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Aga Khan University

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Articles 241 - 270 of 276

Full-Text Articles in Neurosurgery

Management Of Myelomeningocele, A Sattar M. Hashim, Shahid Ahmed, Rashid Jooma Jan 2008

Management Of Myelomeningocele, A Sattar M. Hashim, Shahid Ahmed, Rashid Jooma

Section of Neurosurgery

Objective: T To find out best possible protocol to provide productive life to children born with myelomeningocele.
Study design: Descriptive study.
Place & Duration of study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre Karachi from December 2001 to December 2006.
Patients and Methods: The medical record of 415 children with myelomeningocele operated at our center was reviewed retrospectively. The surgical & medical management protocol used for different sites of myelomeningocele was studied.
Results: The age of most of the patients at the time of myelomeningocele repair was between 25-30 days; however, children with ruptured myelomeningocele were consistently repaired early. All …

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Embolization Of An Intracranial Arteriovenous Malformation Followed By Immediate Surgical Resection: A Case Report, Imaad Ur Rehman, Tanveer Ul Haq, Rashid Jooma, Muhammad Azeemuddin, Zafar Sajjad Jan 2008

Embolization Of An Intracranial Arteriovenous Malformation Followed By Immediate Surgical Resection: A Case Report, Imaad Ur Rehman, Tanveer Ul Haq, Rashid Jooma, Muhammad Azeemuddin, Zafar Sajjad

Department of Radiology

Intracranial arteriovenous malformations (AVMs) are now a recognized entity because of improvements in imaging diagnosis. They are relatively uncommon but can cause serious neurological symptoms or death. We report a case of a 22- year-old man who presented with left parietal hemorrhage and on cerebral angiography was found to have a small AVM in the left middle cerebral artery (MCA) territory. Glue embolization followed by immediate surgical resection of the AVM was carried out, resulting in complete cure.

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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 Oct 2007

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; …

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Neurosurgical Training In Pakistan, Ather Enam Oct 2007

Neurosurgical Training In Pakistan, Ather Enam

Section of Neurosurgery

No abstract provided.

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Re: Various Irrigation Fluids Affect Postoperative Brain Edema And Cellular Damage During Experimental Neurosurgery In Rats, Syed Faraz Kazim, Ather Enam Jul 2007

Re: Various Irrigation Fluids Affect Postoperative Brain Edema And Cellular Damage During Experimental Neurosurgery In Rats, Syed Faraz Kazim, Ather Enam

Section of Neurosurgery

No abstract provided.

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Craniocerebral Aspergillosis In Immunocompetent Hosts: Surgical Perspective, Muhammad Shahzad Shamim, Arshad A. Siddiqui, Ather Enam, Ahmed Ali Shah, Rashid Jooma, Saleha Anwar Jul 2007

Craniocerebral Aspergillosis In Immunocompetent Hosts: Surgical Perspective, Muhammad Shahzad Shamim, Arshad A. Siddiqui, Ather Enam, Ahmed Ali Shah, Rashid Jooma, Saleha Anwar

Section of Neurosurgery

Craniocerebral aspergillosis is a rare but dangerous variety of central nervous system infections. Surgery is being widely recognized as the cornerstone of management. Due to the rarity of the disease, difficulty and delay in diagnosis and poor outcome, there is very little in the literature regarding the various surgical strategies that may be adopted in these patients. Early aggressive surgery followed by chemotherapy offers the best chances. Surgical planning would depend upon the type and location of the disease process as well as the condition of the patient. Perioperative care holds immense importance and knowledge of possible complications is essential. …

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Role Of Surgery In The Management Of Low Grade Glioma, Faraz Kazim, Ather Enam Jul 2007

Role Of Surgery In The Management Of Low Grade Glioma, Faraz Kazim, Ather Enam

Section of Neurosurgery

No abstract provided.

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History Of Epilepsy Surgery, Ather Enam Apr 2007

History Of Epilepsy Surgery, Ather Enam

Section of Neurosurgery

No abstract provided.

