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Ajlan A, Basindwah S, Hawsawi A, Alsabbagh B, Alwadee R, Abdulqader SB, Alzhrani G, Orz Y, Bafaqeeh M, Alobaid A, Alyamany M, Farrash F, Alaskar A, Alkhathlan M, Alqurashi A, Elwatidy S. A Prospective Comparison Between Soft Tissue Dissection Techniques in Pterional Craniotomy: Functional, Radiological, and Aesthetic Outcomes. Oper Neurosurg (Hagerstown) 2024; 26:256-267. [PMID: 37815213 DOI: 10.1227/ons.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/04/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Given the complex anatomy of the operative region and individual surgeon preferences, some techniques for soft tissue dissection before pterional craniotomy have gained more popularity than others. This prospective study used subjective and objective measurements to compare the functional, radiological, and aesthetic outcomes of 3 such dissection techniques. METHODS This multicenter prospective cohort study included all patients who underwent elective pterional craniotomy between 2018 and 2020 at 3 centers in Riyadh, Saudi Arabia. All patients underwent 1 of 3 soft tissue dissection techniques: myocutaneous flap, interfascial, and subfascial dissection techniques. Clinical and radiological assessments were performed upon discharge and at the 3- and 6-month follow-ups. RESULTS We included 78 patients, with a mean age of 44.9 ± 16.3 years. Myocutaneous flap, interfascial, and subfascial dissections were performed in 34 (43%), 24 (30%), and 20 patients (25%), respectively. The myocutaneous flap method had the shortest opening ( P = .001) and closure ( P = .005) times; tenderness was more evident in this group than in the others ( P = .05). The frontalis muscle was most affected in the interfascial dissection group ( P = .05). The frontalis nerve function was similar in all groups after 6 months ( P = .54). The incidence of temporomandibular joint dysfunction was highest in the myocutaneous flap group (29%). Decreased temporalis muscle thickness at the 6-month postoperative follow-up was most severe in the subfascial dissection group (12.6%), followed by the myocutaneous flap (11.9%) and interfascial dissection (9.9%) groups, with no significant difference ( P = .85). Temporal hollowing was more prominent in the myocutaneous flap group ( P = .03). Cosmetic satisfaction was highest in the interfascial dissection group, with no significant difference ( P = .4). CONCLUSION This study provides important information for neurosurgeons in weighing the benefits and risks of each technique for their patients.
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Affiliation(s)
- Abdulrazag Ajlan
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | - Sarah Basindwah
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | - Aysha Hawsawi
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | - Badriah Alsabbagh
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | - Rawan Alwadee
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | | | - Gmaan Alzhrani
- Department of Neurosurgery, King Fahad Medical City, Riyadh , Saudi Arabia
| | - Yasser Orz
- Department of Neurosurgery, King Fahad Medical City, Riyadh , Saudi Arabia
| | - Mohammed Bafaqeeh
- Department of Neurosurgery, King Fahad Medical City, Riyadh , Saudi Arabia
| | - Abdullah Alobaid
- Department of Neurosurgery, King Fahad Medical City, Riyadh , Saudi Arabia
| | - Mahmoud Alyamany
- Department of Neurosurgery, King Fahad Medical City, Riyadh , Saudi Arabia
| | - Faisal Farrash
- Division of Neurosurgery, Department of Neuroscience, King Faisal Hospital and Research Center, Riyadh , Saudi Arabia
| | - Abdulaziz Alaskar
- College of Medicine, Prince Sattam Bin Abdulaziz University, Riyadh , Saudi Arabia
| | - Malak Alkhathlan
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | - Ashwag Alqurashi
- Division of Neurosurgery, Department of Surgery, King Saud University Medical City, Riyadh , Saudi Arabia
| | - Sherif Elwatidy
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
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Madkhali AM, Alaluan HF, Alnajeim MH, Al Saeed EF, Ajlan AM, Abdelwarith A, Abduh A, Albanyan S, Alqurashi A, Alkhalidi H. A New Sarcoma Shortly after Treatment for High-Grade Glioma with Adjuvant Chemoradiation: A Case Report. Case Rep Oncol 2024; 17:573-580. [PMID: 38665312 PMCID: PMC11045215 DOI: 10.1159/000538508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 01/31/2024] [Indexed: 04/28/2024] Open
Abstract
Introduction High-grade gliomas are central nervous system tumors conventionally treated with surgery followed by adjuvant chemoradiotherapy. Secondary cancer due to radiation therapy is a rare yet established phenomenon that typically occurs years after radiation therapy. Case Presentation In this case, we discuss an early presentation of a second cancer adjacent to the radiation field. This case report is of a 52-year-old male who developed a new scalp sarcoma at the site of primary surgery 8 months after radiation therapy. Genetic testing revealed a heterozygous missense variant in the NF1 gene, a variant of uncertain significance. The report highlights that this case does not conform to the expected criteria for postradiation sarcoma in terms of timing. Conclusion Secondary cancers may arise earlier than expected, even in phenotypically normal patients, as they may have unmanifested variants of relevant mutations. The question of pre-radiotherapy screening for radiosensitivity syndromes and diseases requires further study, as current data are limited and do not provide enough insight into the significance of different genetic variants.
