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1. Post-thoracotomy paraplegia after oxidized cellulose spinal compression

Author

Da Jun Than, Vinodh Vayara Perumall, Syamim Johan, Xin Leh Lee, Khasnizal Abd Karim, and Firdaus Hayati

Subjects
Hemostasis, Iatrogenic disease, Paraplegia, Thoracotomy, Cellulose, oxidized, Spinal cord compression, Medicine
Abstract

ABSTRACT Post-thoracotomy paraplegia after non-aortic surgery is an extremely uncommon complication. A 56-year-old woman presented with a 1-year history of progressive shortness of breath. Computed tomography revealed a locally advanced posterior mediastinal mass involving the ribs and the left neural foramina. Tumor excision with a left pneumonectomy was performed. Post-resection, bleeding was noted in the vicinity of the T4-T5 vertebral body, and the bleeding point was packed with oxidized cellulose gauze (Surgicel®). Postoperatively, the patient complained of bilateral leg numbness extending up to the T5 level, with bilateral paraplegia. An urgent laminectomy was performed, and we noted that the spinal cord was compressed by two masses of Surgicel® with blood clots measuring 1.5 × 1.5cm at T4 and T5 levels. The paraplegia did not improve despite the removal of the mass, sufficient decompression, and aggressive postoperative physiotherapy. Surgeons operating in fields close to the intervertebral foramen should be aware of the possible threat to the adjacent spinal canal as helpful hemostatic agents can become a preventable threat.

Published
2023
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3. Risk Prediction of Cerebral Infarction after Anterior Circulation Aneurysm Rupture in an Under-Equipped Centre.

Author

VINODH, Vayara Perumall, GHANI, Abdul Rahman Izaini, KANDASAMY, Regunath, SELLAMUTHU, Pulivendhan, ZENIAN, Mohd Sofan, and KEOWMANI, Thamron

Subjects
*INTRACRANIAL aneurysm surgery, *SURGICAL instruments, *HEALTH facilities, *CEREBRAL infarction, *IDENTIFICATION, *MULTIVARIATE analysis, *PATIENTS, *DESCRIPTIVE statistics, *PREDICTION models, *SENSITIVITY & specificity (Statistics), *RECEIVER operating characteristic curves, *LOGISTIC regression analysis, *EARLY medical intervention, *INTRACRANIAL aneurysms, *DISEASE risk factors, *DISEASE complications
Abstract

Background: Morbidity and mortality is high among aneurysm rupture patients. Despite surviving the initial rupture, morbidity is high as they suffer from vasospasm and cerebral infarction (CI). Most prediction tools for CI after aneurysmal subarachnoid haemorrhage (SAH) are complex and are not routinely available in all neurosurgical centres. Current therapies for prevention of CI are still debatable and selective usage among high-risk patients is advised. These factors necessitate a simple prediction model for identifying patients in the high risk group to initiate early preventive treatment of CI. Methods: Patients with anterior circulation aneurysm rupture who underwent surgical clipping were included. Demographic data and factors related to CI were collected to determine significance and were used to develop VINODH score (VS). Results: Two hundred patients were included with a median age of 51 years old. Multivariate analysis proved only four predictors were significant (P < 0.01) for developing CI. These predictors were used for the development of VS which was named after the main author and the model's sensitivity was 79.0% and specificity was 83.0%. This highly predictive score (receiver operating characteristic [ROC]: 0.902) was internally validated. Conclusion: VS is a reliable tool for early identification of patients at risk of CI after aneurysmal SAH. [ABSTRACT FROM AUTHOR]

Published
2022
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4. Global Perspectives on Task Shifting and Task Sharing in Neurosurgery

