|
|
|
|
|
|
|
|
|
|
|
|
|
Sliman Abdalrasak
33 years old
Basra
A
case of
road traffic accident
on 21-3-07 presented with coma to
emergency unit. Brain CT scan revealed a large
left frontal depress fracture. Surgical interference to
remove depress bone with suturing dural tear. 2ed
postoperative day he return to full consciousness and
discharge to home.
|

Brain CT scan show depress
fracture |

Brain CT scan
(bone window) |
|
Mohmmed ali
abdalhussain
19 years old
basra
A case of headache with right side
weakness.
Brain MRI showed right cerebellar mass (PFT). Posterior fossa
approach with complete excision of the mass done at
7-6-06. Histopathologycal results show medulloblastoma.
The
patient completely freeing from any symptom until 6-3-07
when he complain from repeated vomiting and right side
weakness.
Brain MRI showed recurrent tumour at the posterior
fossa. Urgent ventriculoperitoneal
shunt inserted
was done to decrease intracranial pressure. At 14-3-07 re-exploration and complete
excision was done.
The
histopathologycal results show medulloblastoma nodylar
type.
|

Brain MRI
showed PFT

Brain MRI
6-3-07
showed recurrent PFT |

Brain MRI postop. PFT disappear
|
|
Raaed Abdalumer
10 years old
Basra
Head trauma on 4-3-07 with large
screw driver penetrating his skull.
Brain
CT scan revealed the screw driver penetrated about one inch
inside his brain. Urgent surgical
intervention was done to remove the
screw driver carefully under general
anesthesia with repair of
the brain damage. In the first postoperative day, he was very
well with no serious complications.
|

skull x-ray
 |

Brain CT
scan screw
driver penetrated
brain

|
|
Abdulla Fahed
14 days old
Basra-Alhiania
Congenital
dorsal meningomyelocele. Operated on 2-3-07 with total
excision of the sac and dural repair.
|
 |
|
|
Mwslim Juada
30 years old
Alnassiriyah
On 25-2-07,he exposed to road traffic
accident. He had breathing difficulty with loss
of the
ability to move both legs. Urgent chest tube inserted
to evacuate blood collection inside the chest . Dorsolumbar
MRI
showed severe fracture at D8-D9
with spinal cord compression. Internal vertebral column
fixation with spinal cord decompression was done on
1-3-07.
|

dorsal
x-ray
showed
fracture at D8-D9 |

MRI
showed
fracture at D8-D9 |
|
Aboalhasan Ali
10 years old
Alamara- Almhmodia
A case of congenital encephalocele
with hydrocephaly, ventriculoperitoneal shunt inserted
since the 1st year of his life. Presented to Alumran clinic,
with 4 months history of headache and repeated vomiting.
During examination, he had a
small mass in the back of his head with bilateral
paplledema.
Brain
CT scan revealed hydrocephaly. Operation was done on
18-2-07 with total excision of encephalocele , insertion
of new shunt and removal of the old one. During postoperative day,
the patient was very well with no more headache and
vomiting.
|

Brain CT scan show diluted
ventricle |

Brain CT scan show
encephalocele
|
|
Rasmia Salh
35
years old
Basra-Alqurna
Headache with visual deterioration for 3 months.
Repeated vomiting and inability to walk for one month.
Brain CT scan revealed a 7x4 cm mass at left frontal
region. Surgical intervention on 13-2-07 with very
vascular tumor and she received 9 pints of blood. The
mass removed completely
and sent for histopathology.
|

Brain CT
scan without contrast |

Brain CT
scan with contrast |
|
Haidar
Alkarar
2 days old
Alnassiriyah
Congenital occipital encephalocele.
Operated on 10-2-07 with total excision of the sac and
dural repair.
|
 |
|
|
Hashmia Hettee
70
years old
Alamara
Headache for one year,
complete paralysis of left side of the body
and
weakness of the right side. Brain MRI showed anterior
foramen magnum mass severely compressing the junction
of brain stem and spinal cord. Total excision was done
on 11-2-07, and sent for histopathology.
|

Brain MRI without contrast |

Brain MRI with contrast |
|
Abdalhussein kalaf
65
years old
Right sided weakness for one month with headache. Brain
CT scan revealed a big right frontal mass. Operated on 4-2-07, total
left frontal lobectomy was done and sent for
histopathology. The result showed diffuse astrocytoma
grade 2.
|

