Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity.

Functional Neurosurgery
functionalneuro.surgery
Functionalneurosurgery.net

IOM Sites
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
cns-online.com
cns.surgery
cns.today
e-neurosurgery.com
neurosurgery.ag
neurosurgery.bz
neurosurgery.co
neurosurgery.cz
neurosurgery.fr
neurosurgery.gallery
neurosurgeryvideo.gallery
neurosurgicalvideo.gallery
neurosurgery.guru
neurosurgery.me
neurosurgery.mx
neurosurgery.photos
neurosurgery.tips
neurosurgery.tv
neurosurgery.tw
neurosurgeryspine.org

Neurosurgical Encyclopedia
neurosurgicalencyclopedia.com
neurosurgicalencyclopedia.net
neurosurgicalencyclopedia.org

Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
craniopharyngiomas.net
ependymomas.com
ependymomas.net
glioma.co
gliomas.info
glioma.ws
meningiomas.info
meningiomas.org
neurooncology.me
neurooncology.tv
neurooncology.ws
onconeurosurgery.com
pinealomas.com
pituitaryadenomas.com
pituitaryadenoma.net
schwannomas.com
theneuro-oncology.com

Neuroanatomical Sites
diencephalon.info
diencephalon.org
humanneuroanatomy.com
medullaoblongata.info
mesencephalon.org
microneuroanatomy.com

Neuroanesthesia Sites
neuroanesthesia.info

Neuroendocrinologiacl Site
humanneuroendocrinology.com

Neurobiological Sites
humanneurobiology.com

Neurohistopathological
neurorhistopathology.com

Neuro ICU Site
neuroicu.info

Neuroophthalmological
neuroophthalmology.org

Neurophysiological Sites
humanneurophysiology.com
neurophysiology.ws

Neuroradiological Sites
neuroradiology.ws

NeuroSience Sites
neuro.science

Neurovascular Sites
vascularneurosurgery.com
vascularneurosurgery.net

Personal Sites
cns.clinic
cns-clinic.net
cnsclinic.org
munirelias.com

Spine Surgery Sites
spine.surgery
spinesurgeries.org
spinesurgery.ws
spondylolisthesis.info
paraplegia.ws

Stem Cell Therapy Site
neurostemcell.com


Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


Multigen RF lesion generator .

14-NOVEMBER-2015  AZZAM MUHAMED KURDI  60 YEARS  PITUITARY MIXED PROLACTINOMA WITH LEFT SUPRA AND RIGHT PARASELLAR EXTENSION.

 

Anamnesis

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The patient is a doctor of psychiatry came 11-November-2015 complaining of general weakness and fainting attacks for 4 years and diagnosed as having prolactinoma. He is diabetic for 10 years with hypertension for 20 years. Signs of panhypopituitarism were found and treated with L-thyroxin, testosterone and Dystinox 1/2 tab every 2 days. MRI sella done 29-December-2013 and repeated 14-October-2015 showing the macroadenona is progressing in size and start to compress the optic chiasm from the left and right parasellar extension. The patient noticed visual disturbances of the left eye the last 3 months. PRL level was 6.3 IU/ml performed 14-October-2015.

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The patient was sent for investigations and MRI done 11-November-2015 showing the pituitary adenoma and the MRA showed the relation of the vascular relation to the mass.

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Transsphenoidal approach guided with the C-arm until the anterior wall of the sphenoid sinus reached through the right nostril. The floor of the sella turcica was partially removed to reach the tumor. The tumor is soft in consistency and it was sent for histologic verification. The tumor was removed trying to preserve the pituitary gland, which is actually the tumor capsule. The eroded dorsum sella was seen. A cavity was obtained inside to pituitary gland.  MRI control showed remnant of the tumor at the left side. This part was removed and further removal of the tumor was obtained. 2 Eonmedltech nasal packs with tubes were inserted and another control MRI was performed. The almost radically removed, but packs are directed toward the tumor. They were removed and reinserted to the pharyngio-nasal cavity. The patient then was extubated.

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Smooth postoperative recovery. The patient was sent to the ward.

 

 

Comments  

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The tumor is not responding to Dystinox , which means that it is not a pure prolactinoma. The earlier the resection the better the outcome.

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Intraoperative MRI not only confirm the radical removal of the tumor, but also detect other events such as misdirection of the nasal tubes, which were corrected accordingly.

Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.


Inomed Riechert-Mundinger System, with three point fixation is the most accurate system in the market. The microdrive and its sensor gives feed back about the localization.


Inomed MER system

Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and documentation.

TRUMPF TruSystem 7500

After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014

 


Control MRI of the sella performed 23-December-2015 demonstrating radical resection of the pituitary adenoma. Frontal view.


Sagittal view.

Back Up!

Notice: Not all operative activities can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also escaped from the plan .

  

 

 

 

 

 

 

 

 

 

 

 

 

WELCOME TO AL-SHMAISANI HOSPITAL

 

 

 

[2015] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved