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Article
Study on hydrocephalus and complications of surgical treatment

Author: Saad F. Kadhim* MBChB, FICMS د. سعد كاظم
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 3 Pages: 248-250
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary: Background: Shunt operations are performed for different reasons mainly hydrocephalus congenital or acquired. It’s associated with certain morbidity and mortality.Patients and method: A prospective study from Jan 2004 to Jan 2006, 226 patients under went shunt operation in the specialized surgical hospital in Baghdad. The patients were divided into two groups according to the way of applying the upper end catheter. In group A49 patients where posterior parietal approach was used, and group (B) 174 where parietal or temproprietal approach was used.Results and discussions: different complications were recorded, but the most frequent was upper end obstruction by choroids plexus or by debris.In group (A) only one patient 2% while in group (B) 27 patients 15.5% this wide difference in incidence of this complication, clears the significance of posterior parietal approach as a method of choice in applying ventricular catheter.Other complications were recorded as infection, lower end obstruction of others. A low rate of mortality recorded and discussed thoroughly.Conclusion: Choosing the post parietal type with prophylactic antibiotics carries the best results.Key words: Hydrocephalus, shunt post parietal.


Article
Evaluation of Congenital Hydrocephalus Association With Aqueduct Stenosis in Mosul Pediatric Patients

Author: Zhraa Abd-Al Kader Taboo
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 18-25
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Congenital hydrocephaly is one of the most common central nervous system anomalies. Thisgenerally refers to a condition that exists prenatally and excludes other neural tube defects ; thiscondition usually develops by the twentieth week of gestation , and defect can occur either alone,in association with spina bifida, or as part of a greater syndrome, such as Dandy-Walker Syndrome.There are various types or classifications of congenital hydrocephaly. Aqueductal stenosis is a typeof hydrocephaly that results from narrowing of the aqueduct of Sylvius, an opening connecting thethird and fourth ventricles in the brain.OBJECTIVE:There are few studies evaluating the incidence of aqueduct stenosis out of hydrocephalus patient inpediatric population, in Mosul city ,therefore, this topic was considered in present study .MATERIAL AND METHOD:The study was conducted in Ebn Sena Teaching Hospital, Department of Neurosurgery andRadiology in Iraq Mosul city, as a retrospective study for 250 cases collected between October2007 and 31 December 2008, and prospective for 250 patients are studied between June 2009 andJanuary 2011. Spiral computed tomography of the brain was performed for all patients. fivehundred patients were analyzed by spiral computed tomography.RESULTS:During the analyses the peak age incidence of congenital hydrocephalus association with aqueductstenosis was below 2 years old (39%). The male to female ratio was (1.3:1). The incidence ofaqueduct stenosis was (63.9%) out of congenital hydrocephalus and (16.6%)out of acquired cases.In this series the non-communicating type of hydrocephalus was forming about (65.6%) and thecommunicating type forming about (16.2%), the lest type is compensatory (10.4%).CONCLUSION:The most common cause of hydrocephalus was congenital in origin (56%), and it was mostly dueto congenital aqueduct stenosis (63.9%).


Article
Shunt Revision Overview in Patients with Hydrocephalus

Author: Mohamed A. Al-Tamimi
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2014 Volume: 13 Issue: 2 Pages: 24-27
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Hydrocephalus is a notorious neurosurgical disease thatcarries the adage “once a shunt always a shunt.” Most patients withhydrocephalus are treated with ventriculo‐peritoneal (VP) shunt placement;however, malfunction is common and is usually caused by mechanicalfailure.Aim: To evaluate the patients who were in need for shunt revision, analyzingthem according to their age, sex, and causes of their hydrocephalus, andinvestigating the etiological causes for their revisions.Patients and Methods: In a retrospective study, the records of 90 patientswho underwent their shunt revision in the Neurosurgical hospital andneurosurgical departments of AL‐Kadhmia teaching hospital and thehospital of surgical specialties between January 2000 till June 2002 wereanalyzed peri‐operativelyResults: It was revealed that most of the revised patients were children(their age≤10). The majority of them were shunted at first due to congenitalhydrocephalus and acquired hydrocephalus respectively. Regarding thefrequency of revision in these patients the majority were revised once andfew of them were revised for more than one time. Peri‐operatively clinicalstatus of shunt function was determined which showed upper end block in27.8%, post‐operative meningitis in 13.3%. Yet, lower end block was found in10% of the cases.Conclusion: Shunt failure is still far too common especially in pediatric agegroups. Upper end block together with surgical errors and suboptimaltechniques plays a significant role in shunt revision.


