Background Posterior fossa brain tumours are one of the most devastating forms of human illnesses which are more common in children. Brainstem compression, herniation and death are the risks with tumours in this critical location. Objective To evaluate our results, complications and outcome of posterior fossa tumour surgery in Benha University Hospital. Patients and methods A prospective study including 44 patients with posterior fossa tumours were performed at the Neurosurgery Department in Benha University Hospital between the period of March 2015 and October 2018. In each case, diagnosis was made clinically and confirmed radiologically and histo-pathologically. Results Out of 44 patients, 28 (63.6%) patients were males and 16 (36.4%) were females. The mean age was 17.5 + 14.2 years (ranged 2–30 years). This study showed that excellent surgical outcome was observed in 12 cases (27.3%), good in 22 cases (50%) while poor outcome was observed in 10 cases (22.7%). The best outcome is astrocytoma then ependymoma while the worst outcome is metastatic then medulloblastoma which is statistically insignificant. Conclusion The surgical treatment of posterior fossa tumours still represents a challenge for neurosurgeons. Our Benha experience shows the accepted results, complications and surgical outcome in relation to previous clinical studies. Trial registration IRB#3747. Registered 18 September 2018.
Background: The diagnosis of carpal tunnel syndrome (CTS) is established mainly on a clinical basis, and diagnosis is done after careful history taking and examination including known provocative tests with varying efficacy and reliability. Methods: A prospective clinical study of 123 patients with 171 hands presenting with classical symptoms of carpal tunnel syndrome were included in this study, from October 2013 to October 2015, and they underwent open surgical release of flexor retinaculum at the Neurosurgery Department of Benha University Hospital. Results: ART is positive in 88.3%. This is compared to 75, 81.3, 79.7, and 83.6% of positive results in Tinel's test, compression test, Phalen's test, and combined Phalen's and compression test. ART is the most sensitive and specific test and has the highest positive predictive value of 98.3%, negative predictive value of 81.9%, and accuracy of 91.4%. Conclusion: ART is a simple, reliable, and easily performed test for evaluating carpal tunnel syndrome; it is superior to other tests and could be used also to assess improvement after surgery.
Purpose: To overview the management of encephalocele and evaluate the outcome in our institutions through a period of 5 years. Methods: This is a retrospective study was performed on all infants that were admitted and operated upon for encephalocele in department of Neurosurgery of Benha University and Benha specialized children hospitals in the last 5 years, from June 2016 to June 2021. Results:This study had 58 infants with encephalocele were with age ranged from 1 to 345 days with a mean age ±SD of 244 ±20 days. 6 types of encephalocele according to location and shape were treated; 22 (37.9%) occipital, 12 (20.7%) atretic, 9 (15.5%) vault, 7 (12.1%) occipito-cervical, 5 (8.6%) ethmoidal, and 3 (5.2%) double encephaloceles. we classified encephaloceles into 3 sizes; small, medium and large. We found that 20.7% of infants associated with hydrocephalus. Only 5 deaths were reported and 3 of them were not related to encephalocele and its management. Conclusions: Management of encephalocele includes full investigations and proper diagnosis for optimum surgical plan. Meticulous patient preparation, surgery, and good postoperative care and follow up are mandatory for good outcome. Associated hydrocephalus which was not significantly related to encephalocele type or size and neurological & non-neurological conditions are common and should be taken in consideration.
Background: Intracranial arachnoid cysts (IAC) are pathological conditions that occur in 2.6% of children. Different surgical procedures had significant failure rate. The objective of the current study is to evaluate the effectiveness of open surgical excision in failed first-other surgery. Patients and methods: A total of 23 patients with symptomatic arachnoid cysts, with radiological evidence who had had one previous failed surgical intervention, shunting or endoscopic fenestration, underwent open surgical excision of the arachnoid cyst at the Neurosurgery Department of Benha University and Benha Children Hospitals through the period from January 2018 to January 2022. Results: Children with IAC underwent open surgical excision, totalling 9 (39.1%) cases and partial in 14 (60.9%) cases. In 13 cases, associated microscopic fenestration to basal arachnoid cisterns was done. The mean follow-up period is 28.36 (SD 3.97) months with 77.3% success and 22.7% failure with subsequent treatment by cystoperitoneal shunting. Total excision success is 100%, but partial excision is 64.3%, with 88.9% of them being associated with microscopic fenestration. Mild early transient complications were reported in only 3 cases and were conservatively treated, but late complications occurred in 2 cases. Conclusion: Open surgical excision of IAC has a very good success rate in the treatment of intracranial arachnoid cysts after initial procedure failure; complete excision should be the main aim whenever possible for optimum results that force us to ask: "Could it be the first line of surgical treatment in symptomatic untreated cases?"
The aim of this study was to evaluate the outcome of surgical management of spontaneous intra-cerebral hematoma, and express the predicting factors favoring good or bad outcome. Patients and Methods: The present research was brought in Benha university hospitals on 40 patients having to deal with spontaneous intracerebral hemorrhage with clinical diagnosis of hypertension where we operated upon. The end result of surgery and determinants of the outcome were noted regarding 2 divided groups (survived and died). Results: The mean age ±SD was 56.89±7.93 and 57.64±9.73 years in survived and died groups respectively. Preoperative Glasgow coma scale (GCS) of 13-15 in survived cases was 80% while all cases were died (100%) in died group of GCS 5-8 which was statistically significant. The most common site was basal ganglia (55%). The volume of hematoma and preoperative GCS had a significant prognostic predictor of surgical outcome that detected by Receiving Operator Characteristic (ROC) curve with cutoff point of 56.0 cm 3 and 9 respectively. Conclusion: The sizable hypertensive ICH is a surgically treatable condition. The predicting factors of mortality outcome are preoperative GCS ≤9 and hematoma volume ≥56.0 cm 3 with no value of age, sex or site of hematoma.
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