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Affiliation(s)
- Abdossalam M. Madkhali
- Department of Medicine, Oncology, Hematology and Radiation Oncology Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Eyad F. Al Saeed
- Department of Medicine, Oncology, Hematology and Radiation Oncology Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrazag M. Ajlan
- Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Ali Abduh
- Department of Radiology, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Saleh Albanyan
- Department of Internal Medicine, College of Medicine and King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ashwag Alqurashi
- Division of Neurosurgery, Department of Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hisham Alkhalidi
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Ajlan A, Basindwah S, Hawsawi A, Elmutawi H, Alsaleh S, Alrasheed A, Alroqi A, Alqurashi A. Early Displacement of Reconstruction Material is a Predictor of Cerebrospinal Fluid Leak Post Endoscopic Skull Base Surgery. World Neurosurg 2024; 181:e897-e905. [PMID: 37944857 DOI: 10.1016/j.wneu.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND The reconstruction technique and materials used for endoscopic skull base surgery (ESBS) are important factors in preventing cerebrospinal fluid (CSF) leak, a notable complication following this surgery. Visualizing the status of reconstruction early in the postoperative course can help determine the risk of postoperative CSF leak. Here, we aimed to determine if the radiological status of reconstruction post endonasal endoscopic surgery can predict postoperative CSF leak. METHODS This retrospective study included patients who had undergone ESBS between 2015 and 2020. An early computed tomography (CT) scan (obtained within 24 hours of surgery) was utilized to evaluate the reconstruction and postoperative radiological changes, and its findings were correlated with the occurrence of postoperative CSF leaks. RESULTS Our study included 11 (12.7%) out of 86 patients with CSF leaks. The type of reconstruction, construction material, and type of nasal packing were not identified as significant risk factors for CSF leaks. The location of the fat graft (placed properly vs. displaced out of the surgical cavity) was significantly associated with CSF leak (P = 0.001). All patients with a displaced solid reconstruction (n = 5), displaced septal flap (n = 6), signs of air continuation (n = 2), or significantly increased amount of air (n = 5) presented with a CSF leak (P < 0.001). CONCLUSIONS Early postoperative CT scan is predictive of CSF leak. Displacement of the fat graft in early postoperative CT was the most important factor in predicting CSF leak. In this patient group, paying attention to radiological predictors of CSF leaks is important, supported by clinical findings.
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Affiliation(s)
- Abdulrazag Ajlan
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Sarah Basindwah
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Aysha Hawsawi
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hend Elmutawi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad Alsaleh
- Department of Otolaryngology- Head and neck surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alrasheed
- Department of Otolaryngology- Head and neck surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Alroqi
- Department of Otolaryngology- Head and neck surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ashwag Alqurashi
- Division of Neurosurgery, King Saud University Medical City, Riyadh, Saudi Arabia
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Albaharna H, Alqurashi A, Alshareef M, Alromaih S, Alrasheed AS, Alroqi A, Ajlan A, Alsaleh S. Impact of Concurrent Chronic Rhinosinusitis on Complication Rates after Endonasal Endoscopic Skull Base Surgery: A Single-Center Experience. J Neurol Surg B Skull Base 2023; 84:507-512. [PMID: 37671295 PMCID: PMC10477013 DOI: 10.1055/s-0042-1755602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 06/20/2022] [Indexed: 10/15/2022] Open
Abstract
Objectives Preoperative planning of endoscopic skull base surgery (ESBS) is essential. The safety of performing surgery before managing sinus pathologies including concurrent chronic rhinosinusitis (CRS) in patients undergoing ESBS has been questioned. The current study aimed to evaluate and compare the complication rates between patients with and without CRS undergoing ESBS. Design This is a retrospective study. Setting Present study was conducted at tertiary referral center. Participants We included all patients who underwent ESBS between March 2015 and March 2021. However, patients who had surgical revision for remnant tumor, primary sinonasal tumor excision, and cerebrospinal fluid (CSF) leakage repair were excluded. The presence of concurrent CRS was determined according to the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020) criteria by reviewing electronic charts about the preoperative clinical assessment and CT scan images of the paranasal sinuses. Then, the incidence rates of postoperative meningitis, CSF leakage, and surgical site infection were compared between patients with and without concurrent CRS undergoing ESBS. Main Outcome Measures Postoperative complication rates in patients underwent ESBS with and without CRS. Results From a total of 130 ESBS cases, 99 patients were included in this study. Among them, 24 had concurrent CRS. One patient presented with postoperative meningitis, one with CSF leakage, and two with surgical site infections. The incidence rate of postoperative meningitis, CSF leakage, and surgical site infection did not significantly differ between patients with and without concurrent CRS. Conclusion Concurrent CRS is not a contraindication for ESBS. Moreover, simultaneous endoscopic sinus surgery can safely be performed without additional morbidity in ESBS.
