The Malaysian journal of medical sciences : MJMS, 2008
We describe rare case of a 9-year old boy who presented with a two-week history of right ear disc... more We describe rare case of a 9-year old boy who presented with a two-week history of right ear discharge and mild fever. Contrast enhanced CT scan of the brain showed a lesion in the right cerebellopontine angle with mild enhancement mimicking early abscess formation. Involvement of the mastoid air cells pointing towards a radiological diagnosis of mastoiditis reinforced the diagnosis of an abscess. A magnetic resonance imaging (MRI) was planned for the patient but his conscious level deteriorated and patient slipped into coma warranting immediate surgical intervention. Intraoperatively, about 90% of the tumour was removed and the appearance of the tumour resembled that of an acoustic schwannoma but histopathology confirmed the diagnosis of a glioblastoma multiforme (GBM). MRI done post operatively showed lesion in the pons confirming the diagnosis of an exophytic pontine glioblastoma multiforme.
A 24-year-old male patient with refractory Tourette syndrome was treated with deep brain stimulat... more A 24-year-old male patient with refractory Tourette syndrome was treated with deep brain stimulation (DBS) and developed subsequent bilateral subcortical haematomas. Additional blood tests revealed abnormalities of plasma factor XIIIA and tryptophan levels, which may be associated with Tourette syndrome. Neurosurgeons who perform DBS surgery on patients with Tourette syndrome must be aware of possible disastrous complications resulting from factor XIIIA disorders of blood haemostasis. Routine screening for this condition is not typically performed prior to surgery in these patients.
Introduction Magnetic Source Imaging (MSI) and Diffusion Tensor Imaging (DTI) are currently being... more Introduction Magnetic Source Imaging (MSI) and Diffusion Tensor Imaging (DTI) are currently being widely used to map the brain cortex and white matter. These two functional neuroimaging modalities are also commonly used in neuronavigational guided brain surgery. We describe our experience using MSI and DTI data in mapping the eloquent areas of the brain which helping us in surgical planning and as an additional outcomes assessment tool in patients who underwent awake craniotomy, endoscopic tumoural neurosurgery, microsurgery for extra-and intra-axial brain tumours. Methods Preoperative spontaneous brain magnetic waves, MSI mapping of the motor, sensory, visual and auditory cortices and DTI were performed for patients who presented with tumoural brain lesions. These preoperative functional images then were incorporated into the neuronavigational system and surgeries were performed with various techniques; awake state without endotracheal intubation, burr holes navigated neuroendoscop...
We describe rare case of a 9-year old boy who presented with a two-week history of right ear disc... more We describe rare case of a 9-year old boy who presented with a two-week history of right ear discharge and mild fever. Contrast enhanced CT scan of the brain showed a lesion in the right cerebellopontine angle with mild enhancement mimicking early abscess formation. Involvement of the mastoid air cells pointing towards a radiological diagnosis of mastoiditis reinforced the diagnosis of an abscess. A magnetic resonance imaging (MRI) was planned for the patient but his conscious level deteriorated and patient slipped into ...
The Malaysian journal of medical sciences : MJMS, 2008
We describe rare case of a 9-year old boy who presented with a two-week history of right ear disc... more We describe rare case of a 9-year old boy who presented with a two-week history of right ear discharge and mild fever. Contrast enhanced CT scan of the brain showed a lesion in the right cerebellopontine angle with mild enhancement mimicking early abscess formation. Involvement of the mastoid air cells pointing towards a radiological diagnosis of mastoiditis reinforced the diagnosis of an abscess. A magnetic resonance imaging (MRI) was planned for the patient but his conscious level deteriorated and patient slipped into coma warranting immediate surgical intervention. Intraoperatively, about 90% of the tumour was removed and the appearance of the tumour resembled that of an acoustic schwannoma but histopathology confirmed the diagnosis of a glioblastoma multiforme (GBM). MRI done post operatively showed lesion in the pons confirming the diagnosis of an exophytic pontine glioblastoma multiforme.
A 24-year-old male patient with refractory Tourette syndrome was treated with deep brain stimulat... more A 24-year-old male patient with refractory Tourette syndrome was treated with deep brain stimulation (DBS) and developed subsequent bilateral subcortical haematomas. Additional blood tests revealed abnormalities of plasma factor XIIIA and tryptophan levels, which may be associated with Tourette syndrome. Neurosurgeons who perform DBS surgery on patients with Tourette syndrome must be aware of possible disastrous complications resulting from factor XIIIA disorders of blood haemostasis. Routine screening for this condition is not typically performed prior to surgery in these patients.
Introduction Magnetic Source Imaging (MSI) and Diffusion Tensor Imaging (DTI) are currently being... more Introduction Magnetic Source Imaging (MSI) and Diffusion Tensor Imaging (DTI) are currently being widely used to map the brain cortex and white matter. These two functional neuroimaging modalities are also commonly used in neuronavigational guided brain surgery. We describe our experience using MSI and DTI data in mapping the eloquent areas of the brain which helping us in surgical planning and as an additional outcomes assessment tool in patients who underwent awake craniotomy, endoscopic tumoural neurosurgery, microsurgery for extra-and intra-axial brain tumours. Methods Preoperative spontaneous brain magnetic waves, MSI mapping of the motor, sensory, visual and auditory cortices and DTI were performed for patients who presented with tumoural brain lesions. These preoperative functional images then were incorporated into the neuronavigational system and surgeries were performed with various techniques; awake state without endotracheal intubation, burr holes navigated neuroendoscop...
We describe rare case of a 9-year old boy who presented with a two-week history of right ear disc... more We describe rare case of a 9-year old boy who presented with a two-week history of right ear discharge and mild fever. Contrast enhanced CT scan of the brain showed a lesion in the right cerebellopontine angle with mild enhancement mimicking early abscess formation. Involvement of the mastoid air cells pointing towards a radiological diagnosis of mastoiditis reinforced the diagnosis of an abscess. A magnetic resonance imaging (MRI) was planned for the patient but his conscious level deteriorated and patient slipped into ...
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