Endoscopic removal of third ventricular colloid cysts in non dilated ventricles

Colloid cysts are benign conditions forming not more than 1% of all intracranial neoplasm. The natural history of colloid cysts is not fully understood and the presenting manifestations are usually non specific. Many treatment options have been established for treating colloid cysts, the most recent of them is the endoscopic removal Although small or non dilated ventricles add difficulty to the procedure, yet it is not an obstacle against safe and complete resection. Between 2004 and 2007 we have operated on 10 cases of colloid cysts with non dilated ventricles [average or small sized]. Eight cases were females and two were males. The age ranged between 18 and 43 years. Headache was the outstanding symptom and occurred in all patients. Two patients suffered short term memory deficit. We used the Gaab endoscopic system with an outer sheath diameter of 6.5mm. We used neither neuronavigation nor stereotactic guidance. Follow up period ranged from 35 to 2 monthes. we were able to achieve total cyst removal in all cases. Mild transient short term memory deficit occurred in I patient. There was no mortality. Taping and working inside dilated ventricles are easier than that in smaller ones, however average or even small ventricles are not a contraindication against endoscopic colloid cyst removal even in the absence of neuronavigation and stereotaxy. Still the endoscope in small ventricles can be used safely, effectively with shorter operative period and shorter hospital stay when compared to the traditional operative techniques

Value of complexed prostate specific antigen [CPSA] in detection of cancer prostate

This study was carried on 90 males aged from 40 to 81 years old selected from Al-Hussein Hospital [Al-Azhar University] in the period from August 2005 to August 2006. cases in this study were classified into 3 groups; Group I: Included 20 persons who were apparently normal and without any prostatic disease and with normal digital rectal examination. Group II: Included 50 patients with benign prostatic hyperplasia. Group III: Included 20 patients histopathologically confirmed prostate cancer. The results revealed that there was statistically highly significant increase of complexed prostatic specific antigen[cPSA] in cancer prostate group in comparison to control group [p value 0.001]. A highly statistically significant decrease in Free/Total [F/T] ratio in cancer prostate group in comparison to control group. We found that cPSA is better in diagnosis of prostate cancer than total PSA but its performance was similar to that of F/T ratio except in sporadic cases in which performance of cPSA was better than F/T ratio. In addition, cPSA assay is a single test, measures a single analysis instead of two which is an economic advantage and decrease the chance of errors in diagnosis, it also uses a single set of kits with a single system of analysis. In addition, the complexed PSA is more stable than fPSA which is relatively unstable with long-term storage

Surgical strategy of petrous meningiomas surgery

Petrous meningiomas are benign lesions, their total surgical excision is the only method for complete cure. However their excision is confronted by deep location and critical anatomical relation and exact site of origin from the petrous bone. This study was conducted to plan a surgical strategy based on site of attachment of the lesion in the petrous bone. Twelve cases were studied preoperatively by neuro-imaging especially magnetic resonance imaging [MRI] to classify the types of petrous meningiomas. All cases were studied operatively and postoperatively for the extent of the tumour removal, clinical status, follow up and histopathological verification. A radical surgical removal was achieved in eight patients [66.6%], subtotal removal in two cases [16.665%] and incomplete removal in another two cases [16.6%]. Complete surgical excision of the petrous meningiomas can be planned preoperatively depending on exact site of attachment to the petrous bone. There were four different zones on the surface of the petrous bone on which different types of surgical approaches can be used to achieve a better result as regards the safety of the patient and the radical excision of the lesions