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Spectrum Of Intracranial Pathology: Tumors Versus Infections At A Tertiary Care Hospital, Muhib Alam Khan, Sukaina Aijazali Panju, Ather Enam Jan 2007

Spectrum Of Intracranial Pathology: Tumors Versus Infections At A Tertiary Care Hospital, Muhib Alam Khan, Sukaina Aijazali Panju, Ather Enam

Section of Neurosurgery

Introduction: Aga Khan University Hospital Neurosurgery Department has evolved into a high-volume centre for treatment of neurosurgical diseases. We aimed to compare the relative outcomes of intracranial tumors and CNS infections seen at our facility.
Methods: Hospital records of patients admitted under the neurosurgery service between 1994-2003 were evaluated. Cases with a principal diagnosis of an intracranial lesion were identified for further study. Demographic, clinical,and surgical variables were extracted from the medical record. Length of hospital stay, ICU utilization, and in-hospital mortality were the primary outcome indicators. Data were analyzed through descriptive statistics and comparisons of meansand proportions. …

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Neurosurgeons And Electrocautery, S. Ather Enam Jan 2007

Neurosurgeons And Electrocautery, S. Ather Enam

Section of Neurosurgery

Abstract are not provided by the author/publisher

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Surgery For Prolactinomas, Ashfaq A. Razzaq, Rashid Jooma Apr 2006

Surgery For Prolactinomas, Ashfaq A. Razzaq, Rashid Jooma

Section of Neurosurgery

A large proportion of prolactin secreting tumours of the pituitary gland are treatable by dopamine agonist drugs. however certain subgroups of these patients are better managed by surgical excision. the indications for surgery in prolactinomas remain controversial and this paper attempts to clarify these with illustrative cases. the factors favouring a surgical approach include poor tolerance of long term medical therapy, progression of visual deficits or recurrence while on medical treatment, cystic change in the tumour with pressure effects, csf fistula secondary to tumour shrinkage and prophylactic surgery in tumours anticipated to cause csf leak following medical therapy. the size …

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Trans-Mastoid Approach To Otogenic Brain Abscess, Ashfaq A. Razzaq, Rashid Jooma, Shahid Ahmed Mar 2006

Trans-Mastoid Approach To Otogenic Brain Abscess, Ashfaq A. Razzaq, Rashid Jooma, Shahid Ahmed

Section of Neurosurgery

The treatment of otogenic brain abscess initially involves excision or aspiration of the abscess through a temporal or sub-occipital route depending on its location. This is followed by a mastoidectomy by the ENT surgeon to eradicate the primary source of infection. During the last three years, we have approached such lesions through a mastoidectomy followed by excision of the abscess through the same approach. This trans-mastoid approach is technically feasible in following the tract of suppuration, and clearing the cause and effect of pathology, at the same sitting. This paper describes our initial experience with the trans-mastoid approach to otogenic …

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Long Scarf Injuries, Arshad A. Siddiqui, Muhammad Shahzad Shamim, Rashid Jooma, Ather Enam Feb 2006

Long Scarf Injuries, Arshad A. Siddiqui, Muhammad Shahzad Shamim, Rashid Jooma, Ather Enam

Section of Neurosurgery

Long scarf (Dopatta) traditionally worn by females in South-East Asia have been described to make the females prone to sustain specific injuries when they ride pillion on the cycle powered rickshaw or motor bike. Two cases of females have been described.

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Comparison Of Two Surveys Of Head Injured Patients Presenting During A Calendar Year To An Urban Medical Centre 32 Years Apart, Rashid Jooma, Shahid Ahmed, Abdul Malik Zarden Dec 2005

Comparison Of Two Surveys Of Head Injured Patients Presenting During A Calendar Year To An Urban Medical Centre 32 Years Apart, Rashid Jooma, Shahid Ahmed, Abdul Malik Zarden

Section of Neurosurgery

Objective: To study the patients presenting with head injuries to a tertiary hospital in Karachi during the year 2003.
Methods: During the calendar year 2003, a cross-sectional study was conducted of all patients presenting to the casualty department of Jinnah Postgraduate Medical Centre (JPMC) with head injury. Personal information was collected from the patient's attendants at presentation or later if the patient had been brought in by the emergency services as an unknown person. The circumstances of the injury were similarly established and the clinical features documented.
Results: During the year 2003, a total of 3008 patients reported to the …

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Gas-Producing Brain Abscess, Arshad A. Siddiqui, Khalid N. Chishti Mar 2005

Gas-Producing Brain Abscess, Arshad A. Siddiqui, Khalid N. Chishti

Section of Neurosurgery

A case of a known psychiatric patient who presented with rapid neurological deterioration is reported. Neuroimaging revealed a gas-producing brain abscess in left parietal lobe with a contiguous focus of infection in the adjacent bone and scalp initiated by obsessive scalp scratching. On complete surgical excision of abscess, followed by culture-based antibiotic therapy, a good neurological recovery was achieved with minimal residual deficits at follow-up.

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Preventing Neural Tube Defects By Folic Acid Fortification Of Flour, Rashid Jooma Nov 2004

Preventing Neural Tube Defects By Folic Acid Fortification Of Flour, Rashid Jooma

Section of Neurosurgery

No abstract provided.