Brain CT scan
|

Brain MRI with contrast |
|
Mohammad Ali
17
years old
Basra- Alqurna
A
case of headache with repeated vomiting for 3 months.
Brain CT scan showed a posterior fossa mass compressing
the fourth
ventricle causing hydrocephaly. Urgent
ventriculoperitoneal
shunt was done on 7-1-07.The vomiting and headache
disappeared. On 22-1-07, total removal of posterior
fossa mass and sent for histopathology which revealed desmoplastic medulloblastoma.
|

Brain CT scan before surgery |

Brain CT scan after surgery |
|
Zaher Mohammad
25
years old
Alnassiriyah
Complaining
of generalized
tonic clonic attack of fit. He had history of meningitis in the first year
of his life. In last 6 months, he received medication
for submandibular tuberculosis. Brain MRI showed left
frontal suprasylvien mass. Subtotal excision was done on
21-1-07, postoperatively
the patient became very well.
Histopathology revealed diffuse astrocytoma grade 2 ,so
he was sent for radiotherapy to complete his management.
|

Brain CT scan |

Brain MRI T1 |
|
Amjad laftea
8
years old
Alamara
A
case of congenital hydrocephaly with
ventriculoperitoneal
shunting was done since the
third
month of his life. A mass developed in the way of his shunt
for one week. Surgery was done and showed
infected
shunt with
pus
collection in the mass with consequent removal of the
shunt at 16-1-07.On the first postoperative day, he
developed
repeated vomiting. Brain CT scan revealed
intraventricular hemorrhage , urgent external
ventricular shunt with heavy antibiotics cover to prevent meningitis.
After 8 days, left frontal
ventriculoperitoneal
shunt was done. He improved gradually and
discharged home very well.
|

Brain CT scan before surgery |
|
|
Najim Abdulla
72
years old
Basra -Altwessa
Spastic limbs, headache and loss of speech. On 26-11-06
admitted to neuromedical ward, diagnosed and managed as a
case of meningeal tuberculosis. The patient had a good
improvement. On 20-12-06 ,he was deteriorated with
progressive spastic weakness of limbs. Brain CT scan showed
hydrocephaly as complication of meningeal tuberculosis.
High pressure ventriculoperitoneal
shunt was done on 8-1-07 to correct his condition.
|

Brain CT scan show diluted
ventricle |

Brain CT scan after shunt
surgery
|
|
Kazum Mohammad Abud
49
years old
Basra -Alchbasy
Multiple intracranial shell injury on 6-1-07. He was
confused with impairment of vision. Brain CT scan
showed two inlet at left
occipital area, one of them impacted in the bone and the other
perforated and arrested at the right parietal lobe.
Immediate surgery was done:
1-Removal of left shell.
2-Craniectomy at left occipital bone with dural patch
(site of shell entrance).
3-Craniotomy to the right parietal bone for evacuation
of intracerebral hematoma.
On
10-1-07, he got good improvement in his vision.
|

Brain CT scan 1st entrance
site
|

Brain CT scan 2nd entrance site
|
|
Ali
aeralla
12
years old
Basra-5mile
Presented as scalp mass at right temporal area. Brain CT
scan revealed a bony erosion with soft tissue swelling.
Surgical total excision with removal of unhealthy bony
margin. Histopathology result showed a histiocytosis
mass.
|

Brain CT scan bony defect |
|
|
Nadra Sultan
45
years old
Basra-Alkebla
Headache
for 2 years. In the last 6 months she developed right sided parasthesia
and numbness with visual deterioration
on the right eye. Brain MRI showed parasellar mass
engulfing the right optic nerve and optic chiasm with pressure on
the left optic nerve. Surgical intervention under
microscopical field was done on 18-12-06. Complete freeing of the right optic
nerve, right carotid artery and left optic nerve. She
was very well in the post operative period and her
vision improved gradually. Histopathological result
showed meningioma.
|

Brain MRI tumour
engulf
right optic nerve and carotid artery |

Brain CT scan after surgery
disappear tumour
|
|
Marwa Dawwed
12
years old
Basra-Alqurna
Headache and vomiting especially at morning for 14 days.
On examination, she had bilateral papilledema with left
facial palsy. Brain CT and
MRI scanning showed
dilated brain ventricles with no posterior fossa tumor.
Ventriculoperitoneal shunt
was done. Postoperatively she was free from any headache
and
vomiting and discharged home.
|

