Understanding the brain Derar Aldabek
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This document presents 3 case studies from a neurosurgery resident to demonstrate applications of neurobiology concepts: 1. A 55-year-old patient presented with vision loss and was found to have a pituitary tumor compressing the frontal lobe during removal, causing subsequent agitation and disinhibited behavior due to frontal lobe dysfunction. 2. A 24-year-old patient unconscious after a car accident was found to have a brain contusion in the motor area, explaining his convulsions. 3. A 36-year-old falling victim was quadriplegic due to a cervical spinal cord transection, with implications for respiratory function depending on injury level.
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Annals of Clinical and Medical Case Reports :Explore captivating medical cases & treatments that have garnered public interest.
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Cpc Icd-9-Cm Coding Essay
The document describes several medical cases and procedures. A 54-year-old patient is seen for CLL in remission. Susan Oster is admitted with septicemia, respiratory failure, and acute hepatic failure due to septicemia. An operative report describes a diagnostic thoracentesis and pleural biopsies performed on Mara Bell Lee to investigate an undiagnosed pleural effusion.
neurological alterations
This document provides information on Guillain-Barre syndrome (GBS), craniotomies, and intracranial hypertension. It defines GBS as an acute inflammatory polyradiculoneuropathy causing weakness and diminished reflexes. It describes the pathophysiology and management of GBS, including plasma exchange and IV immunoglobulin treatment. It then discusses different types of craniotomies and pre, intra, and post-operative care. Finally, it examines the pathophysiology and assessment of intracranial hypertension, management to reduce intracranial volume, and herniation syndromes that can occur if intracranial pressure is not controlled.
Harvesters Palsy: An Electrophysiological Study_Crimson Publishers
Harvesters Palsy: An Electrophysiological Study by Kirti Sharma in Techniques in Neurosurgery & Neurology
Neuroimaging Mastery Project Presentation #4: Acute Epidural Hematomas
Drs. Faith Meyers, Madison Watts and Steven Perry are Emergency Medicine Residents at Carolinas Medical Center who are interested in medical education. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), Dr. Christa Swisher (Neurocritcal Care Intensivist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this presentation they will address Atraumatic Neurosurgical Intracranial Infections. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
- Acute Epidural Hematomas
Penetrating carotid artery injuries
BACKGROUND: Penetrating carotid artery injuries (PCAI) in civil time are infrequent, yet they present significant diagnostic and therapeutic challenges and can be associated with significant morbidity and mortality. Proper resuscitation and urgent exploration is necessary for actively bleeding patients.
OBJECTIVE: The aim of this paper is to present our humble experience in management of such injuries with literature review.
PATIENTS AND METHODS: Herein, we present 5 cases of penetrating carotid artery injuries managed in Sulaimania and Basrah from January 1996 to 30th of November 2009.
RESULTS: All patients were young males. Three injuries were located in zone III and 2 in zone II. Four patients presented hours to days after the injury while the fifth presented after few months. Angiography was done in 2 patients with a false aneurysm of internal carotid artery (ICA). All 3 patients with ICA injuries were managed by ligation due to profuse bleeding and poor access. The 2 patients with common carotid artery (CCA) injuries in zone II had an end to end repair. All 5 patients have survived without significant neurological deficits.
CONCLUSIONS: Penetrating carotid artery injuries in zone II usually do not require preoperative angiography unlike those in zone I and III. Repair is always desired. It is a straightforward operation for zone II injuries but really challenging for zone III due to poor access. Certain zone III injuries may be just observed or treated by endovascular stenting when facilities permit. Ligation of ICA carries a high risk of stroke; however, young people with well developed circle of Willis may tolerate it well.
Key Words: carotid artery, penetrating injury, zone I, II and III, neurological deficit.
Publication Date: 2013
Publication Name: The Iraqi Postgraduate Medical Journal
Cervical spine clearance in polytrauma
Cervical spine injuries are common and can be difficult to diagnose, especially in polytrauma patients. A thorough understanding of cervical spine anatomy is important for accurate diagnosis and treatment planning. Goals of management are prompt recognition and prevention of secondary neurological damage. While plain radiographs are usually the initial imaging method, other imaging such as CT, MRI, and flexion-extension views may be needed to fully evaluate the injury. Dynamic imaging should only be performed once the patient is pain free and able to fully move the cervical spine. SCIWORA describes spinal cord injuries identified by MRI where plain radiographs show no abnormality, and can occur in both children and adults.
Akinetic mutism after subarachnoid haemorrhage
This document describes three cases of patients who developed akinetic mutism after suffering subarachnoid haemorrhages from ruptured cerebral aneurysms. Akinetic mutism is characterized by a lack of verbal and motor output despite preserved alertness. In the cases presented, MRI imaging showed bilateral ischemia of the medial frontal lobes in all three patients. The cingulate cortex, which was affected in these cases, plays an important role in motor function, vocalization, and emotions. While prognosis is variable, two of the three patients showed significant improvement in functioning over time despite initial severe symptoms of akinetic mutism.
Question need answers
- CT scan is not mandatory before lumbar puncture if the patient's neurological exam is normal and there are no contraindications. Repeating imaging is not needed if the patient is clinically stable without neurological deficits.
