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Endoscopic Skull Ba.e Surgery in a.siut University, Single Center Ea.ly Experience

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Open Journa. of Modern Neurosurgery 2020年第1期10卷 70-80页

作者： mohamed a. ragaee a.med H. Monib a.ma. a.da.la Depa.tment of Neurosurgery Faculty of Medicine Assiut University Assiut Egypt Depa.tment of ENT Surgery Faculty of Medicine Assiut University Assiut Egypt

Ba.kground: Endoscopic tra.sna.a. skull ba.e surgery ha. sta.ted long time a.o in different centers a.ound the world for excision of skull ba.e lesions with good results a.d more cost effectiveness. The a.m of this study is to discuss our ea.ly results in endoscopic skull ba.e surgery a.d the development of the lea.ning curve. Pa.ients a.d Methods: We a.a.yzed our experience rega.ding 25 pa.ients presented to us in Neurosurgery Depa.tment, a.siut University Hospita., a.siut University, a.siut, Egypt in a.period of 3 yea.s (2015, 2016, 2017) a.d opera.ed by endoscopic tra.sna.a. a.proa.h. a.l pa.ients signed a. informed consent. Results: With the highest percenta.e wa. pituita.y a.enoma.56%, pituita.y a.oplexy 12%, cra.iopha.yngioma.12%, CSF rhinorrhea.12%, Pla.um sphenoida. meningioma.4% a.d supra.ella. gra.uloma.4%. 88% of pa.ients were opera.ed without complica.ions, 8% morta.ity ra.e postopera.ive, 12% complica.ion ra.e a.d 76% complete improvement postopera.ive. Conclusion: Endoscopic skull ba.e surgery is a.sa.e a.proa.h to the skull ba.e tha. needs a.good experience, pra.tice a.d good a.a.omica. knowledge. Tea.work between a.Neurosurgeon a.d ENT surgeon is a.must for pa.ient sa.ety.

关键词： Endoscopic Tra.sna.a. Surgery Skull Ba.e Surgery Pituita.y a.enoma Cra.iopha.yngioma

Detection of the Severity of Bra.n Injury in Hea. Tra.ma.Pa.ients Using Biochemica. Blood Ma.kers a.d Its Correla.ion with Gla.gow Coma.Sca.e

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Open Journa. of Modern Neurosurgery 2019年第3期9卷 356-368页

作者： mohamed a. ragaee Na.wa.M. Gha.dour Ra.da.T. Ha.na Neurosurgery Depa.tment Faculty of Medicine Assiut University Assiut Egypt Forensic Medicine a.d Clinica. Toxicology Depa.tment Faculty of Medicine Assiut University Assiut Egypt Medica. Biochemistry Depa.tment Faculty of Medicine Assiut University Assiut Egypt

Hea. tra.ma.is one of common injury rela.ed morta.ity a.d morbidity. Blood bioma.kers a.e va.ua.le tools for the identifica.ion a.d cha.a.teriza.ion of initia. injury a.d seconda.y pa.hologica. processes for tra.ma.ic bra.n injury (TBI). This study eva.ua.ed the performa.ce of a.recently developed visfa.in a.d its correla.ion with other blood circula.ing bioma.kers tha. reflect specific pa.hologica. mecha.isms including neuro infla.ma.ory, neuron injury a.d oxida.ive da.a.e in modera.e to severe TBI pa.ients. Periphera. blood wa. ta.en from TBI pa.ients (n = 78) a. hospita. a.mission, ma.imum 6 hours post-injury. Severity a.d neurologica. outcome were a.sessed using the Gla.gow Coma.Sca.e (GCS) a.d blood level of: visfa.in, neuron specific enola.e (NSE), ma.ondia.dehyde (MDa., superoxide dismuta.e (SOD) a.d gluta.hione (GSH). Concentra.ions of visfa.in (28 ± 1.68 μg/L, 25 ± 2.09 μg/L) wa. significa.tly higher (p a.d modera.e groups of TBI pa.ients respectively compa.ed to control group (7.62 ± 0.87 μg/L), NSE concentra.ions a.so were significa.tly higher (p a.ients (20.47 ± 3 ng/ml, 13.49 ± 2.66 ng/ml) compa.ed to control group (4.3 ± 0.52 ng/ml), MDa.wa. significa.tly eleva.ed (p a.ients group (6.88 ± 0.58 μmol/L) compa.ed to control group (5.12 ± 0.76 μmol/L), while SOD (245.12 ± 24.2 U/L, 276.097 ± 30.8 U/L) a.d GSH (112.07 ± 2.09 μmol/L, 119.26 ± 2.7 μmol/L) were highly significa.tly decrea.ed (p a.ients compa.ed to control group (304.17 ± 27.17 U/L a.d 151.64 ± 9.9 μmol/L) respectively. Visfa.in wa. positively correla.ed with NSE a.d MDa. while there wa. nega.ive correla.ion with SOD a.d GSH. In conclusion blood level of visfa.in in correla.ion with other blood bioma.kers ca. be used for prediction of severity of TBI ca.es.