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Affiliation(s)
- Hussain Albaharna
- Department of Otolaryngology, Head and Neck Surgery, Qatif Central Hospital, Qatif City, Saudi Arabia
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ashwag Alqurashi
- Department of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Alshareef
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Otolaryngology, Head and Neck Surgery, Khamis Mushait General Hospital, Khamis Mushait City, Saudi Arabia
| | - Saud Alromaih
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz S. Alrasheed
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Alroqi
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrazag Ajlan
- Department of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad Alsaleh
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Ajlan A, Basindwah S, Yaghmoor W, Albakr A, Alsaleh S, Alrasheed A, Alroqi A, Alqurashi A. The 100 Most Cited Articles in Endoscopic Endonasal Skull Base Surgery: A Bibliometric Analysis. World Neurosurg 2023; 171:e363-e381. [PMID: 36509324 DOI: 10.1016/j.wneu.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The accelerated growth of endoscopic endonasal skull base surgery has led to an abundance of highly cited works that have helped shape the field into its current state. Highlighting these works can serve as a guide for trainees and facilitate evidence-based clinical decision making and operative techniques. METHODS Elsevier's Scopus database was used to generate a list of the 100 most cited articles on endoscopic endonasal skull base surgery in September 2022. Results were categorized based on pathology, approach, study design, and study objective. A citation per year analysis was conducted to highlight later publications that may not have had the time to accumulate as many citations as older publications. RESULTS The average number of citations for the 100 most cited articles was 210 per article (range 104-1285). Publication dates ranged from 1997 to 2019, with the highest number of articles among the 100 most cited being published in 2008 (15 articles). The journal with the greatest number of publications was Neurosurgery (30 articles). Of the 100 most cited articles, 77 were published between 2000 and 2010. Moreover, 40 of the 100 articles reported surgical outcomes and related complications, and the most common pathology was pituitary adenoma (25 articles). CONCLUSIONS This article provides a list of highly influential articles in the field of endoscopic endonasal skull base surgery, highlighting its rapid evolution over the last 3 decades and demonstrating its leap from small descriptive series confined to certain pathologies to larger cohorts exploring possible boundaries and other pathologies.
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Affiliation(s)
- Abdulrazag Ajlan
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Sarah Basindwah
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Waseem Yaghmoor
- Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman Albakr
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Saad Alsaleh
- Department of Otolaryngology- Head and neck surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alrasheed
- Department of Otolaryngology- Head and neck surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahamd Alroqi
- Department of Otolaryngology- Head and neck surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ashwag Alqurashi
- Division of Neurosurgery, Department of Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
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Alqurashi A, Albaharna H, Alshareef M, Noor Elahi B, Alromaih S, Alrasheed A, Alroqi A, Alsaleh S, Ajlan A. Classification of Endoscopic Transnasal Lateral Skull-base Approaches: Anatomical Study. World Neurosurg 2023; 173:e559-e570. [PMID: 36842530 DOI: 10.1016/j.wneu.2023.02.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 02/28/2023]
Abstract
OBJECTIVES Endoscopic Transnasal Approaches (ETA) to the ventrolateral skull-base is commonly classified according to coronal plans or anatomical structures. Our goal is to simplify the description of the ETA to lateral skull-base regions in a sequential dissection with correlation to computed tomography, helping in pre-operative planning, efficient surgical exposure, and exposing the surgical anatomy limitations. METHODS Five fresh injected cadaver heads were dissected using an extended ETA to lateral skull-base. Each specimen underwent a high-resolution computed tomography scan. A classification of the lateral skull-base based on well-defined zones was proposed. RESULTS We divided the lateral target into four different zones, in a craniocaudal orientation. • Zone 1 is the space lying between the orbital floor superior and the level of the sellar floor inferior. • Zone 2 On a coronal plane, located between the level of the sellar floor and vidian canal. • Zone 3 is the area lateral to the anterior limb of the petrooccipital fissure, located between the vidian canal and the carotid canal. • Zone 4 is the space located between the carotid canal and extracranial opening of the hypoglossal canal, lateral to the anterior part of the posterior limb of petrooccipital fissure. CONCLUSION Multiple previous works are described and classified the coronal plan and its lateral extensions. Our classification system for the proposed lateral zones enables preoperative planning to select a suitable approach. The craniocaudal orientation facilitates the understanding of surgical corridors and tailored exposure.