Brain CT scan diluted ventricle |
|
|
Saga Thafer
7
months
Alnassiriyah
A
case of repeated vomiting. Treated as gastroenteritis
but not improved. Brain CT scan revealed hydrocephaly.
Surgical intervention with
ventriculoperitoneal
shunt was done on 11-12-06. She was very well
postoperatively. On 15-2-07, she looked healthy.
|

Brain CT scan diluted ventricle |
|
|
Mwayad ufy
30
years old
Basra-Nwab alzbat
A
case of motor cycle accident on 9-12-06, presented to
emergency unit with coma and
bleeding from the right ear. Brain CT scan showed large
right temporal extradural hematoma compressing the
brain temporal side. Urgent craniotomy was done with
evacuation of brain hematoma.
He improved and discharged home in a full
consciousness in the 8th postoperative day.
|

Brain CT scan
right
temporal extradural hematoma |

Right
temporal extradural hematoma
|
|
Hessen Abdalnaby
5
years old
Basra -Shat Alarab
At
5p.m. 2-11-06 presented with
sudden
fall on the ground
when he was playing outside his home. His family thought that someone hit
their child. On examination he was unconscious with
small wound on his vertex, left dilated pupil (very
dangerous sign of brain injury). Brain CT scan showed
bullet arrested at left temporal lobe with tract
hematoma from vertex.
Left sub temporal
craniectomy was done, extraction of bullet and
evacuation of hematoma. In the 1st
postoperative day, he became conscious but still
inability to talk and weakness in the right
side. In the 2nd postoperative day ,he
started talking with gradual increase in the power of right
side. On 3-12-06, he was completely returned to normal
activity with free talking and normal walking.
|

Brain CT scan site of entrance
|

Brain CT scan
bullet
arrested at left temporal |
|
Hessna jlaw
70
years old
Aumra
One
year history of right sided weakness. Treated as
cerebrovascular accident. In last one month she
became unable
to speech. Brain CT scan showed left convexity
meningioma. Surgery was done at 29-10-06 with complete
excision with dural base, dural graft use to close the
dural defect. In the 1st postoperative day she
started to have normal speech. In the 7th postoperative day, she was
discharged home with normal gait.
|

Brain CT scan
left
convexity meningioma
|
|
|
Zeinalabdeen Hazim
7
years old
Basra-Almdayna-Alhalifa
A
case of mild road traffic accident on 28-10-06. No loss
of consciousness ,no vomiting. Brain CT scan showed
normal. In the next day, the patient was very
well, eating and walking normally. Repeated brain CT
scan showed same results. At 10 p.m. 29-10-06 he started
to have headache, repeated vomiting with attacks of
generalized fit, not responding to antiepileptic therapy.
On examination, the patient was very risky, he was
unconscious with right dilated pupil (very dangerous
sign of brain herniation). Brain CT scan showed very big
right intracerebral hematoma with intraventricular haemorrhage. Immediate surgical intervention, right
frontal craniotomy with evacuation of intracerebral
hematoma, homeostasis, external ventricular drain to
evacuate intraventricular blood. At 2nd
postoperative day ,the right pupil retained to normal
size but still had inability to move eye ball(
oculomotor palsy). The external ventricular drain became
clear and it was removed. The patient kept under
courses of aggressive physiotherapy. He was gradually
improved. On 15-12-06, he visited my private clinic ,
seemed very well with an ability to talk and walk.
|

Brain CT scan 28-10-06

Brain CT scan intracerebral
haemorrhage
|

Brain CT scan
29-10-06

Brain CT scan disappear
intracerebral haemorrhage |
|
Ali
Hussein Ziara
17
years old
Umara-Alkfaat
Intracranial shell injury on 19-10-06, inlet site from
right occipital area and arrested at left thalamus causes
tract hematoma with intraventricular
haemorrhage.
on arrival to the causality he was unconscious
with pinpoint
pupils and left side weakness .
Operated on for evacuation of intracerebral hematoma,
removal of bone pieces with external ventricular drain. He
was improved postoperatively.
On
24-10-06, the Patient developed repeated vomiting
because of blocking of the external shunt with
clot. and shunt revision was done.
28-10-06 started to develop complications, he was
feverish with neck stiffness and loss of
consciousness. Removal of the external drain and cover with powerful antibiotics. The patient gradually
improved and he became conscious .At 16-11-06 he
discharged home .
4-1-07 he visited my private clinic with
speech
difficulty and spastic limbs. Brain CT scan showed
hydrocephaly with periventicular oedema. frontal
ventriculoperitoneal
shunt was done. In the postoperative day, he was
able to speak frankly with normal gait.
|
Brain CT scan
sequences