Author

Robertson, Faith C., primary, Esene, Ignatius N., additional, Kolias, Angelos G., additional, Khan, Tariq, additional, Rosseau, Gail, additional, Gormley, William B., additional, Park, Kee B., additional, Broekman, Marike L.D., additional, Rosenfeld, Jeffrey, additional, Balak, Naci, additional, Ammar, Ahmed, additional, Tisel, Magnus, additional, Haglund, Michael, additional, Smith, Timothy, additional, Mendez, Ivar, additional, Brennum, Jannick, additional, Honeybul, Stephen, additional, Matsumara, Akira, additional, Muneza, Severien, additional, Rubiano, Andres, additional, Kamalo, Patrick, additional, Fieggen, Graham, additional, Misra, Basant, additional, Bolles, Gene, additional, Adelson, David, additional, Dempsey, Robert, additional, Hutchinson, Peter, additional, Nikova, Alexandrina, additional, Ghazala, Osama, additional, Buno, Elubabor, additional, Bhattacharjee, Shibashish, additional, Iizuka, Takahiro, additional, Abdullah, Jafri Malin, additional, Chaurasia, Bipin, additional, Morgan, Eghosa, additional, Alcedo-Guardia, Rodolfo E., additional, Lucena, Lynne Lourdes N., additional, Oktay, Kadir, additional, AbdAllah, Omar Ibrahim, additional, Saihi, Ahlem, additional, Abdeldjalil, Gacem, additional, Asmaa, Mahi, additional, Yampolsky, Claudio, additional, Saladino, Laura P., additional, Mannara, Francisco, additional, Sachdev, Sonal, additional, Price, Benjamin, additional, Joris, Vincent, additional, Adeniran Bankole, Nourou Dine, additional, Carrasco, Edgar M., additional, Hodzic, Mirsad, additional, de Sousa Porto, Marcos Wagner, additional, Amorim, Robson, additional, Maldonado, Igor Lima, additional, Yves, Bizoza, additional, Suarez, Gonzalo, additional, Constanzo, Felipe, additional, Valdeblanquez Atencio, Johanna Cecilia, additional, Ruiz Mora, Karen Alexa, additional, Rodriguez Gil, Juan Manuel, additional, Paraskeva, Kiriakos, additional, Egemen, Emrah, additional, Ngamasata, Trevcsor, additional, Ntalaja, Jeff, additional, Beltchika, Antoine, additional, Ntsambi, Glennie, additional, Dunia, Goertz Mirenge, additional, Taha, Mahmoud M., additional, Arnaout, Mohamed, additional, Kirollos, Ramez, additional, Kassem, Mohamed, additional, Elwardany, Omar, additional, Negida, Ahmed, additional, Dolango, Birhanu, additional, Aseged, Mikael, additional, Mldie, Alemu Adise, additional, Laeke, Tsegazeab, additional, Aklilu, Abenezer, additional, Adefris, Esayas, additional, Luoto, Teemu, additional, Behnam, Rezai Jahromi, additional, De Schlichting, Emmanuel, additional, Nassim, Bougaci, additional, Bourdillon, Pierre, additional, Stienen, Martin N., additional, Lackermair, Stephan, additional, Schmidt, Franziska Anna, additional, Konczalla, Juergen, additional, Holzgreve, Adrien, additional, Sagerer, Andre, additional, Weinert, Dieter M., additional, Kumi, Paulette, additional, McLean, Aaron Lawson, additional, Loan, James, additional, Cahill, Julian, additional, Dockrell, Simon, additional, Afshari, Fardad T., additional, May, Paul, additional, Athanasiou, Alkinoos, additional, Papadopoulos, Steven, additional, Espinoza, Edroulfo-Georgios, additional, Chatzisotiriou, Athanasios, additional, Vlachogiannis, Pavlos, additional, Karabatsou, Konstantina, additional, Paschalis, Thanasis, additional, Tsitsipanis, Christos, additional, Longo Calderan, Gabriel Mauricio, additional, Leiva, Ronny, additional, Deora, Harsh, additional, Mukkamala, Sreenivas, additional, Batra, Dipesh, additional, Sukumaran, Arvind, additional, Parmar, Kanishk, additional, Bahl, Anuj, additional, Agrawal, Amit, additional, Dev, Nirankar, additional, Thakur, Nikhil, additional, Behari, Sanjay, additional, Yandrapati, Chandrasekhar