Displaying publications 1 - 20 of 51 in total

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  1. Siti Rohana Abdul Hadi, Saminah Md Kassim, Suriati Mohamed Saini
    ASEAN Journal of Psychiatry, 2013;14(2):183-186.
    MyJurnal
    Objective: This case report highlights psychosis post craniopharyngioma surgery.

    Methods: We report a case of a young Malay lady who presented with psychotic symptoms after she underwent craniotomy for craniopharyngioma.

    Results: Presence of prominent hallucinations and delusions after removal of the tumour and the symptoms lasted more than a month. The psychosis subsided with antipsychotic.

    Conclusion: Psychosis post craniopharyngioma surgery is still possible whether possibly due to the residual tumour or as a result of treatment sequealae.
    Matched MeSH terms: Craniotomy
  2. Iaccarino C, Kolias A, Adelson PD, Rubiano AM, Viaroli E, Buki A, et al.
    Acta Neurochir (Wien), 2021 02;163(2):423-440.
    PMID: 33354733 DOI: 10.1007/s00701-020-04663-5
    BACKGROUND: Due to the lack of high-quality evidence which has hindered the development of evidence-based guidelines, there is a need to provide general guidance on cranioplasty (CP) following traumatic brain injury (TBI), as well as identify areas of ongoing uncertainty via a consensus-based approach.

    METHODS: The international consensus meeting on post-traumatic CP was held during the International Conference on Recent Advances in Neurotraumatology (ICRAN), in Naples, Italy, in June 2018. This meeting was endorsed by the Neurotrauma Committee of the World Federation of Neurosurgical Societies (WFNS), the NIHR Global Health Research Group on Neurotrauma, and several other neurotrauma organizations. Discussions and voting were organized around 5 pre-specified themes: (1) indications and technique, (2) materials, (3) timing, (4) hydrocephalus, and (5) paediatric CP.

    RESULTS: The participants discussed published evidence on each topic and proposed consensus statements, which were subject to ratification using anonymous real-time voting. Statements required an agreement threshold of more than 70% for inclusion in the final recommendations.

    CONCLUSIONS: This document is the first set of practical consensus-based clinical recommendations on post-traumatic CP, focusing on timing, materials, complications, and surgical procedures. Future research directions are also presented.