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Affiliation(s)
- Ashwag Alqurashi
- Division of Neurosurgery, Department of Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hussain Albaharna
- Department of Otolaryngology-Head & Neck Surgery, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Mohammad Alshareef
- Department of Otolaryngology-Head & Neck Surgery, Khamis Mushait General Hospital, Khamis Mushait, Saudi Arabia
| | - Basim Noor Elahi
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saud Alromaih
- Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alrasheed
- Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Otolaryngology-Head & Neck Surgery, The James Cancer Hospital, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Ahmad Alroqi
- Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad Alsaleh
- Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrazag Ajlan
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Hawsawi AH, Bawazir M, Basindwah SA, Alqurashi A, Ajlan A. Modified retrosigmoid extended approach to jugular tubercle meningioma: A video abstract. Surg Neurol Int 2022; 13:289. [PMID: 35855117 PMCID: PMC9282764 DOI: 10.25259/sni_361_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/17/2022] [Indexed: 11/04/2022] Open
Abstract
Background:
Primary jugular fossa meningiomas are one of the rarest subgroups of meningioma, with an estimated incidence of 0.7–4.3% of all skull base meningiomas. Indeed, only 145 cases of jugular foramen meningiomas have been reported in the literature to date. While meningiomas of this region are typically referred to as “jugular foramen meningiomas,” we make a distinction between meningiomas arising directly from the foramen itself, and those arising from the jugular tubercle. Jugular tubercle meningiomas, therefore, represent an even smaller subset of an already uncommon location for meningiomas. The jugular tubercle is the upper surface of the lateral parts of occipital bone presents an oval eminence, which overlies the hypoglossal canal and is sometimes crossed by an oblique groove for the glossopharyngeal, vagus, and accessory nerves. Only eight cases in the anterior foramen magnum lesions excised by a far lateral retrosigmoid approach have been described. The aim of this video article is to describe the surgical approach the senior author used to access lesion involving the jugular tubercle.
Case Description:
In this surgical video, we present a case of a 56-year-old female presented to our hospital with dizziness, headache, lower cranial nerves deficits, and lower limbs weakness. On exam, she was noted to have a left paraparesis, 9th, 10th, and 11th nerves palsies. An MRI scan demonstrated a mass in the region of the left jugular tubercle. Frozen section was suggestive of meningioma and our patient underwent a successful near total resection with no permanent neurologic sequelae.
Conclusion:
Jugular tubercle meningiomas are one of the rarest subgroups of meningioma. The described modified retrosigmoid approach provides outstanding access to the entire ventrolateral brainstem and cerebellopontine angle, with reduced approach related morbidity.
