Displaying publications 1 - 20 of 57 in total

  1. Idris Z, Zakaria Z, Fitzrol DN, Ang SY, Yee SV, Ghani ARI, et al.
    Oper Neurosurg (Hagerstown), 2021 03 15;20(4):E281-E283.
    PMID: 33475706 DOI: 10.1093/ons/opaa473
    Matched MeSH terms: Neurosurgical Procedures
  2. Al-Siweedi SY, Nambiar P, Shanmuhasuntharam P, Ngeow WC
    ScientificWorldJournal, 2014;2014:719243.
    PMID: 24892077 DOI: 10.1155/2014/719243
    This study is aimed at determining anatomical landmarks that can be used to gain access to the inferior alveolar neurovascular (IAN) bundle. Scanned CBCT (i-CAT machine) data of sixty patients and reconstructions performed using the SimPlant dental implant software were reviewed. Outcome variables were the linear distances of the mandibular canal to the inferior border and the buccal cortex of the mandible, measured immediately at the mental foramen (D1) and at 10, 20, 30, and 40 mm (D2-D5) distal to it. Predictor variables were age, ethnicity, and gender of subjects. Apicobasal assessment of the canal reveals that it is curving downward towards the inferior mandibular border until 20 mm (D3) distal to the mental foramen where it then curves upwards, making an elliptic-arc curve. The mandibular canal also forms a buccolingually oriented elliptic arc in relation to the buccal cortex. Variations due to age, ethnicity, and gender were evident and this study provides an accurate anatomic zone for gaining surgical access to the IAN bundle. The findings indicate that the buccal cortex-IAN distance was greatest at D3. Therefore, sites between D2 and D5 can be used as favorable landmarks to access the IAN bundle with the least complications to the patient.
    Matched MeSH terms: Neurosurgical Procedures/methods*
  3. Choo CH, Kwan MK, Chris Chan YW
    AME Case Rep, 2018;2:38.
    PMID: 30264034 DOI: 10.21037/acr.2018.07.02
    Thoracolumbar burst fractures are common entity in polytraumatized patients. The retropulsed burst vertebral fracture may result in spinal canal invasion with or without neurological deficit. In this situation, early surgical stabilization with decompression is vital to restore neurological function. We employed a posterior approach with a unique transpedicular reduction technique at the level of fracture for decompression and stabilisation.
    Matched MeSH terms: Neurosurgical Procedures
  4. Muhammad Wafiuddin Ahmad, Ed Simor Khan, Rajandra Kumar, Zamzuri Zakaria, Ahmad Faiza, Haidar Nusuruddin, et al.
    Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity among teenager. For those indicated, early surgical intervention allows better surgical correction due to flexibility of the spine during teenage years, hence good functional outcome and better cosmetic can be expected. In this case report, there is the management of four patients surgically using the posterior spinal instrumentation and fusion. Pre-operatively patients were examined at IIUM Medical Centre spine clinic, all necessary investigations were carried out. A thorough explanation was done to patient and parents regarding procedure, risk and benefit. All patients were treated using the same surgical technique. Neuromonitoring was used throughout the whole surgery until skin closure. All patients were hospitalized around one week. Post-operatively patients were followed up at two weeks, six weeks, three months, and every six months thereafter. It is important for clinicians to identify patients with AIS as early detection and timely treatment will change the natural history of curve progression. Surgical intervention when necessary will be easier and with less risk of complications when surgery was carried out during teenage years as the spine is more flexible and the deformity is less severe.
    Matched MeSH terms: Neurosurgical Procedures
  5. Abdullah JM
    Malays J Med Sci, 2015 May-Jun;22(3):1-6.
    PMID: 26715890
    16 years have passed since the idea was mooted in 1999 by five neurosurgeons in the corridors of Hotel Perdana, Kota Bharu. They were Dato' Dr Johari Siregar Bin Adnan, Dato' Professor Dr Ahmad Zubaidi Abdul Latif , Dr Azmin Kass Bin Rosman, Dato' Dr Mohammed Saffari Bin Mohammed Haspani and Professor Dato' Dr Jafri Malin Abdullah. They initiated the beginning of the first programme in Neurosurgery in Malaysia. The rest is history.
