Browsing by Author "Seddeg, Yasser"

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    Headache Associated with Chiari Malformation Type One
    (2020-08-20) Seddeg, Yasser; Awad, Ali; Osman, Haytham
    Background: Patients with chiari malformation type one ( CM -1 ) headache may be mistaken by chronic migraines or other causes of headache, so analysis of headache related to CM-1 is corner stone in early diagnosis of the disease. Objective: The purpose of this study was to assess the frequency and clinical characteristics of headache in the patients with CM-1 to help primary care clinicians better understand the relationship between an individual's presenting symptoms of CM 1, so aiding for early diagnosis and early management and for better outcome. Methods: This was prospective observational analytical study carried out in Khartoum state hospitals that provide neurosurgical services, (NCNS, Neurospine Center-Ribat Teaching Hospital, Military Hospital, and Omdurman Teaching Hospital) from February 2018- September 2019. Study was included 18 adult males and females of different ages diagnosed with Chiari MF -1 who undergoing decompressive surgery. Symptomatic patients diagnosed with Chiari MF -1Patients with no history of neurological illnesses or history of cranial surgery were included. Patients with history of any neurological diseases such as multiple sclerosis and with other causes of headache were excluded from the study. Evaluation and full analysis of headache were registered including type of headache, site, duration headache, time lasting, radiation of pain, severity using headache scale, associated ocular and visual symptoms. Results: This study included 18 patients diagnosed with chiari 1 malformation and suffering from headache related to chiari 1 malformation. Full analysis of the headache was obtained. The headache was mostly in the back of the head (n=17/18 , 94.4%) and only in (n=1/18, 5.6%), the headache was in the sides or front of the head. In 12 patients (n=12/18 , 66.7%) headache worsen by bending forward. And in 6 patients (n=6/18 , 33.3%) worsen by cough. Regarding the type of headache, mostly pressure in nature (n=17/18 , 94.4%) and it was rarely throbbing in nature(n=1/18, 5.6%),. All patients were asked to evaluate their headache in headache scale from 1 to 10 (10 more severe). The scale ranged between 5 and 9 with mean 6.88. headache could be long or short lasting (from hours to days).Eye symptoms included blurring of vision complained by 9 patients(n=9/18, 50%), light sensitivity in 5 patients ((n=5/18, 27.8%), and 6 patients (n=6/18 , 33.3%) there were no eye symptoms. Neck pain was a dominant symptom seen in 17 patients (n=17/18, 94.4%) , and back pain in 18 patients (n=18/18 , 100%) . headache subsided after decompression surgery in all patients included in this study. Conclusion: Knowledge and understanding the CM-1 headache characters are important for early diagnosis and early treatment of the disease.
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    Incidence of Carotico-clinoid Foramen and Interclinoid Osseous Bridge in Dry Human Skulls in Sudan_ Neurosurgical Interest
    (2020-06-17) Seddeg, Yasser; Elbadawi, Kamalelden
    Background: Anterior clinoid process is usually drilled in order to approach cavernous sinus and related structures in neurosurgical operations. The presence of carotico-clinoid foramen and interclinoid osseous bridge create difficulties while approaching anterior clinoid process and increases the risks of injury to the internal carotid artery and nearby structures. Aim: To observe incidence, anatomy of carotico-clinoid foramen and interclinoid osseous bridge in the Sudanese dry skulls. Methods: This was a cross sectional study, conducted in the departments of anatomy in different medical schools in Sudan between the period from June 2019 to January 2020. Total 30 dry adult human skulls were examined to observe incidence of carotico-clinoid foramen and of interclinoid osseous bridge. Result: The incidence of carotico-clinoid foramen was 13.3% (4 skulls out of 30). The foramen was bilaterally present in one skull (n=1/30, 3.3%) and unilateral in 3 skulls (n=3/30, 10%). Type I bridge is the carotico-clinoid foramen itself, the Type II interclinoid osseous bridge was found in one skull (n=1/30, 3.3%) , no Type III and Type IV bridges were observed in the present study. Conclusion: the presence of this foramen and interclinoid osseous bridge can complicate neurosurgical operations in cavernous sinus, sellar and para-sellar regions. Therefore, the detailed anatomical knowledge is very important to decrease complications and to increase success rates of neurosurgical operations in this area.