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Affiliation(s)
- Aysha Hamzah Hawsawi
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University,
| | - Minyal Bawazir
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University,
| | - Sarah A. Basindwah
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University,
| | - Ashwag Alqurashi
- Division of Neurosurgery, Department of Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Abdulrazag Ajlan
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University,
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Bardeesi AM, Alqurashi A, Shinawi S, R.Abi Sheffah F, Ajlan A, Binmahfoodh M. Multiple Brown Tumors within the Cranium, in A Patient with Primary Hyperparathyroidism. A Case Report and Review of the Literature. Interdisciplinary Neurosurgery 2022. [DOI: 10.1016/j.inat.2022.101592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Alqurashi A, Baeesa S, Kurdi M, Hussein D, -Juergen Schulten H. Intracranial Meningiomas Developed after Traditional Scalp Thermal Cautery Treatment in Childhood: Clinical Reports and Gene Expression Analysis. Gulf J Oncolog 2022; 1:90-106. [PMID: 35156651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Human skin cautery, a traditional thermal therapy, is traced back to Hippocrates beyond the 5th century. Those ancient healers used this method to control bleeding and infection and remove cancerous tumors. Such traditional procedure is still in practice in several regions of Asia and Africa to treat certain conditions. There is a lack of reports in the literature regarding the long-term complication and the possible tumorigenesis following traditional treatment with thermal cauterization. Here, we report two patients with intracranial meningiomas and investigate the gene expression profile for a patient. Cases presentations: We report two adult patients who presented with a headache and hemiparesis over six months. Brain magnetic resonance imaging (MRI) scans of both patients revealed intracranial meningiomas. During preoperative preparation of the patients, cautery marks were noticed over the scalp region above the intracranial tumors site, which was performed during childhood. The patients underwent uneventful resection of meningiomas with no local recurrence over a 5-year follow up. In addition, we performed a biofunctional genetic microarray expression analysis on the affected meningioma. CONCLUSION There is a lack of evidence-based scientific reports in the literature regarding the long-term complications and tumorigenesis following aggressive treatment with thermal cauterization. Herein, we report the first possible association between previous scalp traditional cautery and the development meningioma in two patients and discuss a proposed causal relationship. However, further advanced studies and research should be done to support, or reject, our hypothesis.
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Affiliation(s)
- Ashwag Alqurashi
- Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saleh Baeesa
- Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maher Kurdi
- Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Deema Hussein
- King Fahd Medical Research Center, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hans -Juergen Schulten
- Center of Excellence in Genomic Medicine Research, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Alqurashi A, Almutairi A, Baeesa S, Alomar S. Management of multiple cervical neurofibromas with myelopathy in neurofibromatosis type 1: A systematic review, case report and technical note. Interdisciplinary Neurosurgery 2021. [DOI: 10.1016/j.inat.2021.101209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Alatar A, Bajunaid K, Alqurashi A, Ajlan A. COVD-12. THE LONGITUDINAL IMPACT OF COVID-19 PANDEMIC ON NEUROSURGICAL PRACTICE. Neuro Oncol 2020. [PMCID: PMC7650349 DOI: 10.1093/neuonc/noaa215.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE This observational cross-sectional multicenter study aimed to evaluate the longitudinal impact of the coronavirus disease 2019 (COVID-19) pandemic on neurosurgical practice. METHODS We included 29 participating neurosurgeons in centers from all geographical regions in the Kingdom of Saudi Arabia. The study period, which was between March 5, 2020 and May 20, 2020, was divided into three equal periods to determine the longitudinal effect of COVID-19 measures on neurosurgical practice over time. RESULTS During the 11-week study period, 474 neurosurgical interventions were performed. The median number of neurosurgical procedures per day was 5.5 (interquartile range [IQR]: 3.5–8). The number of cases declined from 72 in the first week and plateaued at the 30’s range in subsequent weeks. The most and least number of performed procedures were oncology (129 [27.2%]) and functional procedures (6 [1.3%]), respectively. Emergency (Priority 1) cases were more frequent than non-urgent (Priority 4) cases (178 [37.6%] vs. 74 [15.6%], respectively). In our series, there were three positive COVID-19 cases. There was a significant among-period difference in the length of hospital stay, which dropped from a median stay of 7 days (IQR: 4 – 18) to 6 (IQR: 3 - 13) to 5 days (IQR: 2 - 8). There was no significant among-period difference with respect to institution type, complications, or mortality. CONCLUSION Our study demonstrated that the COVID-19 pandemic decreased the number of procedures performed in neurosurgery practice. The load of emergency neurosurgery procedures did not change throughout the three periods, which reflects the need to designate ample resources to cover emergencies. Notably, with strict screening for COVID -19 infections, neurosurgical procedures could be safely performed during the early pandemic phase. We recommend to restart performing neurosurgical procedures once the pandemic gets stabilized to avoid possible post-pandemic health-care system intolerable overload.