Article
A study of 54 cases of cerebellar Astrocytoma (In paediatric age group)

Author: Ali K. AL-Shalchy* MBChB FlCMS FlCNS MRCSI
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 2 Pages: 143-145
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: cerebellar astrocytroma is the commonest paediatric posterior fossa tumor.Patients and method: 54 patients taken from the neuro-surgical unit in the specialized surgical hospital from Aug 1995 till March 2003, all patients studied thoroughly age, gender, Presentation, Radiological diagnoses, surgery, additive therapy & final outcome including 5 years survival & conclusion is reached.Results and discussion: the results show that more than half of the patients were at age 5-7 years with very slight male predominance, most cases diagnosed by CT, some with MRI or MRI alone.Surgery was done for all cases & 16 patients' preceeded by VP shunt. The final out come is compared with other similar studies.Conclusion: cerebellar astrocytoma acommon post fossa pediatric tumor if diagnosed early & proper surgery is done early, good prognosis can be gained.


Article
Demographic and Clinical Presentations of Pediatric Hydrocephalus in Medical City

Authors: Mahjoob N. Al Naddawi --- Numan Nafie Hameed --- ,Amal A. Rasheed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 2 Pages: 139-144
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Hydrocephalus is distension of the ventricular system of the brain related to inadequate passage of cerebrospinal fluid from its points of production within the ventricular system to its points of absorption into the systemic circulation.OBJECTIVE:To study the demographic and clinical presentations of pediatric hydrocephalus in medical city complex , Baghdad.PATIENTS AND METHODS:This is a prospective study ,which was carried out on 100 children with a mean age+- standard deviation ( 24.3 +/- 16.06 )months and median 16 months, who were admitted to Children Welfare Teaching Hospital & neurosurgical department ( Surgical Specialties Hospital) / Medical City complex, Baghdad in the period from April first 2009 to October first 2009. A specially designed questionnaires were used to aid the investigators in performing a family interview. General and neurological examinations, and investigations including neuroimaging studies were done.RESULTS:Of 100 patients,(62%)were males and (38%) were females, with male to female ratio of 1.6:1. Family history of congenital anomaly was positive in (26%) of patients, while hydrocephalus was positive in (14%). Seventy-Two percent of patients had congenital hydrocephalus. Eighty–Seven percent of patients were full term. Fifty-Seven percent of patients were products of NVD ,while (43%) were products of CS,(2%) of them were emergency CS& (41%) were elective. The macrocephaly was diagnosed or noted at birth in (32%)of patients. The study showed that U/S finding of hydrocephalus was positive in (49%).CONCLUSION:The majority of the patients had congenital hydrocephalus, but there was delay in the diagnosis of macrocephaly. Prenatal ultrasound diagnosis yield was low in this study. Family history of hydrocephalus and other neural tube defect was important to be elicited


Article
Characteristics of Cerebrospinal Fluid Shunt–Associated Infections in Iraqi Children patients: A Retrospective Analysis over a 2-Year Period

Author: Mohamed A. Al-Tamimi
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2016 Volume: 15 Issue: 2 Pages: 20-23
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Cerebral shunts are commonly used to treat hydrocephalus, the swelling of the brain would be either due to excess of CSF build up or to obstruction of its drainage. Aim: To evaluate the Iraqi paediatric patients with infected shunts, analyzing them according to their age, sex, sort of causative microorganism, clinical presentation and time of infection postoperatively teeming with causes of their hydrocephalus, investigating the etiological causes for their infection. Patients and Methods: In a retrospective study, 23 children 0–12 years of ages who underwent initial CSF ventriculo-peritoneal shunt placement with a discharge dates between January 1, 2001, and December 31, 2002 were identified from Neurosurgical hospital in Baghdad. For every child who developed shunt infection we extracted information from the medical record about patient factors including gender, age at initial shunt placement, sort of infection, causative microorganism and timing between initial CSF shunt and initial infection and analyze them Results: It was revealed that a higher incidence of infection occurred at a young age (<1 year old). The majority of them were shunted at first due to congenital hydrocephalus (with our without myelomeningocele 39.2% and 21,7% respectively). Most of the infection happened in the first week after shunt insertion (47.8%) presenting themselves mostly with meningitis (52.1%). Staphylococcus Epedermidis and Aureus were the most common isolated causative organism. Conclusion: patient factors such as age and pathological cause behind hydroce


Article
A Study of Early Post-Operative Wound Complications of Spina Bifida Aperta Repair " Incidence and Risk Factors"

