Surgical, radiological and histopathological studies of cases of superficial glioma in children

The clinical, Radiological findings and the Surgical results of 20 patients with superficial glioma in children who were operated in the period from March 2004 to September 2006, 12 boys and 8 girls aged from 8 months to sixteen years old [mean age 12 years]. The patients were presented to neurosurgery, neurology, and pediatric outpatients clinics at Al-Azhar University Hospitals and Al-Sahel teaching Hospital, with repeated attacks of partial complex seizures of different time of onset and progressive course as increase of frequency and prolonged duration of fits. The disease duration expressed between seven months and two years since time of onset. The most common presentation was epileptic fits in all cases, and focal manifestations and increased intracranial pressure were 16 cases. Papilledema was found in the 8 cases, hemiparesis and hemianesthesia of the contra lateral side of the tumor in 11 cases. The most common site of the tumors were temporal lobe 14 cases. Complete tumor removal was accomplished in 18 cases. The most common radiological and histopathological diagnosis among these group of patients of this study were Gangliogliomas 6 cases, and Gangliocytoma 5 cases. Comparative radiological studies between CT [Computerized tomography], MRI [Magnetic resonance imaging] and histopathology were evaluated. Sensitivity, Specificity and accuracy were 83%, 87% and 89% in CT and for MRI were 87.8%, 91.5%, 93.3% respectively. Transcortical approach were done in most cases, post operative radiation therapy was used in one patient. The choice of the radiological modalities, surgical approach, and result will be discussed

Midline posterior microendoscopic discectomy. Is it the future procedure of choice?

This is prospective study of 20 cases with solitary unilateral lumbar and lumbosacral disc prolapse were managed in Al-Azhar University Hospital, Ain, Shams University Hospital and Al-Sahel Teaching Hospital from January 2005 to January 2007. All the cases were operated by posterior midline microendoscopic discectomy procedure, utilizing microendoscopic tubular retractor system [METR'x] and Destandeau method. The postoperative clinical outcome was assessed according the MacNab's criteria. We assessed the factors which affect the outcome including the age, the value of clinical evaluation, pre operative MRI, degree of disc prolapse and duration of symptoms. Complication in the form of dural tear, discitis and superficial wound infection were recorded. We compare the result of our study to those reported in literature and the result of open microdiscectomy. Endoscopic lumbar discectomy is considered an alterative option of traditional open discectomy in appropriately well trained and experienced hands for appropriately selected patients