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Articles 1 - 11 of 11
Full-Text Articles in Medical Specialties
Role Of Preoperative Embolization In Management Of Central Nervous System Tumours, Ummey Hani, Ahmer Nasir Baig, Muhammad Shahzad Shamim, Basit Salam
Role Of Preoperative Embolization In Management Of Central Nervous System Tumours, Ummey Hani, Ahmer Nasir Baig, Muhammad Shahzad Shamim, Basit Salam
Section of Neurosurgery
Preoperative embolization plays a significant role as an adjunct to surgical intervention in the cases of certain vascular tumours of the brain. While the procedure has resulted in facilitated resection of the tumour, and has reduced morbidity and mortality, its application remains debatable within the neurosurgical community, owing to rare, but major post-procedural complications. Herein, we have reviewed the literature to assess the safety and efficacy of preoperative angiographic embolization for brain tumours.
Timing Of Postoperative Magnetic Resonance Imaging (Mri) Following Glioma Resection: Shattering The 72 Hour Window, Syed Sarmad Bukhari, Muhammad Shahzad Shamim, Fatima Mubarak
Timing Of Postoperative Magnetic Resonance Imaging (Mri) Following Glioma Resection: Shattering The 72 Hour Window, Syed Sarmad Bukhari, Muhammad Shahzad Shamim, Fatima Mubarak
Section of Neurosurgery
Extent of enhancing tumour resection is correlated with progression free survival following glioma surgery. Historically, a contrast enhanced MRI has been recommended within 72 hours following surgery to evaluate for residual disease. This theoretical window was established amidst conflicting evidence to avoid reactive enhancement. Recent studies with better designs and better imaging quality have sought to challenge this window with a more pragmatic method of evaluating residual disease.
Diffusion-Weighted Magnetic Resonance Imaging May Be Useful In Differentiating Fungal Abscess From Malignant Intracranial Lesion: Case Report, Syeda Maheen Batool, Fatima Mubarak, Ather Enam
Diffusion-Weighted Magnetic Resonance Imaging May Be Useful In Differentiating Fungal Abscess From Malignant Intracranial Lesion: Case Report, Syeda Maheen Batool, Fatima Mubarak, Ather Enam
Section of Neurosurgery
Background: Diffusion-weighted magnetic resonance has a well-defined role in differentiating between important intracranial lesions. Sometimes, the surgeon is faced with a dilemma of how to diagnose an infectious versus malignant lesion.
Case Description: A 28-year-old male presented to the neurosurgery clinic with complaints of headache and left-sided weakness for 2 weeks. Neurological examination was intact. Magnetic resonance imaging (MRI) scan showed a large infiltrating heterogeneous mass involving the right parietal lobe. On further reviewing, there was homogenous diffusion restriction in the center of lesion. In addition, its aggressive behavior confirmed it to be a fungal abscess.
Conclusions: Correctly identifying an …
Radiological And Clinical Outcomes In Patients Undergoing Anterior Cervical Discectomy And Fusion: Comparing Titanium And Peek (Polyetheretherketone) Cages, Muhammad Junaid, Mamoon Ur Rashid, Syed Sarmad Bukhari, Mamoon Ahmed
Radiological And Clinical Outcomes In Patients Undergoing Anterior Cervical Discectomy And Fusion: Comparing Titanium And Peek (Polyetheretherketone) Cages, Muhammad Junaid, Mamoon Ur Rashid, Syed Sarmad Bukhari, Mamoon Ahmed
Section of Neurosurgery
Objectives: To study clinical and radiological outcomes in patients who had undergone the procedure of anterior cervical discectomy and fusion with titanium or PEEK (polyetheretherketone) cages for cervical disc prolapse.
Methods: This is a retrospective/non-randomized study which was conducted at the Combined Military Hospital Peshawar. Study interval was four years from 1st October, 2010 to 31st September, 2014. Total number of included patients were 149. All of the patients had undergone the procedure of anterior cervical discectomy and fusion with titanium or PEEK (polyetheretherketone) cages. All of the patients had plain MRI cervical spine done for diagnosis of anterior cervical …
Video Microscope Robotic Arm-Assisted, Neuronavigation-Guided Glioma Resection And Regional Sampling, Muhammad Waqas, Ather Enam, Fauzan A Hashmi, Fatima Mubarak, Fazal Arain
Video Microscope Robotic Arm-Assisted, Neuronavigation-Guided Glioma Resection And Regional Sampling, Muhammad Waqas, Ather Enam, Fauzan A Hashmi, Fatima Mubarak, Fazal Arain
Section of Neurosurgery
High-grade gliomas possess internal pathological heterogeneity. Selective sampling of different tumor regions can help in the study of this heterogeneity. In this report, we have described the use of a novel navigation and optical system for the selective regional sampling of a high-grade glioma lesion. A 45-year-old gentleman presented to us with complaints of intermittent frontal headaches for past eight months. On examination, he had subtle pyramidal weakness in left upper and lower extremities. Magnetic resonance imaging (MRI) showed a large contrast-enhancing, space-occupying lesion in the right frontal lobe causing perilesional edema and midline shift. We marked four different regions …
Diffusion Tensor Imaging For Ruptured Cerebral Arteriovenous Malformation, Muhammad Waqas, Ayesha Siddiqui, Fatima Mubarak, Ather Enam
Diffusion Tensor Imaging For Ruptured Cerebral Arteriovenous Malformation, Muhammad Waqas, Ayesha Siddiqui, Fatima Mubarak, Ather Enam
Section of Neurosurgery
Non-ruptured arteriovenous malformations (AVMs) rarely cause tract disruption. Few studies have described how ruptured AVMs influence white matter (WM) tract morphology. We reviewed consecutive AVM cases treated at a tertiary care hospital where diffusion tensor imaging (DTI) tractography was obtained preoperatively. DTI was performed using the Synaptive Plan (Synaptive Medical Inc., Toronto, Canada). Quality control was performed by clinical application specialist. Perinidal fractional anisotropy (FA) value of corticospinal tracts (CST) was obtained. A reference FA value was obtained from the corresponding area on the contralateral side. Images were evaluated by a consultant neuroradiologist. Radiological findings were correlated with clinical findings. …
Diagnostic Accuracy Of Clinical Examination In Cervical Spine Injuries In Awake And Alert Blunt Trauma Patients, Manzar Hussain, Gohar Javed
Diagnostic Accuracy Of Clinical Examination In Cervical Spine Injuries In Awake And Alert Blunt Trauma Patients, Manzar Hussain, Gohar Javed
Section of Neurosurgery
Study design: Observational, case series.
