective: To evaluate the efficacy and efficiency of PESLD of LSS through a uniportal-contralateral approach. Subjective: This was a prospective observational study. The patients were admitted to the Neurosurgery Department, Damanhour Educational Hospital, El-Behira Governorate, and Al Hussain Hospital Al Azhar University in Cairo. All patients underwent PESLD through a uniportal-contralateral approach.. Results: The pre-operative visual analogue scale (VAS) was 7.3 ± 0.9 and decreased significantly post-operative to 2.4±1.0. Intraoperative data showed …

Intravital Imaging Of Cellular Response Due To Traumatic Brain Injury Using Confocal Microscopy, Enoch G. Kim, Jeffrey Horbatiuk, Carolyn Harris

Medical Student Research Symposium

Introduction: Cellular reaction to traumatic brain injury is complex and involves considerable interactions between cells and reactivity to foreign bodies. Our objective was to assess neurons, microglia, astrocytes, and intracellular Ca²⁺ signaling by creating a novel confocal microscopy technique involving an air immersed lens that does not sacrifice resolution and limits signal attenuation. This study aimed to create a consistent dynamic methodology to observe the cortical cellular response using real-time intravital imaging as trauma is being induced.

Methods: Once surgical plane was achieved, rodent cortices were exposed via craniotomy and blunt insertion with a silicone shunt catheter into the …

An Endoscopic Journey To The Center Of The Skull Base For Novice Neurosurgeons: From Cadaver To Theater, Alhusain Nagm, Mohammed Hamadah, Kamal Elbaz, Ibrahim Ewiss

Al-Azhar International Medical Journal

Background: For novice neurosurgeons (nNS), it is important to determine the safety of extended-endoscopic endonasal approaches (eEEA) by analyzing/eliminating surgical drawbacks. Aim: To evaluate the impact of cadaveric training for nNS on reducing obstacles/complication rates in the operative theater.

Subjects and Methods: This unique study has two parts: first; the lab/cadaveric part included a checklist scoring system to estimate the ability of nNS to dissect/identify basic and complex anatomical landmarks (BCAL) (n=50) via eEEA for the center of the skull base (CSB) using 2 formalin-fixed heads and a dry skull for tumor simulation. Second; theater/clinical part included 28 cases with …

Role Of Conventional And Pulsed Radiofrequency In Treatment Of Low Back Pain And Sciatica, Maamoun Mohammed Abo Shosha, Mohammed Ahmed Ellabbad, Mostafa Soliman Elmaghraby, Ahmed Maher Ahmed Ibrahim

Al-Azhar International Medical Journal

Background: Low back pain is a feeling of discomfort, stiffness, or muscle tension below the costal border in the upper part of the back of the thigh, above the lower gluteal folds. Sciatica can occur with low back pain. The two most common techniques are pulsed radiofrequency (PRF) and conventional radiofrequency (CRF). Both techniques employ heat produced by particle vibration to cause a lesion. PRF employs intermittent high-frequency current injection to diffuse heat into nearby tissues and prevent temperatures from rising beyond 42 °C, known as the neuronal injury threshold.

Aim of the study: To assess the efficacy of PRF …

Conservative Versus Surgical Management Of Cranial Pediatric Epidural Hemorrhage, Shehab M. Elkhadrawy, Mohamed Hasan Mansour, Wael F. Sanad

Al-Azhar International Medical Journal

No Abstract

Anterior Cervical Discectomy And Fusion Using Cages Versus Cages And Plating, Hamdy Mohamed Behiry, Mansour Ali Hendawy, Mahmoud Mohammed Bayoumi

Al-Azhar International Medical Journal

Background: The anterior column receives rapid load bearing support, the disc space height is restored, foraminal decompression occurs, and interbody fusion is facilitated by cervical intervertebral disc replacement with cage. Aim: Aim of work was to assess the interbody fusion rate and to assess incidence of complications of 20 consecutive patients for degenerative one or more level anterior cervical disc utilizing cage/s versus cage/s and plate. Patients and Methods: A comparative research of 20 patients with degenerated cervical discs managed by an anterior cervical discectomy procedure and fusion (ACDF) using either cage alone (ACDF-CA) or cage and anterior plating (ACDF-CPC). …

Assessment The Efficacy Of Stent Assisted Techniques For Endovascular Management Of Complex Anterior Circulation Cerebral Aneurysm, Ahmed Mohamed Farid Alsayed, Ali Khodair Ali Khodair, Mohamed Abdalaziz Elbily

Al-Azhar International Medical Journal

Background: Stent-assisted coiling is an established treatment option for intracranial aneurysms, particularly, wide neck aneurysms with complex anatomy.

Aim of the work: To assess safety, efficacy, and outcome of stent-assisted endovascular management of complex anterior circulation cerebral aneurysm.