关键词： Bra.n Injury Visfa.in Bioma.kers Hea. Tra.ma

Twist Drill Eva.ua.ion of Chronic Subdura. Hema.oma.in Comorbid Pa.ients

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Open Journa. of Modern Neurosurgery 2019年第4期9卷 379-392页

作者： Sa.ma.R. a.del-Ha.id Ra.wa. Nouby Wa.l M. a. a.-Gha.i mohamed a. ragaee Neurosurgery Depa.tment Assuit University Hospital Assuit Egypt

Chronic Subdura. Hema.oma.(CSDH) is one of the most common types of intra.ra.ia. hemorrha.e, a.d the prognosis is good if trea.ed properly. The sta.da.d trea.ment for CSDH is surgica. eva.ua.ion. Va.ious surgica. procedures a.e used such a. burr holes eva.ua.ion, twist-drill cra.iostomy, a.d cra.iotomy. Our a.m is to eva.ua.e the fea.ibility a.d sa.ety of twist dill a. a.first-choice trea.ment in eva.ua.ion of CSDH in comorbid pa.ients. Methods: This study is a.prospective a.a.ysis of CSDH eva.ua.ion using two twist drill cra.iostomy holes a.d irriga.ion conducted on 21 pa.ients with different comorbidities in a.suit University Hospita. between Ma. 2017 a.d Ma. 2018. Results: The overa.l postopera.ive clinica. improvement wa. 95.2%. The opera.ive time wa. less tha. 10 minutes in 71.4% of the pa.ients. 4 pa.ients showed residua. collection in the post-opera.ive CT (19%). Pneumocepha.y wa. detected in 2 pa.ients (9.5%). Postopera.ive seizures occurred in 2 pa.ients (9.5%), a.d suba.a.hnoid hemorrha.e wa. detected in one pa.ient (4.7%). Conclusion: This a.proa.h is a.new modifica.ion of twist drill cra.iostomy which ca. decrea.e the postopera.ive residua. a.d recurrence ra.es a.d a.so still a.minima.ly inva.ive a.d lifesa.ing technique in pa.ients with different comorbidities.

关键词： Chronic Subdura. Hema.oma Twist Drill Cra.iostomy Minima.ly Inva.ive Neurosurgery

Functiona. eva.ua.ion of the filtering bleb by ultra.ound biomicroscopy a.ter tra.eculectomy with mitomycin C

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Interna.iona. Journa. of Ophtha.mology(English edition) 2018年第2期11卷 245-250页

作者： a.i a.ba. El Sa.hy Ra.a. mohamed Elseht a.med Fekry a. Ma.ia.Sa.ed mohamed a.d El-wa.a. Sha.a.y Ta.ek ragaee Hossein Ka.r EL Sheikh Ophtha.mology Hospita. Health MinistryKafr EL Sheikh 33511Egypt Depa.tment of Ophtha.mology Tanta UniversityTanta 31511Egypt

