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M S Eljamel

Publications and source records attributed to M S Eljamel.

12 recordsLinked to original sources
PubMed1992

The use of a computer-based image link system to assist inter-hospital referrals.

Early CT scanning leads to the early diagnosis and referral of intracranial lesions, particularly in head injuries. Such early scanning is more feasible with the advent of CT scanners in most peripheral hospitals. However, the neurosurgical service in most countries remains regional with limited bed capacity and involves a potentially hazardous inter-hospital transfer of critically ill patients. We investigated the value and reliability of new information technology in the management of emergency neurosurgical referrals in the Mersey region. One hundred and ninety-nine emergency referrals were studied. In 147 referrals the patient was scanned in the referring hospital and the images were transmitted immediately to the neurosurgical unit. Of these, 51 (34.7%) patients were transferred immediately, 14 (9.5%) the following day and 11 (7.5%) electively. Of those patients who were transferred immediately, 48 (94.1%) underwent emergency surgery. Seventy-one (48.3%) patients were not transferred due to diffuse head injury (40), a cerebral infarct (15), poor grade subarachnoid haemorrhage (10) and normal scans (6). Another 52 patients were transferred to the unit without image transfer, of whom 12 (23.1%) underwent emergency surgery, 17 (32.7%) went back to the referring hospital within 24 h, 17 (32.7%) were electively operated and six (11.5%) died. Comparison of 100 original CT scan films with the corresponding transmitted images showed no significant difference in the quality of the image, diagnosis or clinical decision. Image transfer together with the clinical history has reduced potentially hazardous inter-hospital transfer of patients (p < 0.001). It is reliable, fast, cheap and leads to considerable economic savings.

Adolescent↗
PubMed1991

Non-traumatic CSF fistulae: clinical history and management.

Non-traumatic 'spontaneous' CSF fistulae are uncommon. The clinical features of 23 patients treated for non-traumatic CSF fistulae are presented. Twenty of these patients had normal CSF pressure and six developed meningitis. Surgical repair of these fistulae is recommended in order to reduce the risk of meningitis. For this their localization is essential.

Adolescent↗
PubMed1990

Dissection of the cervical internal carotid artery. The role of Doppler/Duplex studies and conservative management.

Cervical internal carotid dissection is not rare. Doppler ultrasound screening of young patients presenting with stroke, identified 10 patients with reduced common and internal carotid blood flow without any evidence of atheroma. Eight, on angiography proved to have a dissection of the cervical internal carotid artery. All were managed conservatively. Seven received anticoagulant therapy, stopping any further neurological symptoms.

Adolescent↗
PubMed1990

Acute traumatic CSF fistulae: the risk of intracranial infection.

The management of acute traumatic cerebrospinal fluid (CSF) fistulae is still a matter of debate and hinges about what is perceived to be the risk of subsequent intracranial infection. We have therefore carried out a retrospective analysis of 160 cases of traumatic CSF leaks to assess the incidence, cumulative risk and prognosis of intracranial infection. The overall incidence of meningitis in this group before surgical dural repair was 30.6% (49/160), the cumulative risk exceeded 85% at 10 years follow-up and the meningitis was fatal in 4.1% (2/49). The recurrence of CSF leakage after initial spontaneous cessation was 7% and meningitis was recurrent in 30.6% (15/49). Prophylactic antibiotics had reduced the risk of meningitis from 61 to 34%. The commonest pathogen was pneumococcus and the CSF leakage had stopped within 7 days in 60% of those who developed meningitis and in 50% of those who did not develop meningitis. Meningitis is still a serious complication of post-traumatic CSF fistulae and is potentially fatal despite modern therapeutic agents.

Adolescent↗
PubMed1990

Post-traumatic CSF fistulae, the case for surgical repair.

The management of acute post-traumatic CSF fistulae is still a matter of controversy. A long-term analysis of 160 patients with acute post-traumatic non-iatrogenic dural fistulae was undertaken to establish the value of surgical dural repair. One hundred and forty-nine patients underwent dural repairs following traumatic CSF rhinorrhoea. The risk of meningitis following surgical dural repair was 4%. The operative mortality was 1.3% (2/151), as was the negative exploration rate. The first dural repair was successful in 90% and a second dural repair was required in 10%. These results are in favour of surgical dural repair which can be undertaken with a low morbidity and mortality and is highly successful in preventing meningitis following traumatic CSF rhinorrhoea.

Adolescent↗
PubMed1989

Multiple meningiomas and their relation to neurofibromatosis. Review of the literature and report of seven cases.

A review of 158 cases of multiple meningiomas reported in the literature and 7 additional cases are presented. The average incidence of multiple meningiomas is 2.5% of all meningiomas. In the absence of cutaneous manifestations of von Recklinghausen's disease, it is extremely difficult to distinguish between cases associated with central neurofibromatosis and those representing true multiple meningiomas. There are no specific pathognomonic features that distinguish true multiple meningiomas as a separate disease entity.

Adult↗