Patient and methods: In a prospective and retrospective study, 15 patients diagnosed clinically and radiologically to have unruptured complex anterior circulation cerebral aneurysm and underwent endovascular stent assisted techniques at the Neurosurgical Intervention Unit at AL Hussein University Hospital were recruited in the period from beginning of Feb 2022 to the end of Feb 2023. Efficacy was assessed immediately post-procedure using Raymond−Roy …

Cages Alone Versus Plate Fixation With Cages After Four Levels Anterior Cervical Discectomy, Karim Mohamed Mohamed Elshafei, Ibrahim Gamel Ewaiss, Taha Mohamed Adel Fawi, Hamdi Nabawi Mostafa

Al-Azhar International Medical Journal

Purpose: This study assessed clinical and radiological outcomes to support the surgical decision of ACDF using cages alone versus cage-with-plate fixation in patients with four-level spondylotic myelopathy of the cervical spine.

Methods: This study enrolled 30 patients with four levels of cervical spondylotic myelopathy. The C Group (n=15) was subjected to ACDF using four cages, and the C&P Group (n=15) had additional plate fixation. They were followed up clinically and radiologically for at least 12 months. Scheduled for surgical intervention in the neurosurgery department of Misr University and hospitals of Al Azhar University and Nasr Institute from October 2020 to …

Transforaminal Endoscopic Lumbar Discectomy, Elsayed Abdelrahman Elmor, Abdelbaset Ali Saleh, Abdelelah Nazeer Yasin, Abdelreheem Mahmoud Mohamed, Ezz Eldeen Elsayed Mohammed Ibrahim

Al-Azhar International Medical Journal

Background: Clinical problems might result from the structural and morphological changes brought on by lumbar degenerative disc degeneration. The medical costs and lost productivity that result from treating lumbar disc herniation (LDH) are a major burden on families, communities, and nations.Lumbar Discectomy for Prolapsed Intervertebral Disc associated with radicular symptoms in lower limb is probably the most widely performed spinal intervention. Aim: Percutaneous transforaminal endoscopic lumbar discectomy is a less invasive approach for treating LDH, and the purpose of this study is to assess its efficacy. Subject and method: This study was conducted at the neurosurgery department, Ibn Sina hospital …

Clinical Outcome Of Corpus Callosotmy For Management Of Drug Resistant Epilepsy, Islam Magdy Ali Ibrahim, Mamoun Abo Shosha, Mohamed Meligy Rabea Hamed

Al-Azhar International Medical Journal

Background: One of most common chronic neurologic disorders is epilepsy. incapability of significantly reduce percentage of studied cases resistant to all available antiepileptic treatments without producing unacceptable side effects is particularly frustrating. Aim & objectives: Aim of research was to investigate seizure result following corpus callosotomy in relation to extent of resection in pediatric studied cases with Symptomatic generalized epilepsy with normal preoperative brain imaging on MRI Brain. Studied cases & Methods: Research entails prospective analysis of data from 20 pediatric patients who were treated for intractable symptomatic generalized epilepsy by corpus callosotomy. Results: In our patient series, 13 patient …

Outcome Of Epilepsy Surgery In Pediatrics, Mohammed Refaat Mohammed Hammouda, Shehab M. El Khadrawy, Mohamed Hasan Mansour, Alaa Rashad Ibrahim Hassan, Alazzazi Rabei

Al-Azhar International Medical Journal

Background: Epilepsy is a brain disorder characterized by recurrent attacks of seizures. A seizure is a sudden change of behavior due to a transient alteration in the electrical pattern of the brain. Since despite appropriate drug treatment, one-third of patients continue to have seizures, other treatment must be considered. Aim: This study aims at emphasizing the importance of epilepsy surgery in pediatrics by assessing surgical outcome as regard seizure freedom and surgical morbidity & mortality at Al-Azhar university hospitals.

Patients and Methods: Prospective and retrospective study on 27 pediatric patients diagnosed as drug resistant epilepsy, with 6 months to 1 …

Outcome Of Lumbar Discectomy By Using Endoscopic Interlaminar Approach, Ibrahim Gamil Ewaiss, Mostafa Mahmoud El Sayed Aboelkhir, Abelgelel Ragab Abdelgelel Atta

Al-Azhar International Medical Journal

Background: Lumbar degenerative disc disease is a condition which causes anatomical and morphological changes leading to clinical complaints. Lumbar disc herniation (LDH) is a common neurosurgical disease which causes economic and medical burdens to families, society and country. Aim: This study sought to assess the effectiveness of interlaminar endoscopic lumbar discectomy as a minimally invasive method for treating lumbar disc herniation in Al-Azhar university hospitals. Patients and Methods: This study, which included both prospective data, involved 25 patients between February 2021 to October 2022 who had lumber disc prolapse and were treated with endoscopic lumbar discectomy using the EasyGo system …