    Matched MeSH terms: Neurosurgical Procedures
  6. Mehbodniya AH, Moghavvemi M, Narayanan V, Waran V
    World Neurosurg, 2019 Feb;122:e449-e454.
    PMID: 30347306 DOI: 10.1016/j.wneu.2018.10.069
    BACKGROUND: Navigation (image guidance) is an essential tool in modern neurosurgery, and most surgeons use an optical tracking system. Although the technology is accurate and reliable, one often is confronted by line of sight issues that interrupt the flow of an operation. There has been feedback on the matter, but the actual problem has not been accurately quantified, therefore making this the primary aim of this study. It is particularly important given that robotic technology is gradually making its way into neurosurgery and most of these devices depend on optical navigation when procedures are being conducted.

    METHODS: In this study, the frequency and causes of line of sight issues is assessed using recordings of Navigation probe locations and its synchronised video recordings.

    RESULTS: The mentioned experiment conducted for a series of 15 neurosurgical operations. This issue occured in all these surgeries except one. Maximum duration of issue presisting reached up to 56% of the navigation usage time.

    CONCLUSIONS: The arrangment of staff and equipment is a key factor in avoiding this issue.

    Matched MeSH terms: Neurosurgical Procedures
  7. Kahairi A, Ahmed Khan S, Amirozi A
    Malays J Med Sci, 2010 Jan;17(1):56-9.
    PMID: 22135528
    The standard management for the majority of benign jaw cysts is enucleation, marsupialisation, curettage and decompression. Enucleation has the advantage that the whole specimen is sent for microscopic evaluation so that more sinister pathological processes (i.e. squamous cell carcinoma) may not be missed. In a large cystic lesion, enucleation is still possible, but technical difficulties might be encountered. In such instances, inevitable damage can occur to the surrounding structures. We report a case of a large radicular cyst of the maxilla that was enucleated via endoscopic assistance through the Caldwell Luc approach.
    Matched MeSH terms: Neurosurgical Procedures
  8. Al-Kadi MI, Reaz MB, Ali MA, Liu CY
    Sensors (Basel), 2014;14(7):13046-69.
    PMID: 25051031 DOI: 10.3390/s140713046
    This paper presents a comparison between the electroencephalogram (EEG) channels during scoliosis correction surgeries. Surgeons use many hand tools and electronic devices that directly affect the EEG channels. These noises do not affect the EEG channels uniformly. This research provides a complete system to find the least affected channel by the noise. The presented system consists of five stages: filtering, wavelet decomposing (Level 4), processing the signal bands using four different criteria (mean, energy, entropy and standard deviation), finding the useful channel according to the criteria's value and, finally, generating a combinational signal from Channels 1 and 2. Experimentally, two channels of EEG data were recorded from six patients who underwent scoliosis correction surgeries in the Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) (the Medical center of National University of Malaysia). The combinational signal was tested by power spectral density, cross-correlation function and wavelet coherence. The experimental results show that the system-outputted EEG signals are neatly switched without any substantial changes in the consistency of EEG components. This paper provides an efficient procedure for analyzing EEG signals in order to avoid averaging the channels that lead to redistribution of the noise on both channels, reducing the dimensionality of the EEG features and preparing the best EEG stream for the classification and monitoring stage.
    Matched MeSH terms: Neurosurgical Procedures/instrumentation; Neurosurgical Procedures/methods
  9. Waran V, Sek K, Bahuri NF, Narayanan P, Chandran H
    Minim Invasive Neurosurg, 2011 Oct;54(5-6):279-81.
    PMID: 22278798 DOI: 10.1055/s-0031-1297997
    In endoscopic neurosurgery problems with haemostasis due to poor access exist. We have developed a system which allows the delivery of a variety of haemostatic agents in a more efficacious manner. The system has been used successfully in endoscopic skull base surgery and endoscopic surgery within the parenchyma of the brain using tube systems.