    Matched MeSH terms: Craniotomy/standards*
  3. Abdullah J, Zamzuri I, Awang S, Sayuthi S, Ghani A, Tahir A, et al.
    Acta Neurochir. Suppl., 2005;95:311-4.
    PMID: 16463872
    The monitoring of craniospinal compliance is uncommonly used clinically despite it's value. The Spiegelberg compliance monitor calculates intracranial compliance (C = deltaV/deltaP) from a moving average of small ICP perturbations (deltaP) resulting from a sequence of up to 200 pulses of added volume (deltaV = 0.1 ml, total V = 0.2 ml) made into a double lumen intraventricular balloon catheter. The objective of this study was thus to determine the effectiveness of the decompressive craniectomy done on the worst brain site with regard to compliance (Cl), pressure volume index (PVI), jugular oximetry (SjVo2), autoregulation abnormalties, brain tissue oxygen (TiO2) and cerebral blood flow (CBF). This is a prospective cohort study of 17 patients who were enrolled after consent and approval of the ethics committee between the beginning of the year 2001 and end of the year 2002. For pre and post assessment on compliance and PVI, all 12 patients who survived were reported to become normal after decompressive craniectomy. There is no significant association between pre and post craniectomy assessment in jugular oxymetry (p > 0.05), autoregulation (p > 0.05), intracranial brain oxymetry (p = 0.125) and cerebral blood flow (p = 0.375). Compliance and PVI improved dramatically in all alive patients who received decompressive craniectomy. Compliance and PVI monitoring may be crucial in improving the outcome of severe head injured patients after decompressive craniectomy.
    Matched MeSH terms: Craniotomy/statistics & numerical data*
  4. Bin Samsuddin MF, Bin Omar MA
    Asian J Neurosurg, 2019 4 3;14(1):283-285.
    PMID: 30937055 DOI: 10.4103/ajns.AJNS_332_17
    Malignant peripheral nerve sheath tumors (MPNSTs) are uncommon, biologically aggressive soft tissue sarcomas of neural origin that poses tremendous challenges to effective therapy. MPNSTs are among the most challenging mesenchymal malignancies to treat with poor prognosis. They usually affect young and middle-aged adults, tend toward early metastasis, and often demonstrate resistance to chemotherapy. We present a case of a 23-year-old female who initially presented with the right temporal swelling for 1 month associated with constitutional symptom which progressively worsening. The right craniotomy and excision biopsy were done with histopathological examination results suggestive of MPNST. Thorax-abdominal-pelvic computed tomography and magnetic resonance imaging further revealed multiple metastatic lesions involving spine, retroperitoneal, pelvic, chest wall, and lungs. This case illustrates the typical presentation of MPNST with its known poorly outcome.
    Matched MeSH terms: Craniotomy
  5. Wan Hassan WM, Najid NM, Muslim HS, Izaini Ghani AR
    Asian J Neurosurg, 2015 3 15;10(1):59.
    PMID: 25767595 DOI: 10.4103/1793-5482.151528
    Barbiturate coma therapy (BCT) is a choice treatment for refractory intracranial hypertension after all surgical or medical managements have failed to control the intracranial pressure (ICP). It helps to reduce cerebral blood flow, cerebral metabolic rate of oxygen consumption and ICP. However, this therapy can also cause many complications. One of the underreported, but life-threatening complications is refractory hypokalemia, which can lead to subsequent rebound hyperkalemia after sudden cessation. We report our experience of managing unusual complication of refractory hypokalemia during BCT with thiopentone in postdecompressive craniectomy patient.
    Matched MeSH terms: Craniotomy
  6. Idris Z, Kandasamy R, Reza F, Abdullah JM
    Asian J Neurosurg, 2014 Jul-Sep;9(3):144-52.
    PMID: 25685205 DOI: 10.4103/1793-5482.142734
    BACKGROUND: Magnetoencephalography (MEG) is a method of functional neuroimaging. The concomitant use of MEG and electrocorticography has been found to be useful in elucidating neural oscillation and network, and to localize epileptogenic zone and functional cortex. We describe our early experience using MEG in neurosurgical patients, emphasizing on its impact on patient management as well as the enrichment of our knowledge in neurosciences.