Stereotactic Ablative Surgery For Movement Disordres, Ahmed Jamal Awad Al Demiry, El Sayed Abdel Rahman El Mor, Alaa Rashad Ibrahim

Al-Azhar International Medical Journal

Background: Since its inception in the early 1950s, the radiofrequency (RF) ablative technique has served a crucial function in the treatment of movement problems. Ablative surgery is encouraging since it doesn't require substantial perioperative care, doesn't run the risk of hardware issues, and it expenses less than deep brain stimulation. Aim of the work: This study is to evaluate the efficacy and safety of RF ablative surgery for medically intractable movement disorders. Patients and Methods: This study was conducted retrospectively on 20 patients with medically refractory movement disorders who had undergone macrostimulation-guided RF ablative surgery in the institutions affiliated with …

Assessment Of Lateral Orbitotomy Approach In Management Of Extraconal Orbital Lesions, Samy Ibrahim, Mohammed Hassan, Shymaa Adel Ismael

Al-Azhar International Medical Journal

Background: A variety of tumors and pseudotumors can occur in the orbital region, requiring distinct surgical approaches based on lesion characteristics.

Aim of the work: To evaluate the effectiveness of the lateral orbitotomy approach in the surgical management of extraconal orbital lesions.

Patients and Methods: A retrospective review of 14 patients who underwent lateral orbitotomy for extraconal orbital lesions at Al Azhar University Hospitals and Al Salam Specialized Hospital between July 2019 and July 2022. The main outcomes measured included postoperative complications and symptom resolution.

Results: A total of 14 patients were included (7 males, 7 females), with a mean …

Skull Base Reconstruction After Endoscopic Endonasal Skull Base Surgery, Mostafa El-Sayed Mohammed, Hany Hafez Sherif, Islam Mohammed Alaghory, Ahmed Nossir Abd El-Khalek Mobarak

Al-Azhar International Medical Journal

Background: CSF leakage following surgery is a known potential complication associated with substantial morbidity & mortality. Numerous techniques for prevention & treatment after endoscopic skull-base surgery are described. These include lumbar drain, autologous grafts like fat, muscle and fascia and synthetic materials like a polyester-silicon dural substitute. But these grafts alone were associated with a high failure rate, particularly in large defects. The application of vascularized flaps promotes more rapid and complete healing and was associated with a sharp decrease in CSF leaks. These vascularized flaps include nasoseptal, inferior turbinate and peri-cranial flaps. The most common nasoseptal flap (NSF) is …

Endovascular Management For Carotid Artery Stenosis With Or Without Using Of Distal Protection Device, Mostafa Y. Ali, Mohammed Abdulaziz Albialy, Magdy A. El Hawary

Al-Azhar International Medical Journal

Background: Transient ischemic episodes and ischemic strokes are frequently brought on by internal carotid artery atherosclerotic stenosis. Carotid artery stenosis can be treated with medicine, surgery, endovascular therapy, stenting, or a combination of these methods.

Aim of the work: Analyzing the various endovascular treatment options for carotid artery stenosis with and without filters.

Patients and Methods: This is a prospective and retrospective study, was conducted on 30 patients with carotid artery stenosis; 13 with filter and 17 without filter undergoing different endovascular techniques.

Results: In this study we found that in group A, mean age of patients 65.85 (±7.29) while …

Endovascular Management Of Vein Of Galen Aneurysmal Malformations: Case Series And Review Of The Literature, Mohammed A. El-Din Habiba, Sameh M. Saleh

Journal of Medicine in Scientific Research

Background Neonates with vein of Galen aneurysmal malformations (VGAMs) who present with heart failure have a high rate of morbidity and mortality, while those who present later in childhood have considerably better outcomes. Aim To determine the factors that have the greatest predictive value in predicting long-term results in children with VGAM. Patients and methods Between June 2015 and June 2020, 15 patients (seven infants, eight children) were diagnosed with symptomatic VGAMs, four of whom were suffering from intractable high-output heart failure and received initial endovascular treatment. All of them were treated by endovascular procedures. Staged transarterial route was the …

Intracranial Mycoplasma Hominis Infection Following Emergent Craniectomy, Zahra Qamar, Stavropoula Tjoumakaris, Matthew Pattengill, Maliha Ahmed, Bryan Hess

Division of Infectious Diseases and Environmental Medicine Faculty Papers

We present a case of a young healthy female who developed recurrent cranial wound infections after a traumatic injury, the etiologic organism finally identified as Mycoplasma hominis, an uncommon and difficult to isolate bacterium.

Imaging Based Prediction Of Pathology In Adult Diffuse Glioma With Applications To Therapy And Prognosis, Evan Gates

Dissertations & Theses (Open Access)

The overall aggressiveness of a glioma is measured by histologic and molecular analysis of tissue samples. However, the well-known spatial heterogeneity in gliomas limits the ability for clinicians to use that information to make spatially specific treatment decisions. Magnetic resonance imaging (MRI) visualizes and assesses the tumor. But, the exact degree to which MRI correlates with the actual underlying tissue characteristics is not known.