    Matched MeSH terms: Neurosurgical Procedures/instrumentation*; Neurosurgical Procedures/methods
  10. Waran V, Bahuri NF, Narayanan V, Ganesan D, Kadir KA
    Br J Neurosurg, 2012 Apr;26(2):199-201.
    PMID: 21970777 DOI: 10.3109/02688697.2011.605482
    The purpose of this study was to validate and assess the accuracy and usefulness of sending short video clips in 3gp file format of an entire scan series of patients, using mobile telephones running on 3G-MMS technology, to enable consultation between junior doctors in a neurosurgical unit and the consultants on-call after office hours.
    Matched MeSH terms: Neurosurgical Procedures/instrumentation*; Neurosurgical Procedures/standards
  11. Waran V, Vairavan N, Sia SF, Abdullah B
    J. Neurosurg., 2009 Dec;111(6):1127-30.
    PMID: 19408977 DOI: 10.3171/2009.4.JNS081506
    The authors describe a newly developed expandable cannula to enable a more efficient use of an endoscope in removing intraparenchymal spontaneous hypertensive intracerebral hematomas. The cannula is introduced like a conventional brain cannula, using neuronavigation techniques to reach the targeted hematoma accurately, and, once deployed, conventional microsurgical techniques are used under direct endoscopic visualization. This method was used in 6 patients, and, based on the results of intraoperative intracranial pressure monitoring and postoperative CT scanning, the authors were able to achieve good hematoma removal. They found that by using the expandable cannula, efficient endoscopic surgery in the brain parenchyma was possible.
    Matched MeSH terms: Neurosurgical Procedures/instrumentation; Neurosurgical Procedures/methods
  12. Phang ZH, Saw XY, Nor NFBM, Ahmad ZB, Ibrahim SB
    BMC Cancer, 2018 Nov 14;18(1):1112.
    PMID: 30428857 DOI: 10.1186/s12885-018-5012-3
    BACKGROUND: Sacral chordoma is a locally aggressive malignant tumour originating from ectopic notochordal cells. The natural history of sacral chordoma is a slow growing tumour arising at the midline of the lower sacrum that can invade the sacrum and progressively increase in size expanding cranially and anteriorly. Metastasis is very rare even when the tumour is large. Sacral chordoma affects males more than females and is more commonly found in middle age and elderly patients.

    CASE PRESENTATION: A 25 years old female had neglected an extremely large midline sacral mass for 2 years. On presentation to hospital, she had been bed bound for the past 2 years. The sacral mass was so large that it prevented her from lying down supine and sitting on the wheelchair comfortably. Clinical examination showed a 40 cm × 30 cm × 20 cm hard mass over the sacrum that involved both buttocks and the gluteal fold. Neurological exam of bilateral lower limb was normal. Computed Tomography Scan of the Pelvis showed a large destructive sacrococcygeal mass measuring 43 cm × 38 cm × 27 cm with extension into the presacral space resulting in anterior displacement of the rectum, urinary bladder and uterus; and posterior extension into the dorsal soft tissue with involvement of the gluteus, piriformis, and left erector spinae muscles. Biopsy taken confirmed Chordoma. This patient was managed by a multidisciplinary team in an Oncology referral centre. The patient had undergone Wide En Bloc Resection and Sacrectomy, a complex surgery that was associated with complications namely bleeding, surgical site infection and neurogenic bowel and bladder. Six months post operatively the patient was able to lie supine and sit on wheelchair comfortably. She required extensive rehabilitation to help her ambulate in future.

    CONCLUSION: This is a rare case of neglected sacral chordoma in a young female treated with Wide En Bloc Resection and Sacrectomy associated with complications of this complex surgery. Nevertheless, surgery is still worthwhile to improve the quality of life and to prevent complications secondary to prolonged immobilization. A multidisciplinary approach is ideal and team members need to be prepared to address the complications once they arise.

    Matched MeSH terms: Neurosurgical Procedures/adverse effects; Neurosurgical Procedures/methods*
  13. Gendeh BS
    Indian J Otolaryngol Head Neck Surg, 2010 Sep;62(3):264-76.