    MATERIALS AND METHODS: A total of 10 subjects were included; five patients had intraaxial tumors, one with an extraaxial tumor and brain compression, two with arteriovenous malformations, one with cerebral peduncle hemorrhage and one with sensorimotor cortical dysplasia. All patients underwent evoked and spontaneous MEG recordings. MEG data was processed at band-pass filtering frequency of between 0.1 and 300 Hz with a sampling rate of 1 kHz. MEG source localization was performed using either overdetermined equivalent current dipoles or underdetermined inversed solution. Neuromag collection of events software was used to study brain network and epileptogenic zone. The studied data were analyzed for neural oscillation in three patients; brain network and clinical manifestation in five patients; and for the location of epileptogenic zone and eloquent cortex in two patients.
    RESULTS: We elucidated neural oscillation in three patients. One demonstrated oscillatory phenomenon on stimulation of the motor-cortex during awake surgery, and two had improvement in neural oscillatory parameters after surgery. Brain networks corresponding to clinico-anatomical relationships were depicted in five patients, and two networks were illustrated here. Finally, we demonstrated epilepsy cases in which MEG data was found to be useful in localizing the epileptogenic zones and functional cortices.
    CONCLUSION: The application of MEG while enhancing our knowledge in neurosciences also has a useful role in epilepsy and awake surgery.
    KEYWORDS: Awake craniotomy; brain network; epilepsy; magnetoencephalography; neural oscillation
    Matched MeSH terms: Craniotomy
  7. Perumall VV, Harun R, Sellamuthu P, Shah MSM
    Asian J Neurosurg, 2017 4 18;12(1):112-115.
    PMID: 28413551 DOI: 10.4103/1793-5482.144197
    Metastatic tumors are the most common mass lesions in the brain. This case reports a rare form of sarcoma with metastasis to the brain. The appropriate management of a patient with metastatic alveolar soft part sarcoma to the brain is discussed. Author describes a 32-year-old gentleman diagnosed with primary tumor at gluteus and distant metastases at lower lobe of right lung and the brain. Histopathology proves diagnosis as alveolar soft part sarcoma. Craniotomy with excision of brain lesion was done. Repeated magnetic resonance imaging of the brain after 2 months showed rapidly growing new lesions. The next step of management was made by the oncology team as recurrence rate was high and due to multi-systemic involvement. Patient was planned for palliative chemotherapy and to be reassessed later. This case report discusses the appropriate approach to any form of brain metastases and the role of early follow-up especially after surgery for better outcome and choice of post operative management such as radiotherapy or chemotherapy or both for malignant tumors. Based on this report, it was concluded that every brain tumor patient should be frequently monitored even in the outpatient setting as most of them are metastatic and rapidly spreading. The patient should be considered for radiotherapy or chemotherapy or both after surgery if the histopathology result is suggestive of malignancy.
    Matched MeSH terms: Craniotomy
  8. Nujaimin U, Saufi A, Rahman AG, Badrisyah I, Sani S, Zamzuri I, et al.
    Asian J Surg, 2009 Jul;32(3):157-62.
    PMID: 19656755
    This was a prospective cohort study, carried out in the Neuro Intensive Care Unit, Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan. The study was approved by the local ethics committee and was conducted between November 2005 and September 2007 with a total of 30 patients included in the study. In our study, univariate analysis showed a statistically significant relationship between mean intracranial pressure (ICP) as well as cerebral perfusion pressure (CPP) with both states of basal cistern and the degree of diffuse injury and oedema based on the Marshall classification system. The ICP was higher while CPP and compliance were lower whenever the basal cisterns were effaced in cases of cerebral oedema with Marshall III and IV. In comparison, the study revealed lower ICP, higher mean CPP and better mean cerebral compliance if the basal cisterns were opened or the post operative CT brain scan showed Marshall I and II. These findings suggested the surgical evacuation of clots to reduce the mass volume and restoration of brain anatomy may reduce vascular engorgement and cerebral oedema, therefore preventing intracranial hypertension, and improving cerebral perfusion pressure and cerebral compliance. Nevertheless the study did not find any significant relationship between midline shifts and mean ICP, CPP or cerebral