Ayman Khalil

Mediclinic Middle East · Neurosurgery

Background: Diagnosing cerebral sinus venous thrombosis (CSVT) manifested as a spontaneous subdural hematoma (SDH) is challenging due to variability of its clinical features. The neuroradiological investigation is crucial to confirm the diagnosis. The management of SDH secondary to CVST is controversial and not well established. Case description:...

An internal septum within a basilar artery aneurysm is an infrequent anomaly and is very rarely reported in the literature. We report a 62-year-old lady that was incidentally diagnosed with basilar tip aneurysm. Further imaging with magnetic resonance imaging (MRI) revealed internal septation within this aneurysm which was later confirmed with digi...

Background: Bleeding secondary to recurrences of spontaneously obliterated arteriovenous malformations (AVMs) is an extremely rare occurrence. Case description: We report a 25-year-old man with cerebellar hemorrhage secondary to a recurrent AVM. His current admission with bleeding from a ruptured cerebellar AVM followed a previous presentation 1...

Spinal extradural meningeal cysts (SEMC) are uncommon causes of back pain. The literature contains only case reports of this pathology, and treatment remains controversial due to its rarity. We present a case of SEMC and describe an approach via hemilaminectomy, with the choice of side guided by radiological imaging, followed by complete excision o...

Background: Spindle cell pseudotumours are formed by histiocytes in response to infection by mycobacterium avium-intracellulare complex (MAC) and is rare in patients without AIDS. Case description: A 66 year old gentleman presented with neck pain, ataxia, and a history of sarcoidosis. A cerebellar lesion was identified on MRI and surgically exci...

Multiple cranial nerves palsies following a posterior fossa exploration confined to an extradural compartment is a rare clinical presentation. This case report describes a young man who developed a unilateral abducens and bilateral facial nerve palsies following a posterior fossa exploration confined to an extradural compartment. There are differen...

Background Cerebrospinal fluid (CSF) sampling is performed during ventriculoperitoneal (VP) shunting procedure surgery for early detection of infection. We have performed a retrospective study to determine whether routine intraoperative CSF sampling at new VP shunt insertion has predicted shunt infection or changed subsequent surveillance or manage...

Peri-operative elevated serum lactate could be a sign of high risk of morbidity among affected patients. However, this finding can be self-limiting and with no consequences in some conditions. We present a case of transient elevated serum lactate level in a 33 year old man that underwent a cranial meningioma resection. The patient had an elevation...

Pilocytic astrocytomas in the supratentorial compartment make up 20 % of all brain tumours in children with only 5 % of these arising in the suprasellar region. Optic pathway gliomas or suprasellar gliomas are often seen in neurofibromatosis type 1 (NF1) patients. Given their location, suprasellar pilocytic astrocytomas are challenging to manage su...

The field of neuroendoscopy is rapidly expanding with increasing indications for endoscopic third ventriculostomy (ETV). As a treatment for hydrocephalus, ETV has the advantage of providing a more physiological cerebrospinal fluid diversion without shunt hardware which reduces the risk of recurrent infection and malfunction. The success rate of ETV...

We describe a patient who within 2 months of undergoing radio-chemotherapy for glioblastoma developed an Epstein-Barr virus-positive primary diffuse large B-cell CNS lymphoma. To our knowledge, this is the first such case reported in the literature showing that new tumefactions following aggressive treatment for glioblastomata might represent secon...

The usage of a drain following evacuation of a chronic subdural haematoma (CSDH) is known to reduce recurrence. In this study we aim to compare the clinical outcomes and recurrence rate of utilising two different types of drains (subperiosteal and subdural drain) following drainage of a CSDH. Prospective randomised single-centre study analysing 50...

Metastases from prostate cancer are common to the pelvic lymph nodes and the axial skeleton. Brain metastases from prostate primary are rare and most reported cases are from an autopsy series. Case presentation: A 60-year-old Irish man presented to the neurosurgery department with a one-month history of confusion and one-week history of progressi...