    PMID: 23120724 DOI: 10.1007/s12070-010-0077-6
    Sinus surgery has the potential of allowing ENT surgeons to encroach the boundaries of our colleagues in ophthalmology and neurosurgery. The advent of nasal endoscope and lately powered instrumentation and computer-assisted navigational systems has avoided the use of the conventional and more radical approaches by the ENT surgeon for the treatment of inflammatory pathology or tumors of the orbit and skull base. As rhinologists have gained more experience in endoscopic surgery, more areas related to the orbit and the anterior skull base are accessible and surgery is safer.
    Matched MeSH terms: Neurosurgical Procedures
  14. Kumar CM, Van Zundert AAJ
    Can J Anaesth, 2018 05;65(5):578-585.
    PMID: 29368315 DOI: 10.1007/s12630-018-1074-6
    The Valsalva maneuver (VM) involves expiratory effort against a closed mouth and/or glottis in the sitting or supine position with the increased intraoral and intrathoracic pressure raised to 40 mmHg for 15-20 sec after which the pressure is suddenly released and the breathing restored to normal. Complex cardiovascular and other physiologic changes occur during the VM. The VM has been used for diagnostic and therapeutic reasons as well as intraoperatively during specific surgical procedures. Although the VM is usually safe, rare complications have been reported. This review examines the published literature surrounding the VM and explores the physiologic changes that occur during its performance. Attempts have been made to understand its intraoperative uses and complications and how these can be prevented.
    Matched MeSH terms: Neurosurgical Procedures
  15. Chung WH, Tan RL, Chiu CK, Kwan MK, Chan C
    Malays Orthop J, 2020 Nov;14(3):170-173.
    PMID: 33403080 DOI: 10.5704/MOJ.2011.027
    Delayed post-operative spinal epidural haematoma (DPSEH) is diagnosed when the onset of symptoms is more than three days from the index surgery. DPSEH is a rare but serious complication of spinal surgery. Missed diagnosis will result in irreversible neurological deficit which may lead to permanent disabilities. We report two cases of DPSEH who presented with worsening neurological deficit four days after the index surgery. Magnetic resonance imaging (MRI) showed the presence of an epidural haematoma compressing the spinal cord. Surgical evacuation of haematoma were performed for both patients. Both patients experienced neurological improvement. Surgeons should have high index of suspicion to identify delayed onset of spinal epidural haematoma (SEH) and timely intervention should be taken to avoid irreversible neurological damage.
    Matched MeSH terms: Neurosurgical Procedures
  16. Faruk NA, Mohd-Amin MZ, Awang-Ojep DN, Teo YY, Wong CC
    Malays Orthop J, 2018 Nov;12(3):50-52.
    PMID: 30555648 MyJurnal DOI: 10.5704/MOJ.1811.013
    Giant cell tumour (GCT) is a benign tumour but can be locally aggressive and with the potential to metastasise especially to the lungs. Successful treatments have been reported for long bone lesions; however, optimal surgical and medical treatment for spinal and sacral lesions are not well established. In treating spinal GCTs, the aim is to achieve complete tumour excision, restore spinal stability and decompress the neural tissues. The ideal surgical procedure is an en bloc spondylectomy or vertebrectomy, where all tumour cells are removed as recurrence is closely related to the extent of initial surgical excision. However, such a surgery has a high complication rate, such as dura tear and massive blood loss. We report a patient with a missed pathological fracture of T12 treated initially with a posterior subtraction osteotomy, who had recurrence three years after the index surgery and subsequently underwent a three level vertebrectomy and posterior spinal fusion.
    Matched MeSH terms: Neurosurgical Procedures
  17. Raffiq A, Abdullah JM, Haspani S, Adnan JS
    Malays J Med Sci, 2015 Dec;22(Spec Issue):5-8.
