Transoral approach to foramen magnum lesions; report of 12 cases and review of literature

This study reported 12 cases [8 females and 4 males] presented with extradural lesion at the region of foramen magnum. Clinical, radiological and pathological studies were discussed in details with a surgical treatment. The surgery was in the form of transoral excision of the compressing lesion, followed by posterior fusion

Congenital toxoplasmosis: a significant cause of congenital hydrocephalus in Egypt

This study was performed on 100 hydrocephalic children aging from one month to 8 years. The patients were examined physically and radiologically to exclude any hydrocephalic case associated with any other intracranial lesion. Serum and CSF samples were taken during ventriculoperitoneal shunt operation for all patients and serum samples from all mothers were collected and examined to detect anti- toxoplasma IgG using indirect ELISA. Serum samples of 40 normal children and their mothers sera were examined for IgG as controls. Positive anti-toxoplasma IgG was detected in 23% of the hydrocephalic children and their mothers denoting that their infection may be congenital from their mothers. The mean optical density [OD] of anti- toxoplasma IgG antibodies in the cerebrospinal fluid of hydrocephalic cases was significantly higher than their level in the serum of the same patients

Management of recurrent malignant glimoa and prognostic value of mutant P 53

Thirty cases of malignant recurrent glioma were operated on and received radiotherapy with or without chemotherapy. The expression of p53 in these cases was estimated. Prognostic covariates including p53 were analyzed to evaluate their predictive prognostic values. The results showed that a repeated excision of malignant glioma, even in patients who received radiation with or without chemotherapy, can improve the survival rate and quality of life, only to the extent offered by the degree of surgical debulking. There is a positive correlation between mutant p53 and poor survival in patients with recurrent glioma

Management of acute traumatic subdural haematoma

30 cases of acute traumatic subdural haematomas are reported. They were diagnosed among a total of 375 cases of acute head injury admitted to and treated in the Neurosurgery department, AL-Azhar university hospitals. They were divided into two groups depending upon the clinical presentation of the patients as well as the CT scan brain findings. 20 patients were managed surgically and 10 patients were managed conservatively. Analysis of the results of this study revealed that the overall mortality rate was 57%. The clinical presentation of the patients is more important in determining the outcome rather than the timing of surgery, as the outcome was worse with the presence of brain stem signs, and this even furthermore worse with development of dilated fixed pupils. On the other hand, the outcome did not differ between cases operated upon few hours after trauma and those brought to surgery one day later. Also surgical treatment of cases of acute traumatic subdural haematomas had not shown better results than conservative treatment

Clinical presentation and management of unilateral acute and chronic epidural, hematomas of posterior fossa

Posterior Fossa epidural hematomas [PFEDHs] was detect in 14 patients secondary to the head injury in the period from Jan. 1999 to Feb 2001 - the goal of this study was to analyze the differences in preoperative clinical presentation and management between a group of acute [8 patients] and a group of chronic [6 patients] of epidural hematomas of posterior fossa. In this study [chronic epidural hematomas was defined as a delay of more than 72 hours from the accident to surgery]. All patients were admitted to neurosurgery departments of Al Azhar university hospitals. C.T brain scan without contrast and with bone window was used as a tool for diagnosis, followed by surgical evacuation of the hematoma for all patients. The outcome and good recovery was obtained in 13 patients but only one patient died