compliance even though lower ICP, higher CPP and compliance were frequently observed when the midline shift was less than 0.5 cm. As the majority of our patients had multiple and diffuse brain injuries, the absence of midline shift did not necessarily mean lower ICP as the pathology was bilateral and even when after excluding the multiple lesions, the result remained insignificant. We assumed that the CT brain scan obtained after evacuation of the mass lesion to assess the state basal cistern and classify the diffuse oedema may prognosticate the intracranial pressure and cerebral perfusion pressure thus assisting in the acute post operative management of severely head injured patients. Hence post operative CT brain scans may be done to verify the ICP and CPP readings postoperatively. Subsequently, withdrawal of sedation for neurological assessment after surgery could be done if the CT brain scan showed an opened basal cistern and Marshall I and II coupled with ICP of less than 20 mmHg.
    Matched MeSH terms: Craniotomy
  9. Suhara S, Wong AS, Wong JO
    Br J Neurosurg, 2008 Apr;22(2):295-7.
    PMID: 18348031 DOI: 10.1080/02688690701687678
    A 27-year-old patient presented with severe headache and seizures about a month after the initial head trauma. Computed tomography (CT) brain scan revealed acute subdural bleed continuous into the interhemispheric region, with no subarachnoid haemorrhage. This was due to rupture of a traumatic pericallosal artery aneurysm. This represents a rare case of traumatic pericallosal artery aneurysm presenting with subdural haematoma without subarachnoid haemorrhage.
    Matched MeSH terms: Craniotomy/methods
  10. Selladurai BM, Sivakumaran S, Aiyar S, Mohamad AR
    Br J Neurosurg, 1993;7(2):205-7.
    PMID: 8098607
    Micrococcus spp. are commensal organisms colonizing the body surfaces of humans. In a few instances these organisms have been reported to colonize ventricular shunts. We report a patient, with no overt evidence of immunosuppression, in whom Micrococcus luteus was responsible for intracranial suppuration at multiple sites.
    Matched MeSH terms: Craniotomy
  11. Tevaraj JM, Li Min ET, Mohd Noor RA, Yaakub A, Wan Hitam WH
    Case Rep Ophthalmol Med, 2016;2016:1701509.
    PMID: 27738538
    Neurofibromatosis type 2 usually presents with bilateral acoustic schwannomas. We highlight the rare presentation of neurofibromatosis initially involving third nerve. A 23-year-old Malay female presented with left eye drooping of the upper lid and limitation of upward movement for 8 years. It was associated with right-sided body weakness, change in voice, and hearing disturbance in the right ear for the past 2 years. On examination, there was mild ptosis and limitation of movement superiorly in the left eye. Both eyes had posterior subcapsular cataract. Fundoscopy showed generalised optic disc swelling in both eyes. She also had palsy of the right vocal cord, as well as the third and eighth nerve. There was wasting of the distal muscles of her right hand, with right-sided decreased muscle power. Pedunculated cutaneous lesions were noted over her body and scalp. MRI revealed bilateral acoustic and trigeminal schwannomas with multiple extra-axial lesions and intradural extramedullary nodules. Patient was diagnosed with neurofibromatosis type 2 and planned for craniotomy and tumour debulking, but she declined treatment. Neurofibromatosis type 2 may uncommonly present with isolated ophthalmoplegia, so a thorough physical examination and a high index of suspicion are required to avoid missing this condition.
    Matched MeSH terms: Craniotomy
  12. Pant I, Joshi SC
    Childs Nerv Syst, 2008 Jan;24(1):157-9.
    PMID: 17657495
    Intra-axial dermoid cysts are rare intracranial space occupying lesions, more so in the pediatric age group. Dermoid cysts account for about 0.2 to 1.8% of all intracranial tumors and are commonly located in the cisternal spaces, mainly in the cerebellopontine angle and parasellar cisterns. A purely intra-axial position as reported in this paper is quite exceptional.
    Matched MeSH terms: Craniotomy/methods
  13. Aung YN, Nur AM, Ismail A, Aljunid SM
    Clinicoecon Outcomes Res, 2019;11:505-513.
    PMID: 31447570 DOI: 10.2147/CEOR.S209108
    Purpose: Care at ICUs is expensive and variable depending on the type of care that the patients received. Knowing the characteristics of the patient and his or her disease is always useful for improving health services and cost containment.