B.V.K., additional, Bhoot, Ritesh, additional, Bhatt, Pragnesh, additional, Bhaumik, Uday, additional, Agrawal, Manish, additional, Thomas, Antony, additional, Chandrappa, Harish, additional, Mathur, Ankit, additional, Wahjoepramono, Petra, additional, Oswari, Selfy, additional, Al-Mahfoudh, Rafid, additional, Alnaji, Abbas, additional, Abuhadrous, Nidal, additional, Jarad, Bakr Abo, additional, Nour, Ibrahim, additional, Cohen-Inbar, Or, additional, Colasanti, Roberto, additional, Conti, Alfredo, additional, Raffa, Giovanni, additional, Castrioto, Corrado, additional, Baccanelli, Matteo M., additional, Tomasi, Santino Ottavio, additional, Zoli, Matteo, additional, Veroni, Andrea, additional, Di Cristofori, Andrea, additional, Giannachi, Luigi, additional, Lippa, Laura, additional, Sgubin, Donatella, additional, Broggi, Morgan, additional, Barbato, Marcello, additional, Restelli, Francesco, additional, Ganau, Mario, additional, Taddei, Graziano, additional, Albadawi, Hamzeh, additional, Salameh, Mohammed, additional, Gulmira, Madieyva, additional, Lashhab, Muffaq, additional, El Gaddafi, Walid, additional, Altoumi, Mohammad, additional, Manvinder, S.M., additional, Kanesen, Davendran, additional, Teo, Mario, additional, Sriram, Prabu Rau, additional, Zamri, Sarah Atiqah M., additional, Vinodh, Vayara Perumall, additional, Denou, Moussa, additional, Melhaoui, Adyl, additional, Outani, Oumaima, additional, Boutarbouch, Mahjouba, additional, Gretschel, Armin, additional, Yadav, Pradhumna, additional, Karmacharya, Balgopal, additional, Incekara, Fatih, additional, Boogert, Hugo den, additional, Lopez, Buccket Argvoello, additional, Amadou, Hassane Ali, additional, Sale, Danjuma, additional, Bello, Sanusi, additional, Edward, Poluyi, additional, Ukachukwu, Alvan-Emeka, additional, Nwaribe, Evaristus, additional, Aniaku, Ikechukwu, additional, Ndajiwo, Aliyu Baba, additional, Ayodele, Olabamidele, additional, Bot, Gyang Markus, additional, Ndubuisu Achebe, Sunday David, additional, Jamal, Bakht, additional, Tariq, Muhammad, additional, Farooq, Ghulam, additional, Khan, Danyal Zaman, additional, Khizar, Ahtesham, additional, Hussain, Zahid, additional, Nazir, Anisa, additional, Gonzales-Portillo, Marco, additional, Bautista, Jhosep Silvestre, additional, Torres, Roland A., additional, Javier-Lizan, Abigail, additional, de los Santos, Isagani Jodl G., additional, Morais, Nuno, additional, Dias, Lydia, additional, Noronha, Carolina, additional, Silva, Jovelo Monteiro, additional, Seromenho-Santos, Alexandra, additional, Lozanche, Kiril, additional, Negoi, Ionut, additional, Tascu, Alexandru, additional, Kozyrev, Danil A., additional, Nkeshimana, Menelas, additional, Karekezi, Claire, additional, Ndayishyigikiye, Marcel Didier, additional, Alabbass, Faisal, additional, Farrash, Faisal, additional, Alhazmi, Rawan, additional, Golubovic, Jagos, additional, Lepifá, Milan, additional, Ilifá, Rosanda, additional, Stanimirovifá, Aleksandar, additional, Garcia-Garcia, Sergio, additional, Rodriguez Arias, Carlos A., additional, Lau, Ruth, additional, Delgado-Fernandez, Juan, additional, Arraez, Miguel A., additional, Mateos, C. Fernandez, additional, Castano Leon, Ana M., additional, Wadanamby, Saman, additional, Bervini, David, additional, Shabani, Hamisi K., additional, Limpastan, Kriengsak, additional, Ayadi, Khalil, additional, Sencer, Altay, additional, Yalcinkaya, Ali, additional, Eren, Elif, additional, Basaran, Recep, additional, Gokoglu, Abdulkerim, additional, Mykola, Vyval, additional, Tayong, Felicita, additional, Zuccarello, Mario, additional, Quinsey, Carolyn, additional, Dewan, Michael C., additional, Young, Paul H., additional, Laws, Edward, additional, Rock, Jack, additional, Kurland, David B., additional, Muh, Carrie R., additional, Delgado Aguilar, Eri Dario, additional, Burns, Kenneth, additional, Low, Jacob, additional, Keogh, Conor, additional, Uff, Chris, additional, Spina, Alfio, additional, and Alelyani, Fayez, additional