Authors: Wameedh Q. Abdul-hussein د. وميض قيس عبدالحسين --- Ali K. AL-Shalchy أ.د. علي كامل الشالجي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2018 Volume: 60 Issue: 2 Pages: 89-92
Publisher: Baghdad University جامعة بغداد

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Background: Myelomeningocele is the single most common congenital anomaly that affects the CNS and vertebral column. The third world countries having a higher incidence. The management is usually surgical with relative high incidence of complications.Objectives: to evaluate the possible risk factors that may predispose to early wound complications of myelomeningocele.Methods: This prospective study was carried out in the Surgical Specialization Hospital in Medical City Complex - Baghdad from 2009-2012. 147 cases were included in the study. Requested data were gestational age, type of delivery, gender, age at operation, type of suturing of the wound, tension of suturing, duration of operation, site of the lesion, ruptured vs non ruptured myelomeningocele, associated shunting, peri-operative stay in hospital and associated jaundice.Result: Forty four (44 %) of the total developed complications. All premature infants developed complications. Hydrocephalic cases was associated with higher rate of complication (86%). Type of delivery, age at operation, duration of operation, ruptured cases and site of the lesion were not associated with complications.Conclusion: Myelomeningocele was predominantly affecting female. Most of the complications were wound infection with or without dehiscence, CSF leakage or seroma.Keywords: Neural tube defect, Hydrocephalus, Cerebrospinal fluid, Myelomeningocele.


Article
MOYAMOYA SYNDROME
متلازمة مويامويا

Authors: Abdulameer Jasim Mohamad عبدالامير جاسم --- Samir hassan abood سمير حسن عبود
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2007 Volume: 5 Issue: 3 Pages: 102-107
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Abstract: Moyamoya syndrome is a chronic progressive occlusive cerebrovascular disorder. We present a 41 years old man who had this syndrome, and presented as intraventricular hemorrhage complicated by communicating hydrocephalus. We describe in this report the clinical features and the diagnostic radiological investigations. The patient was treated by a ventriculoperitonial shunt with full recovery. Keywords: Moyamoya, Intracranial hemorrhage, Hydrocephalus

متلازمة مويامويا مرض يتميز بانسداد مزمن متطور للأوعية الدموية للدماغ. نقدم في هذا التقرير حالة لرجل في الأربعين من العمر مصاب بهذا المرض, أصيب بنزف في تجاويف الدماغ مسببا استسقاء متصل في تجاويف الدماغ. نصف في التقرير الحالة السريرية ونتائج الفحوص التشخيصية الشعاعية. المريض عولج ببزل تجاويف الدماغ إلى الجوف البريتوني بتحسن تام.كلمات مفتاحيه: مويامويا, نزف داخل القحف, استسقاء الدماغ.


Article
A Comparative Study Between Ventriculoperitoneal Shunt and Endoscopic Third Ventriculostomy in the Manegment of Obstructive Hydrocephalus

Authors: Abdulameer Alkhafaji --- Samir Faissal Hassan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 4 Pages: 486-492
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND: Uncertainty persists on the best treatment for patients with obstructive hydrocephalus: endoscopic third ventriculostomy (ETV) or V-P shunt. Most patients with obstructive hydrocephalus are treated with ventriculo-peritoneal (VP) shunt placement.OBJECTIVE:Of this study is to compare between V-P shunt and ETV in the manegment of obstructive hydrocephalus in relation to the degree of complication.METHODS: This is a prospective study of 90 patients with obstructive hydrocephalus of various etiologies operated by V-P shunt or Endoscopic 3rdventriculostomy in the Department of Neurosurgery in Al-Khdhemia Teaching Hospital, Neurosciences Teaching Hospital and Neurosurgical Teaching Hospital from October 2011 to December 2012. Presenting symptoms and signs, clinical shunt function, operative findings and outcome were recorded. RESULTS: Common presenting features were headache, vomiting, irritability and general toxic look of patients. Male to female ratio was 1.14:1. Patients with obstructive hydrocephalus were treated with V-P shunt or with endoscopic third ventriculostomy and followed for 6 months as an average. In patients with V-P shunts, upper end block was a common problem followed by wound dehiscence and valve exposure and other complications such as lower end obstruction, slipped catheter, subdural hematoma, and subcutaneous CSF collection. While in patients with ETV spontaneous closure of the stoma was more frequent than other complications. The complication rate in ETV is lower than that of V-P shunt (30% in V-P shunt and 17% in ETV). However ETV is less successful in patients below 2 years old and in those with normal pressure hydrocephalus.CONCLUSION: Endoscopic third ventriculostomy is becoming more popular as an alternative to shunting in the management of obstructive-type hydrocephalus. Obstructive hydrocephalus is the main indication for endoscopic third ventriculostomy. However, in cases where this procedure is indicated, good knowledge of third ventricle anatomy, surgeon preference and experience with endoscopic surgery can yield success rates of up to 80%.