    Patients and methods: An observational study was conducted at four different intensive care units of an academic medical institution. Demographic characteristics, disease-management casemix information, cost and outcome of the high costing decile, and the rest of the cases were compared.

    Results: A total of 3,220 discharges were included in the study. The high-cost group contributed 35.4% of the ICU stays and 38.8% of the total ICU expenditure. Diseases of the central nervous system had higher odds to be in the top decile of costly patients whereas the cardiovascular system was more likely to be in the non-high cost category. The high-cost patients were more likely to have death as an outcome (19.2% vs 9.3%; p<0.001). The most common conditions that were in the high-cost groups were craniotomy, other ear, nose, mouth, and throat operations, simple respiratory system operations, complex intestinal operations, and septicemia. These five diagnostic groups made up 43% of the high-cost decile.

    Conclusion: High-cost patients utilized almost 40% of the ICU cost although they were only 10% of the ICU patients. The chances of admission to the ICU increased with older age and severity level of the disease. Central nervous system diseases were the major problem of patients aged 46-69 years old. In addition to cost reduction strategies at the treatment level, detailed analysis of these cases was needed to explore and identify pre-event stage prevention strategies.

    Matched MeSH terms: Craniotomy
  14. Hasmi AH, Khoo LS, Koo ZP, Suriani MUA, Hamdan AN, Yaro SWM, et al.
    Forensic Sci Med Pathol, 2020 09;16(3):477-480.
    PMID: 32500339 DOI: 10.1007/s12024-020-00270-z
    During a disease pandemic, there is still a requirement to perform postmortem examinations within the context of legal considerations. The management of the dead from COVID-19 should not impede the medicolegal investigation of the death where required by the authorities and legislation but additional health and safety precautions should be adopted for the necessary postmortem procedures. The authors have therefore used the craniotomy box in an innovative way to enable a safe alternative for skull and brain removal procedures on suspected or confirmed COVID-19 bodies. The craniotomy box technique was tested on a confirmed COVID-19 positive body where a full postmortem examination was performed by a team of highly trained personnel in a negative pressure Biosafety Level 3 (BSL-3) autopsy suite in the National Institute of Forensic Medicine (IPFN) Malaysia. This craniotomy box is a custom-made transparent plastic box with five walls but without a floor. Two circular holes were made in one wall for the placement of arms in order to perform the skull opening procedure. A swab to detect the presence of the SARS-CoV-2 virus was taken from the interior surface of the craniotomy box after the procedure. The result from the test using real-time reverse transcriptase polymerase chain reaction (rRT-PCR) proved that an additional barrier provided respiratory protection by containing the aerosols generated from the skull opening procedure. This innovation ensures procedures performed inside this craniotomy box are safe for postmortem personnel performing high risk autopsies during pandemics.
    Matched MeSH terms: Craniotomy/adverse effects; Craniotomy/instrumentation*
  15. Sim, S.K., Theophilus, S.C., Noor Azman, A.R.
    MyJurnal
    Intracranial nail gun injury is a rare subset of penetrating head injury. Here we report a case of intracranial nail gun injury in a Vietnamese patient who attempted suicide with no neurological deficit. Three nails were launched. Because the nail head acted as a brake, the launched nail could make a hole into the skull but could not entirely pass it. A rational management strategy should permit these patients to be discharged with no additional injury. Some medical and surgical management in penetrating head injury are discussed. The use of antibiotics and antiepileptic drugs and the retraction of the nail aided by the performance of a craniotomy surrounding the entry point are recommended.
    Matched MeSH terms: Craniotomy
  16. Wong EHC, Lim CC, Ong CA, Narayanan P
    Int J Surg Case Rep, 2020;72:587-589.
    PMID: 32698294 DOI: 10.1016/j.ijscr.2020.06.086
    BACKGROUND: Cholesterol granuloma (CG) is a rare entity but is the commonest lesion in the petrous apex. They are associated with chronic ear disease and previous temporal bone surgery. While bone wax has been known to cause foreign body reaction due to its non-resorbable property in the mastoid, it has not been documented to cause CG formation.

    CASE PRESENTATION: We described a 43 years old male who presented with a right mastoid swelling, nine years after a right retro-sigmoid craniotomy and excision for a cerebellopontine angle meningioma. He also had multiple cranial neuropathies involving trigeminal, facial and vestibulocochlear nerves. Temporal bone CT and MRI showed features suggestive of cholesterol granuloma with extensive bony erosions. He was treated with surgical excision and drainage where bone wax residues were found intraoperatively. Histopathological analysis of the lesion confirmed the diagnosis of cholesterol granuloma. Post-operatively, the mastoid swelling resolved and his recovery was uneventful.

    CONCLUSION: Our case showed that CG could manifest as a complication of bone wax usage in a neurosurgical procedure. Even though further study is needed to draw a definitive conclusion on this theory, we believe this paper will contribute to the current literature as it is the only reported case of cholesterol granuloma with bone wax as the possible causative agent. This is important so that surgeons are aware of this potential complication and use this haemostatic agent more judiciously.