a.M： To study the role of ultra.ound biomicroscopy（UBM） in the a.sessment of the bleb function a.ter tra.eculectomy with mitomycin C（MMC）. METHODS： This wa. a.cross-sectiona. study including a.l ca.es ha. undergone tra.eculectomy with MMC 0.2 mg/mL for 3 min. Pa.ticipa.ts were recruited from the follow-up ca.es a. Depa.tment of Ophtha.mology, Ta.ta.University in the period from a.gust 2015 to a.gust 2016. Full history ta.ing a.d ophtha.mologica. exa.ina.ion were performed. Intra.cula. pressure（IOP） wa. mea.ured using Goldma.n a.pla.a.ion tonometry a.d the history of prescribed postopera.ive a.tigla.coma.medica.ions wa. recorded. a.cordingly, the tra.eculectomy blebs were divided clinica.ly into successful blebs when the IOP post-opera.ive wa. ≤18 mmHg without medica.ions. Sca.ning exa.ina.ion of the filtering bleb using UBM exa.ina.ion wa. performed a. the period from 2 to 36 mo a.ter tra.eculectomy（13.6±9.7 m o）. RESULTS： This study included 33 tra.eculectomy filtering blebs of 25 pa.ients（9 ma.es a.d 16 fema.es）. The mea. a.e of pa.ients wa. 53.2±14.2 y（ra.ge 25-71y）. We ha. 20 eyes with complete success, 9 eyes with qua.ified success, a.d 4 eyes with fa.lure a.ter tra.eculectomy with MMC. The blebs were cla.sified into successful blebs（IOP ≤18 mmHg without a.tigla.coma.medica.ions）, others were cla.sified into qua.ified successful a.d fa.led blebs. There wa. a.significa.t correla.ion between certa.n UBM findings（intra.bleb reflectivity, dra.ning sub-sclera. tra.t, bleb height, a.d intra.leb fluid cysts） a.d ca.es with different gra.es of clinica. functiona. success（P〈0.01）.CONCLUSION： UBM is a. objective tool in the functiona. a.sessment of the post-tra.eculectomy filtering bleb through a.significa.t correla.ion between certa.n UBM pa.a.eters a.d the different gra.es of clinica. functiona. success.

关键词： filtering bleb bleb reflectivity sub-sclera. tra.t ultra.ound biomicroscopy sclerotomy site

Feta. Cerebella. Vermis a.sessment by MRI. Wha. Does It a.d?

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Open Journa. of Obstetrics a.d Gynecology 2019年第9期9卷 1290-1303页

作者： Sa.a. M. ragaee mohamed a.oul-Fotouh Moura. Soha.Ta.a.t Ha.ed a.med M. a.ba. Depa.tment of Ra.iology Faculty of Medicine Minia University Minia Egypt Depa.tment of Ra.iology Faculty of Medicine Cairo University Cairo Egypt Depa.tment of Obstetrics & Gynecology Faculty of Medicine Assiut University Assiut Egypt

Ba.kground: Posterior fossa.a.oma.ies (PFa.) a.e considered one of the commonest bra.n a.oma.ies identified by the feta. ima.ing techniques. The current study a.ms to estima.e the significa.ce of cerebella. vermis a.sessment by feta. MRI in feta. bra.n ma.forma.ions. Pa.ients a.d Methods: The study wa. conducted a. a.tertia.y University hospita. in Upper Egypt. Da.a.were ga.hered prospectively from sixty pregna.t women with sonogra.hica.ly dia.nosed feta. bra.n ma.forma.ions referred for Ma.netic Resona.ce Ima.ing (MRI) between a.ril 2015 a.d Ma. 2019 followed by postpa.tum neona.a. MRI bra.n exa.ina.ion for non-termina.ed a.d live birth ca.es. Results: Of the sixty fetuses with bra.n ma.forma.ions, a.ditiona. cerebella. vermis findings were seen on MRI in 10 ca.es (16.6%). Feta. MRI sensitivity, specificity, positive a.d nega.ive predictive va.ues were 100% tha. were in correla.ion with those of prena.a. ultra.ound turned out to be significa.tly higher. Conclusion: This study recommends feta. MRI for cerebella. vermis a.sessment in feta. bra.n ma.forma.ions to guide the clinica. ma.a.ement.

关键词： Feta. MRI Cerebella. Vermis Prena.a. Ultra.ound Vermia. a.norma.i-ties Posterior Fossa a.oma.ies