Shell entrance site

Shell arrested site

ventricular drain disappear
intraventricular haemorrhage

after 3 month Brain CT scan
show diluted ventricules |

Intraventricular hemorrhage

Postop. remove of depress seg.
with ventricular drain

Removable ventricular drain

frontal
vp shunt |
|
Mohammad Shaker
33 years old
Basra -Alharthee
4 months history of headache with vision deterioration,
and
hearing loss in the left ear. On examination,
bilateral papilledema with left sided facial palsy and
absent left corneal reflex . Brain CT and MRI scan
showed cerebellopontine angle tumor. Surgery was done on
13-10-06 with left sub occipital approach and debulking was done. On the 1st
postoperative day ,the patient was very well with
on more
headache and gradual improvement of his vision. Histopathology
result revealed schwannoma (a benign tumor with a very response
to gamma knife) ,so he was sent for gamma knife
for removal of ruminant part of the tumour.
|

Brain CT scan |

Brain MRI |
|
Sufar Taher
55 years old
Basra-Alqurna
A
case of
road traffic accident
on 7-10-06 presented with coma to
emergency unit. Brain CT scan revealed right
temporal extra dural hematoma with left sided brain
contusion. Urgent surgery was done with right temporal
craniotomy and removal of the right extra dural hematoma. In
the postoperative days, he returned his
consciousness
but still had memory loss and inability to walk. After
one week of physiotherapy ,he was able to walk and
his memory returned back gradually.
|
|
|
|
Reias abd alsmad
42 years old
On 3-10-06 , A case of depressed occipital fracture with
injury to the posterior third of the superior sagital
sinus. He was presented to causality as severe bleeding
from the wound with blindness. During surgery severe multiple, depressed
segments was found causing partial tear to posterior
third of the superior sagital sinus. He received 5 pints
of blood within 30 min, removal of bony pieces, dural
suturing was done. In the 4th
postoperative day ,his vision improved ,so he discharged home.
|

Brain CT scan fracture site
|

Brain CT scan bone window |
|
Hania Hussein
30 years old
Alnassiriyah
Ataxic gait with diplopia for several
years.
Brain
MRI showed herniated cerebellum
(chiari syndrome grade 2). Surgical intervention was
done on 25-8-07 with craniectomy of the posterior fossa,
removed C1 lamina with incised dura to be closed with
patch to give more space for herniated cerebellum to be
return back. After surgery, she was dramatically
improved. After 3 months , ataxic gait and diplopia
disappeared and returned back to her work.
|

Brain MRI
cerebellar herniation
|
|
|
Banen Mantaza
2 months
Slow deterioration of consciousness with feeding
difficulty. when
she reached to Basra teaching hospital she was
unconscious and dilated right pupil with left sided
paralysis. Brain CT scan showed massive right
intracerebral hematoma. Urgent craniotomy was done on
16-8-06 to evacuate the hematoma. Within the 1st
postoperative week, she returned to her normal breast feeding
and the pupil size became normally reacting to light but still
she was unable to move the right eye ball( oculomotor palsy).
At
the end of 1st month, she became very active
child with normal movement for both eyes.
|

Brain CT scan massive right intracerebral hematoma |
|
|
Ashwaq Dakal
26 years old
Alnassiriyah-Alssader city
A case of severe backache for 4 months not responding to
medication. When she visited my private clinic, she was
severely ill with severe tenderness at dorsolumber region.
She had rapid response to steroid.
Dorsolumber
MRI showed extradural hyperintese lesion extend from
D11-D12. Dorsal laminectomy with complete excision of
mass was done on 15-5-06 histopathology revealed spinal
cord lymphoma. she was sent for chemotherapy . On
11-1-07, she visited my
private clinic and her new MRI
showed complete
resolution of the mass.
|

MRI extradural hyperintese lesion extend from D11-D12 |

11-1-07 MRI complete resolution |
|
Najam Abdullah
37 years old
Kerbala
Suffered from backache and inability to walk.
lumbosacral MRI showed
disc prolapsed at two levels L4-L5,L5-S1.Leminectomy and
discectomy was done for two levels on 19-4-06. Post
operatively, the patient started
walking
and after two
weeks,
he joined his job.
|

MRI disc prolapsed
L4-L5,L5-S1
|

Mylography
|