Published
2020
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5. Alveolar soft part sarcoma with brain metastases

Author

Rahmat Harun, Pulivendhan Sellamuthu, Mohd Shariman Md Shah, and Vinodh Vayara Perumall

Subjects
medicine.medical_specialty, medicine.medical_treatment, Brain tumor, central nervous system neoplasm, Case Report, Malignancy, Metastasis, 03 medical and health sciences, 0302 clinical medicine, combined therapy, Metastatic Alveolar Soft Part Sarcoma, Alveolar soft part sarcoma, brain metastases, medicine, Craniotomy, business.industry, General Medicine, medicine.disease, Primary tumor, tumor recurrence, 030220 oncology & carcinogenesis, Sarcoma, Radiology, business, 030217 neurology & neurosurgery
Abstract

Metastatic tumors are the most common mass lesions in the brain. This case reports a rare form of sarcoma with metastasis to the brain. The appropriate management of a patient with metastatic alveolar soft part sarcoma to the brain is discussed. Author describes a 32-year-old gentleman diagnosed with primary tumor at gluteus and distant metastases at lower lobe of right lung and the brain. Histopathology proves diagnosis as alveolar soft part sarcoma. Craniotomy with excision of brain lesion was done. Repeated magnetic resonance imaging of the brain after 2 months showed rapidly growing new lesions. The next step of management was made by the oncology team as recurrence rate was high and due to multi-systemic involvement. Patient was planned for palliative chemotherapy and to be reassessed later. This case report discusses the appropriate approach to any form of brain metastases and the role of early follow-up especially after surgery for better outcome and choice of post operative management such as radiotherapy or chemotherapy or both for malignant tumors. Based on this report, it was concluded that every brain tumor patient should be frequently monitored even in the outpatient setting as most of them are metastatic and rapidly spreading. The patient should be considered for radiotherapy or chemotherapy or both after surgery if the histopathology result is suggestive of malignancy.

Published
2017

6. Neurosurgical Dilemmas During the Emergence of Covid-19 in Sabah, Malaysia.

Author

Vinodh, Vayara Perumall and Sellamuth, Pulivendhan

Subjects
*NEUROSURGEONS, *AMBULATORY surgery, *COVID-19 pandemic, *COVID-19, *BLOOD products, *INTENSIVE care units, *DILEMMA
Abstract

Neurosurgeons in Sabah were in a dilemma when Covid-19 became a pandemic and manpower was diverted into becoming front-liners at screening centers. Careful screening was introduced for cases requiring admission to the ward. We labelled our patients who are going for surgery into high and low risk categories. Level 3 PPE was used for high risk cases only. Emergency and semi emergency cases were continued with careful consideration. Elective cases were postponed based on the idea that we don't clog up the intensive care unit(ICU) beds and ventilators which might be needed for ill Covid-19 patients or avoidable usage of blood products which are in acute shortage during this pandemic. All outpatient clinic cases were screened by neurosurgeons and only those awaiting surgeries or those recently discharged home after major procedures were seen while others were managed via tele-medicine. Staff were divided to ensure that if someone becomes a positive contact, then it is easier to quarantine them. We believe that this is the first neurosurgery related article to the management of patient care during this pandemic in eastern Borneo and the approach we have taken can serve as a guide to most neurosurgeons during this unexpected time of Covid-19 pandemic. [ABSTRACT FROM AUTHOR]

Published
2022
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7. Smartphones in remote medicine and daily neurosurgery: The Sabah update

Author

Vinodh Vayara Perumall, Mohd Sofan Zenian, Rahmat Harun, and Pulivendhan Sellamuthu

Subjects
Service (systems architecture), medicine.medical_specialty, Telemedicine, Referral, remote medicine, business.industry, Neurosurgery in Sabah, teleconsultation, General Medicine, medicine.disease, smartphones, Telephone consultation, Health care, medicine, Original Article, telemedicine, Medical emergency, Communication source, Instant messaging, Neurosurgery, business, Simulation
Abstract

Introduction: Healthcare costs continue to rise every day as the demand outgrows the supply of surgeons. The application of telephone consultation for immediate management is needed as most neurosurgeons are technology orientated. This enables a specialist at a remote mobile site to receive the necessary information and reduce transmission time, from the second the patient is seen till the management is obtained. Materials and Methods: We conducted a survey on smartphone ownership among doctors and gathered cases that needed neurosurgical input from 1 st November 2012 till 30 th April 2013 from all 24 district hospitals in Sabah, Malaysia. Results: The percentage of smartphone ownership among doctors surveyed and usage of it for remote and daily medicine at various departments at Queen Elizabeth Hospital, Kota Kinabalu, which shows at least 90% smartphone ownership and proves 100% ownership of cross-platform instant messaging applications and its usage for remote and daily medicine. It also proves to be a more popular mode of referral compared to "teleconsultation" (TC). Discussion: In Sabah, the TC service is used for remote medical consultation and only available at four hospitals. The sender needs direct access to a computer with the TC software, and it causes delay whereas doctors using smartphones will just need to discuss the case on the spot and obtain the appropriate management within minutes. Smartphone usage is also important in daily neurosurgery especially at the department level to promote efficient communication, organization, and interaction between all the staff. As for the department's administrative sector, it is useful to notify if anyone is on leave, attending courses or even meetings as the shortage can be avoided, and redistribution easily done. It also allows us to transfer simple intra-departmental data at any time, and any place whenever required. Conclusion: With all the given fact, it is clear that a day without utilizing this service in our daily life will leave us handicapped and struggling with time and resources.

Published
2015

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