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SNI Digital, Innovations and Learning, an association with the Hose Neurosurgery Lab and Baghdad Iraq are pleased to present. The 22nd SNI and SNI Digital Baghdad Neurosurgery Online Meeting held
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on March 23, 2024, the meeting originator and coordinator of Sammer Hose of the Universities of Baghdad and Cincinnati.
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The subject of this meeting is Pediatric Neurosurgery, Global Pediatric Neurosurgery Experience and Cases from Argentina, Iraq and Nicaragua. The meeting organizer and moderator is Jorge Lassruff,
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Emeritus Professor Pediatric
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Neurosurgery at the UCLA Medical Center in Los Angeles, California.
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This talk is on myositis ossificans and hydrocephalus, how I treated it by Juan Bosco Gonzales-Torres, he was in pediatric neurosurgery at the Children's Hospital in the hospital, Bautista, in
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Monagra, Nicaragua. And talking about myositis ossificans, hydrocephalo is a very strange relationship
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I did not find
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many information about this topic, this relationship. This case was a real challenge for me. This reason I bring all of you and share my experience.
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Okay, this is a 13 years old female passing with an economic model and Portuguese father and when she, she had seven years of age, was made the diagnosis of myocytus Pacificans
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problems it And this was a consequence of a trauma in the shoulder, the right shoulder. After this trauma injury, the person can move this arm So, the meositus Pacificans has a very low incidence,
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a very low prevalence, is very, very strange. So, in Nicaragua, noise, noise so, no it's common, this pathology. But, Tengi, 100 years ago, was
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made the first classification about the meosit Pacifican problem. but actually I think the most useful specification is this. The third type, the one type is first time is the prerequisite or
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synonymus fibrotid plasius or significance prerequisite. The second time is the post-traumatic and the third is the aftermath type. So the genetic has show it the way for the training So actually
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the training, you know, is a curate. It's just an alternative palliative for a stop the globe in the calcification parts. Talking about this case, this passing in 2022,
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suddenly after a mild trauma
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present headache for three days growing as a shadow with vomiting was the emergency room in 10 points of Glasgow Common Scale. So the first CT scan was made, showing an obstructive either cephalous.
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I talk about the parents about the risk with the, about the two option bifishan or ETV. We decide for ETV for many reasons So the clinical resolution was excellent. The person returned to home in
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five points, Glasgow Conscale. So to class everything was okay, but three months later to the emergency room again with the interactional hypertension. So a new CT scan showed an active either
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cephalous in, in, in, I thought the, uh, deos to me. very, very fast. So, for this reason, I decided to put a BPHM. I told with the parents, everything agreed. So, but, um, Oh.
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Um, after, um, two days after, um, placement, the, the vision, the person say, I have pain pain in abdominal area, um, I decided review and going to operation room to check this area Um,
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but I saw the liquid was contained in the abdominal area. So the vision though, though, is doesn't work. I take it a sample of this liquid. Um, and German grow. For this reason, I put an
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external system
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But she received training with antibiotic for two weeks. The revolution was good. The CBC
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was good. And I decided to close the external drain and make a new
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ETB bed. But when I closed for two or three days, the external drain, the passing improved. And
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I did a new CT scan. The CT scan was good. So I observed for a
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few days in the hospital And she was discharged to home, but she returned later, four months later, again,
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with the intracranial importation. So in this case, I decided to do the new CTB, the
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second ETB So,
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you can see
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the new membrane under the pre-mambular membrane, like close it, that the first ostomy. But in this second BTV,
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no, no,
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no. Everything was good, relatively easy. Just the particularly, as you can see the, this new membrane, but
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the second BTV was working. This is a view to the final second BTV was opened. And actually, this passion has maybe 16 months after the second NTV and now she's okay. So in conclusion,
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This pathology showed a rejection to the BP shown, so in my opinion it's very hard trying to get a good conclusion. But in my experience with
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this case, the first option will be the ETV.
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Thank you Thank you.
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One of your colleagues, Dr. Salado Perez, is asking whether the Ayrocephalus was secondary to an obstruction on the level of the bone obstruction on the level of the skull base, you know But
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because,
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but you can ask answering directly about that. No, it's a, it's an interesting case. And again, so the, why do you agree with the. failure of the first ETD
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failure of the option? Yeah, I think
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there is a relationship between the
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myosites with the new membrane in the pre-mammular area, because it was very fast, the closer and the first ETD. I think this is the problem in this passing with the myosites, because they have a
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capacity of game calcification in many areas. I've seen this was the reason.
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I see. And how long since the last, since the last surgery, how many months? 16th.
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I was gonna be my question, Hori. What's the relationship between hydrocephalus and myosophis, myositis, myosophicans? And the
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one I use.
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you're suggesting there's some coagulation or some collagen disorder with this or something?
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I'm sorry, Professor? I was trying, it's a case of a relationship of hydrocephalus with another disease myositisosificand which is genetic disease. And does the myositis have anything to do with
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the hydrocephalus or could it have occurred incidentally? Yeah, the person has had a little trauma a little head trauma playing in the garden. I think it was a neurodevelopmental hemorrhage. Okay,
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how do you understand my point is this? What's the relationship to this genetic disease? I'm
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not sure that's clear to me Yeah, I mean, the question again, what is. Correlation and it a causation is there is there is the cause of I don't suffer those related to the myositis Ocificantis or
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just inside the coincidence that she had anything and she had this sabbadah in hemorrhage I I I wonder if that so called failure of the first it would be whether has something to do with the old
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Pathology of the of the patient no
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Yeah
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Yeah See I had a correlation in Kuala Lumpur, I think also the law Was the was the cause of the of the correlation between the one disease and the other Yeah, it's it's very
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hard to say there is a relationship in between in to the of two diseases. It's very hard to say. there is a relationship, maybe was a coincidence, because the passing has a little frown, but it's
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very hard to say. Okay, is there any literature where they report my acificans and it is associated with hydrocephalus in the literature, I don't, I've never seen a case. No, I never seen a case
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either Yeah, yeah, me too, I never, I never find many information about this relationship was very hard to find information.
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I would say how many of your cases of
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external of ETV, of endoscopic third ventricular stomach are you need to go back again in such a small time? I just wondering if the so-called failure of the first and the need for the second may
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have been related to the pathology of the child. I mean, what's your success rate with your ETVs, 90
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percent one?
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And in another case, with ETV,
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is enough, just one.
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That's, that's it's a problem saying. Maybe the association that you and experienced surgeons in ETVs, you don't have a return, maybe somehow is related to your, to the ossificantis, you know.
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Anyway, it's a subject that I will start inquiring now as we are. Absolutely. And thank you very much, one and then say good presentations. We hope you enjoyed these presentations.
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