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  1. Fulltext Reverse Cervical Lordosis Caused by Giant Vertebral Artery Aneurysm in von Recklinghausen Disease
    Saleh U, Ismail MI, Sapiai NA, Loh KB, Abd Wahab N, Abdullah JM
    Cureus, 2022 Sep;14(9):e29795.
    PMID: 36340543 DOI: 10.7759/cureus.29795
    Neurofibromatosis type 1 (NF1) is a variable penetrance autosomal dominant condition predominantly involving the peripheral nervous system. NF1 exhibits a wide spectrum of clinical patterns involving the skin, eye, brain, spinal cord, and, to a lesser extent, long bones and arteries. Arterial stenosis or aneurysms have been variously studied, but the association with NF1 has not been firmly established. A 31-year-old gentleman with NF1 experienced progressive neck pain over a five-month period, associated with limited range of motion and dysphagia. Magnetic resonance imaging (MRI) of the cervical spine suggests paraspinal plexiform neurofibromas with excessive reverse cervical lordosis. Further workups revealed a large left vertebral artery fusiform aneurysm and a pseudoaneurysm. The patient made a full recovery following endovascular embolization. It is crucial to maintain a high index of suspicion for vascular malformations in patients with NF1. The pathogenesis of vascular manifestations in NF1 and options for therapeutic management were discussed.
  2. Fulltext Examination Approaches to Brachial Plexus Injury for Neurosurgical Residents
    Saleh U, Tan GY, Fuad M, Abdullah JM, Idris Z, Ghani ARI, et al.
    Malays J Med Sci, 2023 Dec;30(6):61-69.
    PMID: 38239251 DOI: 10.21315/mjms2023.30.6.7
    BACKGROUND: Brachial plexus injury is a severe peripheral nerve injury that affects the upper extremities and causes functional damage and disability. A detailed and accurate clinical examination is required to accurately localise the site of injury. This video manuscript aims to provide guidelines for the structured assessment of a patient with brachial plexus injury, specifically tailored to Malaysian medical students and trainees.

    METHODS: A video demonstrating the examination of the brachial plexus was made. This video, created at the School of Medical Sciences at Universiti Sains Malaysia (USM), demonstrates the proper examination technique for brachial plexus.

    CONCLUSION: We hope that this video will help students and young doctors evaluate patients with brachial plexus injury and reach accurate localisation of the injury.

  3. Fulltext Pain as a Guide in Glasgow Coma Scale Status for Neurological Assessment
    Nallaluthan V, Tan GY, Murni MF, Saleh U, Abdul Halim S, Idris Z, et al.
    Malays J Med Sci, 2023 Oct;30(5):221-235.
    PMID: 37928790 DOI: 10.21315/mjms2023.30.5.18
    Neurological status is essential and often challenging for neurosurgical residents and also for neurosurgeons to determine surgical management. Pain as a component of the Glasgow Coma Scale (GCS) can be used as a tool in patients, especially an unconscious or comatose patient. In order to elicit this adequate noxious stimulus, a certain amount of pressure-pain threshold is required upon performing either as the central or peripheral technique. The scientific explanation behind each technique is required and needs to be well understood to aid the localisation of the defect in the neurological system. This paper will briefly review the aid of pain as a neurological guide in GCS status assessment.
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