    Matched MeSH terms: Craniotomy
  17. Shanti, R., Sam, I.C., Hany Ariffin
    JUMMEC, 2009;12(1):35-38.
    MyJurnal
    Following craniotomy for an atypical rhabdoid tumour of the posterior cranial fossa, a fourteen-month-old boy developed a ventriculitis with methicillin resistant Staphylococcus epidermidis (MRSE) which is associated with the use of a ventriculoperitoneal shunt. Treatment with intravenous vancomycin resulted in a severe allergic skin reaction. Substitution with intravenous teicoplanin resulted in negative blood culture and MRSE ventriculitis was successfully eradicated with concomitant use of intraventricular teicoplanin. No signs of recurrent infection or adverse events occurred. Intraventricular teicoplanin is safe and effective for the treatment of staphylococcal neurosurgical shunt infections.
    Matched MeSH terms: Craniotomy
  18. Ainal Adlin N, Umi Kalthum MN, Amizatul Aini S, Reena Rahayu MZ
    MyJurnal
    A 47-year-old lady, presented with progressive proptosis of left eye with deterioration of vision. She had a history of left solitary fibrous tumour and had undergone left frontal craniotomy and orbitotomy in 2004. Surveillance Magnetic resonance imaging (MRI) six years later showed tumour recurrence with intracranial extension. However, she did not follow-up and only presented again 3 years, later. Tumour resection and left exenteration was performed. Histology showed ‘patternless’ pattern of neoplastic cells, and CD34 staining was diffusely positive. Diagnosis of recurrent solitary fibrous tumour with intracranial extension was made.
    Matched MeSH terms: Craniotomy
  19. Raajini Devi K, Aida Zairani MI, Hazlita MI, Jemaima CH, Farizal F, Safinaz Mohd Khialdin
    MyJurnal
    A 21-year-old Chinese gentleman with no known medical illness, presented with a history of right painless blurring of vision with central scotoma of two weeks duration. He also had a history of multiple episodes of seizures prior to presentation. Visual acuity was 1/60 with unremarkable anterior segment findings and no relative afferent pupillary defect. Fundus examination of the right eye revealed dilated and tortuous retinal veins with multiple retinal capillary hemangiomas and sub retinal hard exudates at the macula with edema. A diagnosis of Von Hippel Lindau disease was made when a posterior fossa mass suggestive of hemangioblastoma with obstructive hydrocephalus was seen on computed tomography of the brain. Craniotomy with nodule excision was performed. The retinal capillary hemangiomas were treated with the combination of laser photocoagulation and intravitreal Ranibizumab injections. Visual acuity subsequently improved to 6/36.
    Matched MeSH terms: Craniotomy
  20. Sidhu A, Murgahayah T, Narayanan V, Chandran H, Waran V
    J Acupunct Meridian Stud, 2017 Jan;10(1):45-48.
    PMID: 28254101 DOI: 10.1016/j.jams.2016.06.005
    Although acupuncture has existed for over 2000 years, its application as an anesthetic aid began in the 1950s in China. The first surgical procedure performed under acupuncture anesthesia was a tonsillectomy. Soon thereafter, major and minor surgical procedures took place with electroacupuncture alone providing the anesthesia. The procedures performed were diverse, ranging from cardiothoracic surgery to dental extractions. Usage of acupuncture anesthesia, specifically in neurosurgery, has been well documented in hospitals across China, especially in Beijing, dating back to the 1970s. We present a case of a 65-year-old man who presented with right-sided body weakness. He had a past medical history of uncontrolled diabetes mellitus, hypertension, and obstructive sleep apnea requiring use of a nasal continuous positive airway pressure device during sleep. We performed a computed tomography brain scan, which revealed a left-sided acute on chronic subdural hemorrhage. Due to his multiple comorbidities, we decided to perform the surgical procedure under electroacupuncture anesthesia. The aim of this case report is to describe a craniotomy performed under electroacupuncture on an elderly patient with multiple comorbidities who was awake during the procedure and in whom this procedure, if it had been performed under general anesthesia, would have carried high risk.
    Matched MeSH terms: Craniotomy/methods*
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