Stereotactic surgery: diagnostic and therapeutic role in the management of brain disorders and our experience at Ibn Sina hospital

To present the results of our experience with stereotactic surgery, which is a safe and minimally invasive technique, in the field of neurosurgery. Prospective study. Department of Neurosurgery, Ibn Sina Hospital, Kuwait. Forty patients underwent stereotactic surgery for diagnostic and therapeutic purposes during the five years between 2006 and 2011. There were 26 male and 14 female patients with a mean age of 47 years [range 9 - 70 yrs]. Twenty seven [67.5%] patients had diagnostic brain procedures and 13 [32.5%] had diagnostic as well as therapeutic procedures. The stereotactic surgery was carried out with the help of computerized tomography [CT] - guided Leksell stereotactic frame[registered] and Leksell SurgiPlan[registered] software. Stereotactic surgery. Outcome of surgery and complications. Stereotactic biopsies confirmed 28 [70%] patients with brain tumors; six [14%] with cerebral infections, four [10%] with multiple sclerosis and one with cerebral infarction. Stereotactic aspirations were performed in nine patients; four with cystic brain tumors and five with brain abscesses. Stereotactic insertion of Ommaya reservoir was performed in four patients with cystic brain lesions. Complication, related to the procedure was observed only in one patient and was managed conservatively. No other morbidity or mortality was noted. Stereotactic surgery is a minimal invasive technique that helps the neurosurgeon in further planning of an appropriate treatment after tissue biopsy. It can also be used as primary mode of treatment in patients with brain abscesses, cysts and intracranial hematomas

Gamma knife radiosurgery: one year preliminary experience at Kuwait gamma knife center, Ibn Sina Hospital, Kuwait

To introduce a novel treatment modality in neurosurgery practice in Kuwait and report our preliminary experience with this technique. Prospective study. Ibn Sina hospital, Kuwait. Fifty-seven patients who underwent radiosurgery in the first year of operation in our center. There were 32 [56%] male and 25 [44%] female patients with their age ranging from 12 to 76 years. Thirty five [61.5%] patients presented with benign tumors, 12 [21%] with malignant tumors [high grade gliomas, metastases], 8 patients [14%] with vascular malformations and two [3.5%] with functional disorders [trigeminal neuralgia]. Thirty one [57.2%] patients underwent radiosurgery for their residual lesions after attempted surgical excisions or other procedures. Gamma knife radiosurgery. Outcome of surgery and complications. The mean follow-up period was 9.7 months [range 3- 20 months]. The follow-up was achieved in 54 [95%] patients while three were lost to follow-up. Post-radiosurgery imaging demonstrated decrease in lesion size in 24 patients, no change in 27 and increase in three patients. These three patients were managed with surgery. Patients with trigeminal neuralgia were pain-free without any medications within three months of Gamma knife. Complications were observed in five [9.3%] patients, which were transient and improved after conservative treatment. No mortality was experienced in our patients, related to the procedure. Gamma knife radiosurgery is a safe and an effective treatment alternative to conventional neurosurgery in selected patients with brain disorders