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33 years old male presented as a
case of
road traffic accident
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.
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Brain CT scan show depress
fracture |

Brain CT scan
(bone window) |
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young patient 19 years old
had a headache with right side
weakness.
Brain MRI showed right cerebellar mass (PFT). Posterior fossa
approach with complete excision of the mass done. Histopathologycal results show medulloblastoma,
he refused radiation.
The
patient completely freeing from any symptom for one
year, after that he became 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. After 2
weeks re-exploration and complete
excision was done.
The
histopathologycal results show medulloblastoma nodylar
type.
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Brain MRI
showed PFT

Brain MRI
6-3-07
showed recurrent PFT |

Brain MRI postop. PFT disappear
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Child 10 years old
had head trauma 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.
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skull x-ray
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Brain CT
scan screw
driver penetrated
brain

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Child 14 days old
had congenital
dorsal meningomyelocele. Operated with total
excision of the sac and dural repair.
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30 years old male 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.
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dorsal
x-ray
showed
fracture at D8-D9 |

MRI
showed
fracture at D8-D9 |
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10 years old male had congenital encephalocele
with hydrocephaly, ventriculoperitoneal shunt inserted
since the 1st year of his life. Presented with 4 months history of headache and repeated vomiting. During examination, he had a
small mass in the back of his head with bilateral
papilledema.
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 became very well with no more headache and
vomiting.
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Brain CT scan show diluted
ventricle |

Brain CT scan show
encephalocele
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35
years old female had a
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.
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Brain CT
scan without contrast |

Brain CT
scan with contrast |
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2 days old infant had a congenital occipital encephalocele.
Operated with total excision of the sac and dural repair.
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70
years old female had aheadache 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.
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Brain MRI without contrast |

Brain MRI with contrast |
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65
years old male had right sided weakness for one month with
aheadache. 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.
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Brain CT scan
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Brain MRI with contrast |
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17
years old male had a 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. The vomiting and headache
disappeared. After 2 weeks, total removal of posterior fossa mass.
The histopathology result revealed desmoplastic medulloblastoma.
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Brain CT scan before surgery |

Brain CT scan after surgery |
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25
years old male had 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, postoperatively
the patient became very well.
Histopathology revealed diffuse astrocytoma grade 2 ,so
he was sent for radiotherapy to complete his management.
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Brain CT scan |

Brain MRI T1 |
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Child 8
years old with 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.
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Brain CT scan before surgery |
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72
years old male had spastic limbs, headache and loss of speech.
He was
admitted to neuromedical ward, diagnosed and managed as a
case of meningeal tuberculosis. The patient had a good
improvement. After one month,
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 to correct his condition.
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Brain CT scan show diluted
ventricle |

Brain CT scan after shunt
surgery
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49
years old male had multiple intracranial shell injury. 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.
After 3 days, he got good improvement in his vision.
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Brain CT scan 1st entrance
site
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Brain CT scan 2nd entrance site
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12
years old male
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.
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Brain CT scan bony defect |
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45
years old female had a 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. 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.
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Brain MRI tumour
engulf
right optic nerve and carotid artery |

Brain CT scan after surgery
disappear tumour
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12
years old
Child had 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.
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Brain CT scan diluted ventricle |
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7
months Child had repeated vomiting. Treated as gastroenteritis
but not improved. Brain CT scan revealed hydrocephaly.
Surgical intervention with
ventriculoperitoneal
shunt was done. She was very well
postoperatively.
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Brain CT scan diluted ventricle |
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30
years old male had a motor cycle accident, 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.
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Brain CT scan
right
temporal extradural hematoma |

Right
temporal extradural hematoma
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Child 5
years old 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
unable 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. After one month, he was completely returned to normal
activity with free talking and normal walking.
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Brain CT scan site of entrance
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Brain CT scan
bullet
arrested at left temporal |
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70
years old female had one
year history of right sided weakness. Treated as cerebrovascular accident. In last one month she
became unable
to speek. 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.
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Brain CT scan
left
convexity meningioma
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Child
7
years old had a mild road traffic accident. 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. After 2 days 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. After one month
seemed very well with an ability to talk and walk.
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Brain CT scan 28-10-06

Brain CT scan intracerebral
haemorrhage
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Brain CT scan
29-10-06

Brain CT scan disappear
intracerebral haemorrhage |
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17
years old male had
Intracranial shell injury, 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.
5th day, the Patient developed repeated vomiting
because of blocking of the external shunt with
clot. and shunt revision was done.
9th day
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 .on the 33rd day he
discharged home .
After one year he was
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.
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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 |
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33 years old male had
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 with left sub occipital approach and debulking was done. On the 1st
postoperative day ,the patient was very well with
no 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 tumor.
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Brain CT scan |

Brain MRI |
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42 years old male had a 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.
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Brain CT scan fracture site
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Brain CT scan bone window |
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30 years old male had ataxic gait with diplopia for several
years.
Brain
MRI showed herniated cerebellum
(chiari syndrome grade 2). Surgical intervention was
done 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. Then
she returned back to her work.
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Brain MRI
cerebellar herniation
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Infant
2 months had slow deterioration of consciousness with
difficulty
feeding. when
she reached 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.
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Brain CT scan massive right intracerebral hematoma |
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26 years old female 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. Frequent
postoperative MRI showed complete
resolution of the mass.
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MRI extradural hyperintese lesion extend from D11-D12 |

11-1-07 MRI complete resolution |
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37 years old male
Suffered from backache and un ability to walk.
lumbosacral MRI showed
disc prolapsed at two levels L4-L5,L5-S1.Leminectomy and
discectomy was done for two levels. Post
operatively, the patient started
walking
and after two
weeks,
he joined his job.
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MRI disc prolapsed
L4-L5,L5-S1
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Mylography
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