Purpose: To determine the sensitivity and specificity of clinical judgment as compared to the use of X-ray images in detecting cervical spine injuries in trauma patients presenting in the emergency department of Aga Khan University Hospital, Karachi.
Overview of literature: Cross-table cervical spine views are important in patients with signs and symptoms relating to cervical spine, but asymptomatic patients constitute a different subgroup. Accuracy of clinical examination in these patients has not been subjected to scrutiny.
Methods: All patients with blunt trauma who presented to the emergency department and underwent cross-table X-rays as part of …
Craniocerebral Aspergillosis: A Review Of Advances In Diagnosis And Management, Muhammad Shahzad Shamim, Ather Enam, Rushna Ali, Saleha Anwar
Craniocerebral Aspergillosis: A Review Of Advances In Diagnosis And Management, Muhammad Shahzad Shamim, Ather Enam, Rushna Ali, Saleha Anwar
Section of Neurosurgery
Craniocerebral aspergillosis is a rare but dangerous central nervous system infection. The infection has a spectrum of presenting features, mostly affecting immunocompromised individuals. The incidence appears to be on the rise that has been especially observed in the immunocompetent population. A high index of suspicion, a comprehensive understanding of the infectious process and advanced laboratory and radiological diagnostic techniques, allow early diagnosis. Surgery, followed by systemic antifungal medications, remains the cornerstone of management. Early administration of empirical anti-fungal agents along with immunomodulators may further improve prognosis. Immunocompetent patients tend to have better outcomes as compared to those who are immunocompromised. …
Cost-Effectiveness Of Clipping Vs Coiling Of Intracranial Aneurysms After Subarachnoid Hemorrhage In A Developing Country-A Prospective Study, Muhammad Zubair Tahir, Ather Enam, Rushna Pervez Ali, Atta Bhatti, Tanveer Ul Haq
Cost-Effectiveness Of Clipping Vs Coiling Of Intracranial Aneurysms After Subarachnoid Hemorrhage In A Developing Country-A Prospective Study, Muhammad Zubair Tahir, Ather Enam, Rushna Pervez Ali, Atta Bhatti, Tanveer Ul Haq
Section of Neurosurgery
Background: Endovascular coil treatment is being used increasingly as an alternative to clipping for some ruptured intracranial aneurysms. The relative benefits of these 2 approaches have yet to be fully established. The aim of this study was to compare the clinical outcome, resource consumption, and cost-effectiveness of endovascular. treatment vs surgical clipping in a developing country.
Methods: The study population consisted of 55 Patients with aneurysmal subarachnoid hemorrhage (SAH) identified prospectively from January 2004 to June 2007. Of the 55 Patients with ruptured intracranial aneurysms, 31 underwent surgical clipping, whereas 24 were treated via interventional coils. Clinical outcome at 6 …
Traumatic Carotid-Cavernous Fistula: Clinical Presentation And Outcome, Atta A. Bhatti, S. Soulat Raza, Muhammad Ehsan Bari, S. Ather Enam, Tanveer Ul Haq, Zafar Sajjad
Traumatic Carotid-Cavernous Fistula: Clinical Presentation And Outcome, Atta A. Bhatti, S. Soulat Raza, Muhammad Ehsan Bari, S. Ather Enam, Tanveer Ul Haq, Zafar Sajjad
Section of Neurosurgery
Objective:To evaluate the presentation, clinical course and outcome of traumatic carotid-cavernous fistula (CCF) withendovascular treatment at our institution during the last five years.
Design: Retrospective descriptive study.
Setting: The study included patients seen at Aga Khan University Hospital from January 2000 to December 2005.
Methods: Retrospective analysis based on data retrieval from medical records using ICD coding system. Only those cases who had traumatic CCF and underwent endovascular treatment were included in the study.
Results: A total of 8 patients were diagnosed with post-traumatic CCF and 11 procedures were done. Mean age at presentation was 35.6 years; …
Radiosurgery For The Control Of Glomus Jugulare Tumours, Muhammad Ehsan Bari, A A. Kemeny, D M C Forster, M W. Radatz
Radiosurgery For The Control Of Glomus Jugulare Tumours, Muhammad Ehsan Bari, A A. Kemeny, D M C Forster, M W. Radatz
Section of Neurosurgery
Objective: To ascertain the efficacy of stereotactic radiosurgery (gamma knife) for the control of glomus jugulare tumours.
Method: Between March 1994 and December 1997 we treated eight patients of glomus jugulare tumour with radiosurgery. These patients have been followed for more than four years (range 52 to 97 months). The age of the patients ranged between 32-64 years (mean 53 years). The male: female ratio was 3:5. Three patients had previously undergone surgery and one had unsuccessful embolization. The dose applied to tumour margin ranged between 16-25 Gy (median 25 Gy). Patients were followed up with yearly MRI scans and …