Article
Studying of Oxidative Stress and Activity of Some Enzymes in Cerebrospinal Fluid from Children with Hydrocephalus Disease
دراسة الكرب التأكسدي وفعالية بعض الانزيمات في سائل النخاع الشوكي لدى الأطفال المصابين بمرض الاستسقاء الدماغي

Author: *Luay Abed Al-Helaly لؤي عبد الهلالي
Journal: kirkuk university journal for scientific studies مجلة جامعة كركوك - الدراسات العلمية ISSN: 19920849 / 26166801 Year: 2017 Volume: 12 Issue: 3 Pages: 432-461
Publisher: Kirkuk University جامعة كركوك

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Abstract

This research include studying the oxidative stress state and the activity of some enzymes in the cerebrospinal fluid (CSF) from children with hydrocephalus by the determination of (15) Biochemical parameters which include: Acetylcholinesterase (AChE), Pseudocholinesterase (PChE), Monoamin oxidase A (MAOA), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP), Creatinine kinase (CK), Lactate dehydrogenase (LDH), Superoxide dismutase (SOD), Uric acid (UA), Vitamin D, Total protein (Tp), Albumin (Alb), Ceruloplasmin (Cp), Malonadialdehyde (MDA), The study was done on (176) child with hydrocephalus (110) were male , (66) female and (67) healthy child as control group (39) were male and (28) female ,the age of children with hydrocephalus and control group ranged from 1-14 month for both sexes.The results showed that there was a significant increase in the activity of AChE, PChE, MAOA, AST, ALT, ALP, CK and LDH in CSF for children with hydrocephalus compared with healthy group for both sexes, these result were indicated that these parameters may be good biochemical markers for this disease . Beside of that, the results showed there was a highly oxidative stress in the patients for both sexes, so there was a significant increase in the activity of SOD, Tp, Alb and oxidant indicator of MDA, with a significant decrease in vit. D, uric acid and Cp levels in CSF patients compared with healthy group for both sexes,

تضمن البحث دراسة حالة الكرب التأكسدي وفعالية بعض الانزيمات في سائل النخاع الشوكي لدى الأطفال المصابين بالاستسقاء الدماغي من خلال قياس (15) متغيراً من المتغيرات الكيموحيوية والتي تضمنت: إنزيم الأسيتايل كولين أستريز (AChE)، إنزيم البسيدو كولين أستريز (PChE)، إنزيم المونوأمين أوكسيديز (MAOA)، إنزيم اسبارتيت امينوترانسفيريز(AST)، إنزيم الانين امينوترانسفيريز (ALT)، إنزيم الفوسفاتيز القاعدي(ALP)، إنزيم الكرياتين كاينيز(CK)، إنزيم لاكتيت ديهايدروجنيز (LDH)، إنزيم سوبر اوكسايد ديسميوتيز (SOD)، حامـض اليوريك ((UA، فيتامين D، البروتين الكلي (TP)، الألبومين ((Alb، السيرولوبلازمين(Cp) والمالوندايالديهايد (MDA)، أجريت هذه الدراسة على (176) طفل مريض بالاستسقاء الدماغي ((110 كانوا ذكوراً و((66 اناثاً و(67) طفلاً من الأصحاء(طفلاً من الأصحاء((39 كانوا ذكوراً و(28) اناثاً وتراوحت أعمارهم بين 14-1 شهراً. أشارت النتائج الى ان هناك ارتفاع معنوي لدى الأطفال المصابين الأستسقاء الدماغي لكل من الانزيمات: AChE وPChE وMAOA وAST وALT وALP وCK وLDH في سائل النخاع الشوكي مقارنة مع الاصحاء ولكلا الجنسين، وهذا يدل بشكل واضح ان هناك تأثراً في وظائف جسم المريض بشكل عام. بالإضافة الى ذلك، لوحظ ان هناك حالة كرب تأكسدي عالي لدى المرضى ولكلا الجنسين من خلال ملاحظة ان هناك ارتفاع معنوي في فعالية إنزيم SOD والبروتين الكلي والألبومين ومؤشر الاكسدة المالوندايالديهايد ولكن هناك انخفاض معنوي في فيتامين D وحامض اليوريك والسيرولوبلازمين في سائل النخاع الشوكي للمرضى مقارنة مع مجموعة الاصحاء ولكلا الجنسين .

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