    PMID: 27006632 MyJurnal
    The development of neurosurgical services and training in Malaysia began in 1963, with the first centre established in its capital city at Hospital Kuala Lumpur, aimed to provide much needed neurosurgical services and training in the field of neurology and neurosurgery. This center subsequently expanded in 1975 with the establishment of the Tunku Abdul Rahman Neuroscience Institute (IKTAR); which integrated the three allied interdependent disciplines of neurosurgery, neurology and psychiatry. The establishment of this institute catalysed the rapid expansion of neurosurgical services in Malaysia and paved the way for development of comprehensive training for doctors, nurses, and paramedics. This culminated in the establishments of a local comprehensive neurosurgery training program for doctors in 2001; followed by a training program for nurses and paramedics in 2006. To date, there are more than 60 neurosurgeons providing expert care in 11 centers across Malaysia, along with trained personnel in the field of neurosciences.
    Matched MeSH terms: Neurosurgical Procedures
  18. Hassan R, Siregar JA, A Rahman Mohd NA
    Malays J Med Sci, 2014 Mar;21(2):54-62.
    PMID: 24876808 MyJurnal
    Telemedicine in neurosurgery or teleneurosurgery has been widely used for transmission of clinical data and images throughout the country since its implementation in 2006. The impact is a reduction of patient number that need to be reviewed in the level III hospitals and an increment in the number of patients that are kept in level II hospitals for observation by the primary team. This translates to reduction of unnecessary transfer of patients and subsequently cost benefits for patients and medical providers. The main aim is to determine the amount of reduction in unnecessary transfer by the implementation of teleneurosurgery in the management of referrals to neurosurgical department in Hospital Sultanah Amninah Johor Bahru (HSAJB). Other factors associated with transfer decision are also evaluated.
    Matched MeSH terms: Neurosurgical Procedures
  19. Theophilus SC, Adnan JS
    Malays J Med Sci, 2011 Jan;18(1):30-7.
    PMID: 22135571
    BACKGROUND: A double-blind randomised control study was conducted on all patients who were admitted or referred to the Department of Neurosurgery, Sultanah Aminah Hospital, Johor Bahru, with a diagnosis of hydrocephalus where a ventriculoperitoneal shunt was indicated.
    METHODS: The period of study was from November 2005 to May 2007, and the follow-up period was 3 months after surgery. Randomisation was carried out in the operating room prior to the procedure. The scrub nurse selected a sealed envelope, which contained the assignment of each patient to 1 of 2 treatment groups: Group 1 patients were treated with topical methicillin, and Group 2 patients were not treated with topical methicillin. Prophylactic antibiotic, cefuroxime (25 mg/kg) was given intravenously at induction. Standard sterile operative technique was followed in preparing and draping the patients.
    RESULTS: A total of 90 patients were recruited in the study, and 13 (14.4%) patients developed an infection within 3 months post-operation. Group 1 had a 8.9% risk of infection, and Group 2 had a 20% risk; however, there was no statistically significant post-operative ventriculoperitoneal shunt (VPS) infection reduction with the use of topical methicillin in VPS surgery (P = 0.230). Multivariate analysis showed that only duration of surgery had a significant influence on the incidence of post-operative VPS infection in the non-methicillin group (P = 0.02). The non-methicillin group had an 8 times greater risk of developing post-operative VPS infection than the methicillin group if surgery lasted longer than 1 hour.
    CONCLUSION: Topical methicillin had no significance in the reduction of post-operative VPS infection.
    KEYWORDS: methicillin; neurosurgery; post-operative wound infection; topical administration; ventriculoperitoneal shunt
    Study site: Patient admitted or referred to Hospital Sultanah Aminah Johor Bahru, Johor, Malaysia
    Matched MeSH terms: Neurosurgical Procedures
  20. Awang MS, Abdullah MZ
    Malays J Med Sci, 2011 Apr;18(2):53-7.
    PMID: 22135587 MyJurnal
    Surgical robots have been appearing in operating rooms over the past decade, and neurosurgery has been one of the pioneers in this area. In neurosurgery, the clinical use of robots has been limited to stereotactic procedures and endoscopic manoeuvres, although the brain is a unique organ and well-suited for robotic application. The aim of this study was to assess the ability of our vision-guided robotic system to perform basic neurosurgical procedures.
    Matched MeSH terms: Neurosurgical Procedures
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