- Lumbar puncture is contraindicated in cases of increased intracranial pressure with midline shift, posterior fossa mass, loss of cerebellar or quadrigeminal cisterns on CT scan. It may also be contraindicated in patients with mild mass effect if they have risk factors like older age, immunocompromise, or abnormal consciousness.
- While CT may show mild mass effect or cerebral edema, it cannot reliably predict which patients will experience brain herniation
Decompressive craniectomy final
This document discusses decompressive craniectomy for refractory intracranial hypertension. It provides rationale and indications for decompressive craniectomy, which aims to reduce intracranial pressure by removing part of the skull. Common complications are also mentioned. Guidelines from the American Association of Neurological Surgeons are presented regarding criteria for performing decompressive craniectomy in patients with traumatic brain injury or refractory increased intracranial pressure. Outcomes of decompressive craniectomy are discussed for different patient groups.
Cranial nerves
Ask the patient to follow your finger as you move it slowly left, right, up and down in front of their face. Observe for any weakness or paralysis.
Pupillary response
CN III
Shine light into each eye separately and observe for constriction. Unequal or sluggish response indicates pathology.
Eyelid position
CN III
Observe for ptosis (drooping) of upper eyelid which indicates weakness of the levator palpebrae superioris muscle.
Accommodation
CN III
Ask patient to read smallest line possible on a Snellen chart. Inability to focus at near indicates weakness of ciliary muscle.
Progressive multifocal leukoencephalopathy
Brief review of pathogenesis and clinical features of Progressive multifocal leukoencephalopathy, PML.
MHT
This document discusses multiple hippocampal transection (MHT) as a promising new epilepsy surgery technique. MHT involves making a series of shallow cuts in the hippocampus rather than completely removing it. This helps control seizures while avoiding memory loss associated with standard temporal lobe epilepsy surgery. A recent study found that 14 out of 15 patients who underwent MHT remained seizure-free during follow-up, and verbal memory was preserved in all cases. MHT shows potential as an alternative to standard temporal lobe epilepsy surgery with fewer side effects and good seizure control outcomes.
Myaesthenia Gravis
1) The patient is a 46-year-old female with a history of rheumatic heart disease, severe mitral stenosis, and severe left ventricular dysfunction who presented with new onset weakness.
2) Electrodiagnostic testing showed reduced amplitudes of compound muscle action potentials without conduction slowing, consistent with an axonal neuropathy.
3) The patient was diagnosed with critical illness myopathy and neuropathy (CIMN) based on her clinical presentation and electrodiagnostic findings. She experienced a complicated hospital course and ultimately died.
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Introduction to Neurosurgical Subspecialties Tumor and Skull Base Neurosurger...
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Annals of Clinical and Medical Case Reports - Acmcasereport
Annals of Clinical and Medical Case Reports - Acmcasereport
final lec brain tumors.pptxtumorrrrrrrrrrrrrrrrrrrrrrrrrrrrr
final lec brain tumors.pptxtumorrrrrrrrrrrrrrrrrrrrrrrrrrrrr
Harvesters Palsy: An Electrophysiological Study_Crimson Publishers
Harvesters Palsy: An Electrophysiological Study_Crimson Publishers
Neuroimaging Mastery Project Presentation #4: Acute Epidural Hematomas
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Understanding the brain Derar Aldabek
- 1. UNDERSTANDING THE BRAIN: THE NEUROBIOLOGY OF EVERYDAY LIFE
- 2. INTRODUCTION This is Derar Aldabek, a neurosurgical resident at Saudi German Hospital. I will be presenting real cases that I myself admitted to our hospital days and weeks ago. I hope they comply with your Neurobiology of Everyday Life.
- 3. CASE PRESENTATION 1 On 19th may 2015 we did an operation for a 55 years old patient who previously was transferred to our neurosurgery clinic and was complaining of bitemporal hemianopia (loss of lateral visual field in each eye). Magnetic resonance imaging was done and showed a suprasellar mass pointing to a pituitary macroadenoma. We did the operation and we removed the tumor. We only could reach to it by compressing the FRONTAL LOBE posteriorly (backward). After recovery, the patient woke up and started to be severely agitated and irritable. He was fighting with everyone. That was due to frontal lobe edema post compression. Conclusion: Partial or complete loss of frontal lobe function might leave the patient disinhibited and agitated, since the FL is a center of social disinhibition and the factory of human logic.
- 4. CASE PRESENTATION 2 24 years old male patient presented to emergency department post road traffic accident. Patient was unconscious, had 3 bouts of vomiting, AND TWO (2) ATTACKS of CONVULSIONS. Neurosurgery team was consulted. Computed tomography scan (CT scan) was done and revealed a right precentral (fronto-pariatal) brain contusion. (motor area) Conclusion: Lesions affecting the brain’s motor area might lead to either upper motor neuron diseases, or convulsions.
- 5. CASE PRESENTATION 3 36 years old male patient presented to ER post falling from 2 floors height. Patient was conscious and oriented. On examination, the patient had quadriplegia. CT scan was done and revealed severe 5th cervical vertebra dislocation that resulted in cord transection at that level. Patient had some other simple and compound fractures and contusions spread all over his body. Patient still can ventilate himself adequately. Conclusion: spinal cord transection at any of the cervical vertebrae will cause quadriplegia if below c5, and will cause that in addition to breathing cessation if above c5 level.
- 6. THANK YOU