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Bajunaid K, Alqurashi A, Alatar A, Alkutbi M, Alzahrani AH, Sabbagh AJ, Alobaid A, Barnawi A, Alferayan AA, Alkhani AM, Salamah AB, Sheikh BY, Alotaibi FE, Alabbas F, Farrash F, Al-Jehani HM, Alhabib H, Alnaami I, Altweijri I, Khoja I, Taha M, Alzahrani M, Bafaquh MS, Binmahfoodh M, Algahtany MA, Al-Rashed S, Raza SM, Elwatidy S, Alomar SA, Al-Issawi W, Khormi YH, Ammar A, Al-Habib A, Baeesa SS, Ajlan A. Neurosurgical Procedures and Safety During the COVID-19 Pandemic: A Case-Control Multicenter Study. World Neurosurg 2020; 143:e179-e187. [PMID: 32702490 PMCID: PMC7370909 DOI: 10.1016/j.wneu.2020.07.093] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 12/20/2022]
Abstract
Objective Quantitative documentation of the effects of outbreaks, including the coronavirus disease 2019 (COVID-19) pandemic, is limited in neurosurgery. Our study aimed to evaluate the effects of the COVID-19 pandemic on neurosurgical practice and to determine whether surgical procedures are associated with increased morbidity and mortality. Methods A multicenter case-control study was conducted, involving patients who underwent neurosurgical intervention in the Kingdom of Saudi Arabia during 2 periods: pre-COVID-19 and during the COVID-19 pandemic. The surgical intervention data evaluated included diagnostic category, case priority, complications, length of hospital stay, and 30-day mortality. Results A total of 850 procedures were included, 36% during COVID-19. The median number of procedures per day was significantly lower during the COVID-19 period (5.5 cases) than during the pre-COVID-19 period (12 cases; P < 0.0001). Complications, length of hospital stay, and 30-day mortality did not differ during the pandemic. In a multivariate analysis comparing both periods, case priority levels 1 (immediate) (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.24–2.67), 1 (1–24 h) (OR, 1.63; 95% CI, 1.10–2.41), and 4 (OR, 0.28; 95% CI, 0.19–0.42) showed significant differences. Conclusions During the early phase of the COVID-19 pandemic, the overall number of neurosurgical procedures declined, but the load of emergency procedures remained the same, thus highlighting the need to allocate sufficient resources for emergencies. More importantly, performing neurosurgical procedures during the pandemic in regions with limited effects of the outbreak on the health care system was safe. Our findings may aid in developing guidelines for acute and long-term care during pandemics in surgical subspecialties.
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Affiliation(s)
- Khalid Bajunaid
- Department of Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia; Department of Neurology and Neurosurgery, Montreal Neurological Institute and hospital, McGill University, Montreal, Quebec, Canada
| | - Ashwag Alqurashi
- Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alatar
- Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Alkutbi
- Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Anas H Alzahrani
- Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulrahman J Sabbagh
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdullah Alobaid
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulwahed Barnawi
- Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | | | - Ahmed M Alkhani
- Division of Neurosurgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ali Bin Salamah
- Department of Neurosurgery, King Saud Medical City, Riyadh, Saudi Arabia
| | - Bassem Yousef Sheikh
- Vascular Endovascular and Skull Base Neurosurgery, College of Medicine, Taibah University, Madinah, Saudi Arabia
| | - Fahad E Alotaibi
- Department of Pediatric Neurosurgery, National Neuroscience institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Faisal Alabbas
- Department of Neurosurgery, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Faisal Farrash
- Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hosam M Al-Jehani
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and hospital, McGill University, Montreal, Quebec, Canada; Department of Neurosurgery, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Husam Alhabib
- Department of Spine Surgery, Dr Sulaiman Alhabib Hospital, Khobar, Saudi Arabia
| | - Ibrahim Alnaami
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ikhlass Altweijri
- Division of Neurosurgery, Department of Surgery, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Isam Khoja
- Department of Neurosurgery, International Medical Center, Jeddah, Saudi Arabia
| | - Mahmoud Taha
- Department of Neurosurgery, King Fahad specialist Hospital, Dammam, Saudi Arabia
| | - Moajeb Alzahrani
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mohammed S Bafaquh
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Binmahfoodh
- Neurosciences Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mubarak Ali Algahtany
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Sabah Al-Rashed
- Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Syed Muhammad Raza
- Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Sherif Elwatidy
- Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Soha A Alomar
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wisam Al-Issawi
- Department of Neurosurgery, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Yahya H Khormi
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ahmad Ammar
- Department of Neurosurgery, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Amro Al-Habib
- Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saleh S Baeesa
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulrazag Ajlan
- Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Alghamdi Y, Farahat A, Alqurashi A, Alburayk A, Alabbasi A. Comorbidities among HIV Adult Patients in King Abdulaziz Medical City, Western Saudi Arabia: 30 Years Retrospective Cohort Study. J Infect Public Health 2019. [DOI: 10.1016/j.jiph.2018.10.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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