Medicine and Health Sciences Commons^™

Intraoperative Decision Making For Neurolysis Versus Neurectomy In Surgical Treatment Of Meralgia Paresthetica, Yasser Bahgat Elsisi, Ahmed Gabry El Nagar, Osama Saber Shereef

Menoufia Medical Journal

Aim: To evaluate the intraoperative decision for neurolysis or neurectomy in management of meralgia paresthetica.
Methods: Diagnosis of Meralgia paresthetica is usually based on clinical examination and is supported by sensory nerve conduction (SNC) studies. The initial treatment is always conservative. In limited number of patients who are refractory to conservative managements, surgical treatment via decompression/neurolysis or neurectomy is concerned.
Methods: A retrospective study conducted on 40 patients from a cluster sample from patients with meralgia paresthetica who operated through neurolysis or neurectomy between January 2017 to March 2022 at the neurosurgical departments, Menoufia University, Egypt.
Results: completely pain and …

Clinical Factors Associated With Need For Neurosurgical Care In Young Children With Imaging For Macrocephaly: A Case Control Study, Jessica F. Rohde, Jeffrey Campbell, Julie Barbera, Elena Taylor, Ashok Ramachandra, Christopher Gegg, Andrea Scherer, Joseph Piatt

Department of Pediatrics Faculty Papers

BACKGROUND: Macrocephaly is present in 2.3% of children with important neurosurgical conditions in the differential diagnosis. The objective of this study was to identify clinical associations with actionable imaging findings among children with head imaging for macrocephaly.

METHODS: We conducted a case-control study of head imaging studies ordered for macrocephaly among children 24 months and younger in a multistate children's health system. Four neurosurgeons reviewed the images, determining cases to be a 'concern' if neurosurgical follow-up or intervention was indicated. Electronic health records were reviewed to collect patient-level data and to determine if surgery was performed. Controls were matched 3:1 …

Evidenced-Based Practice Competency Assessment For Competency-Based Orientation Protocol To Improve Competency Level Among Medical-Surgical Nurses, Maryann Ornelas

Student Scholarly Projects

Practice Problem: Within a 12-month period, high incidences of severe post-spinal surgical complications resulted in a host of concerns in this clinical site when patients either returned to the operating room for spine revision or increased the length of stay.

PICOT: The PICOT question that guided this project was: "In Medical Surgical (Med-Surg) nurses (P), how would a Competency-Based Orientation (CBO) protocol with the inclusions of four critical elements of postoperative spinal care [POSC] (I) compared to the usual postoperative practice (C) enhance competency level in Med-Surg nurses when delivering postoperative practice at an inpatient setting (O) over 10 weeks …

Assessment Of Attitudes And Knowledge Of Osteopathic Manipulative Medicine Amongst Neurosurgeons, Devin Kolmetzky, Dillon B. Gooder, Evan Polly, Sarah Glisan, Zein Al-Atrache, Clint Badger, Steven Yocom, Alan Turtz, Donald Allison

Research Day

Introduction: Osteopathic Manipulative Medicine (OMM) is highly researched and integrated into many medical and surgical subspecialties. Though OMM has been shown to have benefits in treating non-specific cervical and lower back pain and managing post-operative pain, it has rarely been integrated or studied in the neurosurgical community.

Method: Using SurveyMonkey, a survey was dispersed to physicians of the American Association of Neurological Surgeons (AANS). Information collected included the provider’s type of practice, degree type (MD vs. DO), familiarity with the tenets of OMM, frequency of referral/use of OMM, comfort level with OMM as a non-surgical pre-op option, a post-op pain …

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 …

The Value Of Suction Drainage For A Chronic Subdural Hematoma In Elderly Patients: A Retrospective Cohort Study, Mohamed Ar Abdelfatah, Ibrahim Abdelmohsen, Sherif Bahaa, Mohammed Elwardany, Sameh Hefny

Mansoura Medical Journal

Background: The use of suction in the subgaleal drainage system after the burr-hole evacuation of chronic subdural hematoma (CSDH) is still debatable. This study aimed to investigate the value of adding suction to the drainage system of CSDH in elderly patients. Methods: This cohort study retrospectively reviewed the data of the CSDH patients operated on at our university hospital in the last eight years. The inclusion criteria were elderly patients who underwent evacuation of a unilateral CSDH through two burr holes followed by placing a subgaleal drainage tube. Two hundred seventy-three consecutive patients met the inclusion criteria. Seventy-six patients (27.8%) …

Spinal Cord Lipomas In Children: Surgical Resection And Outcome, Ramy Omar Omar El Sakhry, Hatem Ibrahim Badr, Ibrahim El Sayd Ahmed Abdel-Aal, Amr Farid Khalil

Mansoura Medical Journal

Background: management of spinal lipomas is considered a challenging task for pediatric neurosurgeons. Study Design: A prospective, clinical study. Objectives: To assess the neurological outcomes after surgical resection of spinal lipomas. Patients and methods: The study was performed on 30 patients, underwent surgical resection of spinal cord lipomas. The cases were followed up post-operatively in the outpatient clinic for at least 24 months. Results; This study included 30 patients with spinal lipomas (12 boys and 18 girls) with age of less than two years at surgery. At presentation, all the 30 cases had low back swelling.19 (63.3%) with bladder dysfunction, …

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 …

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 …