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Complete Surgical Excision Of Intramedullary Schwannoma At The Craniovertebral Junction In Neurofibromatosis Type-2, A A. Siddiqui, A A. Shah Apr 2004

Complete Surgical Excision Of Intramedullary Schwannoma At The Craniovertebral Junction In Neurofibromatosis Type-2, A A. Siddiqui, A A. Shah

Section of Neurosurgery

Intramedullary spinal schwannomas are extremely rare. We describe a case of a 13-year-old female who was found to have an intramedullary schwannoma at craniovertebral junction along with incidental bilateral acoustic neuromas, which was excised completely. To our knowledge, this is the first report of a case of intramedullary schwannoma in association with NF-2 located at the craniovertebral junction. The literature has been reviewed with emphasis on radiological imaging, histopathological diagnosis and technique to achieve complete microsurgical excision.

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An Audit Of Head Trauma Care And Mortality, Arshad A. Siddiqui, Hasnain Zafar, S H. Bashir Mar 2004

An Audit Of Head Trauma Care And Mortality, Arshad A. Siddiqui, Hasnain Zafar, S H. Bashir

Section of Neurosurgery

Objective: To analyze the factors contributing to deaths from head trauma by using standardized assessment parameters and to provide a peer-review of head injury deaths with focus on identifying deficiencies and analyzing contributory factors.
Design: Descriptive study.
Place and duration of study: The study was carried out at the Emergency, Aga Khan University Hospital during January 1998 to December 1999.
Subjects and method: One hundred and three patients above the age of 15 years presenting alive to the Aga Khan University Hospital (AKUH) emergency with head injury were included in this study. Identified deaths data was reviewed by the Hospital …

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Extradural Granulocytic Sarcoma Causing Acute Paraparesis, Arshad A. Siddiqui, Naim-Ur Rehman Jan 2004

Extradural Granulocytic Sarcoma Causing Acute Paraparesis, Arshad A. Siddiqui, Naim-Ur Rehman

Section of Neurosurgery

A case of 9 years old female presenting with rapidly progressive paraparesis during remission phase of acute myeloblastic leukemia is reported. Radiological imaging revealed an extradural mass in the upper dorsal spine producing significant cord compression. The patient showed a dramatic neurological recovery after spinal cord decompression and subsequently treated with appropriate chemotherapy and local radiotherapy.

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Giant Choroid Plexus Papilloma Of The Third Ventricle, Ashfaq A. Razzaq, Khalid N. Chishti Nov 2003

Giant Choroid Plexus Papilloma Of The Third Ventricle, Ashfaq A. Razzaq, Khalid N. Chishti

Section of Neurosurgery

Abstract are not provided by the author/publisher

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Peritumoral Cystic Meningioma, Arshad A. Siddiqui, Junaid Asharaf, Ahmed Ali Shah Aug 2003

Peritumoral Cystic Meningioma, Arshad A. Siddiqui, Junaid Asharaf, Ahmed Ali Shah

Section of Neurosurgery

A case of 39 years old male is described who presented with headache, right-sided focal fits and decreased power in the right hand. CT scan brain showed a left fronto-parietal cystic lesion with centrolateral intramural nodule with homogenous enhancement. At surgery, the extra-axial lesion with cyst containing xanthochromic fluid had a well-defined capsule that could easily be separated from the peri-lesional cortical surface. The dural-based nodule with its cyst wall was resected in toto. The histopathology of mural nodule was reported as meningioma while the cyst wall histology revealed meningothelial cells.

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Experience In 118 Consecutive Patients Undergoing Ct-Guided Stereotactic Surgery Utilizing The Cosman-Robert-Wells (Crw) Frame, G. R. Sharma, H. Siddiqui, Rashid Jooma Jun 2003

Experience In 118 Consecutive Patients Undergoing Ct-Guided Stereotactic Surgery Utilizing The Cosman-Robert-Wells (Crw) Frame, G. R. Sharma, H. Siddiqui, Rashid Jooma

Section of Neurosurgery

Aims: To evaluate the efficacy of CT-guided neurosurgical procedures done on patients operated by this modality.
Methods: Between January 1997 and March 2000, 118 patients undergoing CT-guided stereotactic procedures were recruited to the study. The CRW III stereotactic system (Radionics, USA) and the TSX-00ZA CT Scanner (Toshiba, Japan) were used for all the procedures in the series. These procedures were directed to symptomatic brain lesions or for the treatment of Parkinsonian tremor.
Results: Of 118 patients, 109 had intra-cranial lesions and 9 had Parkinson's Disease. The stereotactic procedures performed on these patients were: biopsies in 62, guided mini-craniotomies in 22, …