In this work, we derive quantitative relationships between imaging and underlying pathology. These relations increase the value of MRI by allowing it to be a better surrogate for underlying pathology and they allow evaluation of the …

Evaluation Of Posterior Decompressive Lumbar Surgery For Multilevel Lumbar Spinal Canal Stenosis With And Without Fusion, Sameh M. Saleh

Journal of Medicine in Scientific Research

Background There is no consensus regarding the best treatment of patients with multilevel lumbar stenosis. Surgical and invasive procedures are widely used in adults with degenerative lumbar spinal stenosis when conservative treatments fail. However, little is known about the comparative efficacy and safety of these interventions. Aim and objective The aim was to study and evaluate the outcome of surgery for degenerative lumbar canal stenosis (LCS) on a clinical, radiological, and functional basis and to identify whether spinal decompression with fusion has a better effect than decompression alone for patients with degenerative lumbar spinal stenosis or not. Patients and methods …

Segmental Epidural Anesthesia For Percutaneous Kyphoplasty:Comparison With General Anesthesia, Alparslan Apan, Özgün Cuvaş Apan, Emi̇ne Arzu Köse

Turkish Journal of Medical Sciences

Background/aim: This is a feasibility study evaluating whether segmental epidural anesthesia is an alternative anesthetic approach to general anesthesia for percutaneous kyphoplasty. Materials and methods: After ethics committee approval was obtained, 52 ASA class I-III patients scheduled for elective, single-level percutaneous kyphoplasty were recruited. The patients were divided into two equal groups. In Group E (Group Epidural) segmental epidural anesthesia was performed using the loss of resistance technique with saline. In Group G (Group Control) general anesthesia was performed. Hemodynamic parameters, intraoperative and postoperative analgesic requirements, visual analogue scale (VAS) scores, length of stay in the postanesthesia care unit (PACU), …

Malignant Peripheral Nerve Sheath Tumor (Mpnst): An Overview With Emphasis On Pathology, Imaging And Management Strategies., Timothy C. Beer

Timothy C Beer

MPNSTs are rare malignancies that are classically associated with pre-existing plexiform neurofibromas in neurofibromatosis type 1 (NF-1) patients, but also occur in association with radiation as well as sporadically in patients with no known risk factors. The typical presentation of sporadic MPNST is a new painless enlarging mass. The typical presentation of MPNST in an NF-1 patient is rapid enlargement or new onset of pain associated with a pre-existing plexiform neurofibroma. Although both MPNST and benign neurofibromas share in common the absence of neurofibromin function due to loss of both NF-1 alleles, malignant transformation to MPNST requires several additional aberrations, …

Emergency Reversal Of Antiplatelet Agents In Patients Presenting With An Intracranial Hemorrhage: A Clinical Review, Peter G. Campbell, Md, Anish Sen, Bs, Sanjay Yadla, Md, Pascal Jabbour, Md, Jack Jallo, Md, Phd

Department of Neurosurgery Faculty Papers

Abstract

Objective: Prehospital use of antiplatelet agents has been associated with an increased risk for ICH as well as a secondary increase in ICH volume after the initial hemorrhage. Strategies to reestablish platelet aggregation are used in clinical practice, but without any established guidelines or recommendations. This article serves to evaluate the literature regarding “reversal” of antiplatelet agents in neurosurgical populations.

Methods: PUBMED and MEDLINE databases were searched for publications from 1966 to 2009 relating to intracranial hemorrhage and antiplatelet agents. The reference sections of recent articles, guidelines and reviews were reviewed and pertinent articles identified. Studies were classified by …

Traumatic Thoracic Asia A Examinations And Potential For Clinical Trials, James S. Harrop, Md, Mitchell G. Maltenfort, Phd, Fred H. Geisler, Md, Phd, William Coleman, Phd, Linda A.T. Jones, Pt, Ms, Edward Wirth, Md, Alexander Vaccaro, Md, Phd

Department of Neurosurgery Faculty Papers

Study Design: Retrospective review of prospective database

Objectives: To define the variability of neurologic examination and recovery after non-penetrating complete thoracic spinal cord injuries (ASIA A).

Background Data: Neurologic examinations after SCI can be difficult and inconsistent. Unlike cervical SCI patients, alterations in thoracic (below T1) complete SCI (ASIA A – based on the ASIA Impairment Scale [AIS]) patients’ exams are based only on sensory testing, thus changes in the neurological level (NL) are determined only by sensory changes.

Methods: A retrospective review of the placebo control patients in a multicenter prospective database utilized for the pharmacologic trial of Sygen. …