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Radiosurgery For The Control Of Glomus Jugulare Tumours, Muhammad Ehsan Bari, A A. Kemeny, D M C Forster, M W. Radatz Apr 2003

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 …

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Predictors Of Mortality In Brain Abscess, H U. Qureshi, A A. Habib, A A. Siddiqui, T Mozaffar, A R. Sarwari Mar 2002

Predictors Of Mortality In Brain Abscess, H U. Qureshi, A A. Habib, A A. Siddiqui, T Mozaffar, A R. Sarwari

Section of Neurosurgery

Objective: Brain abscess carries significant morbidity and mortality. Our objective was to elucidate the clinical presentation of brain abscess and to assess predictors of mortality in these patients.
Methods: All patients with a brain abscess presenting to the Aga Khan University Hospital, a tertiary care referral center in Karachi, Pakistan, were studied retrospectively. Statistical analysis involved univariate analysis and a logistic regression model.
Results: Among the 66 patients analyzed, a distant metastatic focus of infection was the most commonly identified predisposing factor (29%). Otogenic infection was the commonest contiguous source and sinusitis was noticeably absent. Multiple abscesses were frequent (35%). …

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Bilateral Cervical Radiculopathy As A Presentation Of Spinal Tuberculosis: Report Of Two Cases, G R. Sharma, Rashid Jooma Sep 2001

Bilateral Cervical Radiculopathy As A Presentation Of Spinal Tuberculosis: Report Of Two Cases, G R. Sharma, Rashid Jooma

Section of Neurosurgery

No abstract provided.

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Giant Hypothalamic Hamartoma And Associated Seizure Types, M K. Chishti, Ashfaq A. Razzaq Aug 2001

Giant Hypothalamic Hamartoma And Associated Seizure Types, M K. Chishti, Ashfaq A. Razzaq

Section of Neurosurgery

No abstract provided.

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Neoplastic Growth Of Cerebral Cavernous Malformation Presenting With Impending Cerebral Herniation: A Case Report And Review Of The Literature On De Novo Growth Of Cavernomas, Arshad A. Siddiqui, Rashid Jooma Jul 2001

Neoplastic Growth Of Cerebral Cavernous Malformation Presenting With Impending Cerebral Herniation: A Case Report And Review Of The Literature On De Novo Growth Of Cavernomas, Arshad A. Siddiqui, Rashid Jooma

Section of Neurosurgery

Background: Cerebral cavernomas are rare vascular anomalies and their expansile growth has been considered to be mainly due to recurrent hemorrhages. They are not generally reported to show aggressive behavior.
Case description: A 27-year-old male presented with headache, visual disturbances, and a 17-year history of seizures. He was known to have a temporal lobe lesion on CT scan, consistent with a diagnosis of cavernous malformation but with no relevant family history. Serial clinical and radiological follow-up revealed a progressive increase in the size of the lesion with formation of a growing cyst of 7 cm in diameter, which produced mass …

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Vestibular Schwannomas: Clinical Presentation, Management And Outcome, M S. Awan, H U. Qureshi, A A. Sheikh, M M. Ali Feb 2001

Vestibular Schwannomas: Clinical Presentation, Management And Outcome, M S. Awan, H U. Qureshi, A A. Sheikh, M M. Ali

Section of Neurosurgery

Objective: To review the demographic trends clinical spectrum, diagnosis, management and outcome of patients with vestibular Schwannoma and to identify areas where improvements are needed.
Methods: All patients with vestibular schwannoma admitted to the Aga Khan University Hospital over the past 11 years were reviewed retrospectively.
Results: The age range of majority of 22 patients analyzed, was 41-50 years (23%). Hearing loss was the most common presenting symptom (96%). Other clinical features included cranial nerve palsies (59%) and headache (55%). Fifty percent had signs of raised intracranial pressure. Neuroimaging revealed "Stage IV b" (tumor distorting the brainstem and compressing the …

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Foreign Body Granuloma After Craniotomy For Tumor: A Diagnostic Dilemma, Ashfaq A. Razzaq, M. K. N. Chishti Dec 2000

Foreign Body Granuloma After Craniotomy For Tumor: A Diagnostic Dilemma, Ashfaq A. Razzaq, M. K. N. Chishti

Section of Neurosurgery

No abstract provided.

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Cerebellopontine Angle Medulloblastoma, Naim-Ur-Rahman, A Jamjoom, M Al-Rayess, Z A. Jamjoom Jun 2000

Cerebellopontine Angle Medulloblastoma, Naim-Ur-Rahman, A Jamjoom, M Al-Rayess, Z A. Jamjoom

Section of Neurosurgery

No abstract provided.

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