Large bilobbed MCA bifurcation aneurysm operated by us at Ivy hospital with good outcome

  A 45 year old lady presented to our emergency  with complaints of headache  followed by loss of consciousness  . CT head revealed SAH with large  haematoma  in temoropaietal region. CT Angiography  revealed large bilobbed aneurysm  at MCA bifucation  on right side. Patient  was operated via right Forto-temporoparital craniotomy with clipping of aneurysm  and removal of haematoma. Pt was discharged  without any deficit

Fig. 1 . CT HEAD SHOWING SAH WITH HAEMATOMA

FIG. 2,3. ANGIOGRAM SHOWING LARGE BILOBBED  MCA BIFURCATION ANEURYSM . 

FIG 4 POST OP CT OF THE PT.

PIC 5 PT AT FOLLOW UP.

Large wide necked MCA BIFURCATION ANEURYSM operated by us at ivy hospital mohali chandigarh punjab with good outcome

A 70 year old female presented to us with sudden onset severe headache followed by loss of consiousness. CT angio brain revealed large aneurysm at MCA bifurcation left side and small aneurysm at M2-m3 junction distal  to it. Patient underwent leftpterional craniotomy with clipping of aneurysm. 
CT ANGIO BRAIN SHOWING LARGE ANEURYSM AT MCA BIFURCATION LEFT SIDE WITH SMALLER ANEURYSM DISTAL TO IT AT M2-M3 JUNCTION. IMAGES 12 34

Images 5 and 6 post op ct

Picture 7 patient just before discharge.
POST OP CT

Large Acoustic Schwannoma operated by Dr Vineet Saggar Neurosurgeon mohali chandigarh punjab

A 55 yrs female presented to us with complaints of headache right sided hearing loss and Ataxia. Clinical examination  revealed rt sided senosineural hearing loss with mild facial wakes lmn type and decreased  gag reflex on right side. Crebellar signs were more pronounced on rt side. MRI revealed large CP angle mass on right side compressing  brain stem . Patient underwent  right Retro mastoid Suboccipital craniotomy with complete removal of mass with preservation  of facial nerve  function.

MRI showing right CP angle mass.
CT showing complete  removal of mass.

Rare intra orbital tumour operated via supra orbital craniotomy approach. Chandigarh, mohali, punjab

A 50 year old man presented in our opd with complaints of proptosis and gradually progressive visual loss with restricted ocular movements. MRI of orbit revealed extraconal mass with inferior displacement of superior rectus and superior oblique muscles . Patient underwent supra orbital craniotomy with removal of orbital tumour and vision  and exatraocular movements were preserved along with improvement in ptosis. 

MRI IMAGES SHOWING EXTRACONAL MASS WITH INFERIOR DISPLACEMENT OF SUPERIOR RECTI AND SUP OBLIQUE MUSCLES.

Postoperative picture of the pt showing recovered ptosis and preserved extraocular movements. 

Postoperative CT showing reconstruction of supra orbital rim with plates and screws.

TRANSSPHENOIDAL REMOVAL OF PITUTARY MACRO ADENOMA

A 60 year old female presented to us gradually progressive visual loss.  MRI brain with sellar cuts revealed large pituitary macro adenoma with suprasellar extension compressing chiasma. Patient underwent neartotal removal of macro adenoma via transphenodal  route.
1.MRI BRAIN SHOWING LARGE MACRO ADENOMA WITH SUPRASELLAR EXTENSION.
2.POST OPERATIVE CT SCAN SHOWING  NEARTOTAL REMOVAL OF TUMOUR

Rare vertebral artery - pica jn aneurysm operated by us at ivy hospital mohali with good outcome

A 50 year old female presented to us with sudden onset severe headache followed by loss of consiousness. CT head revealed haematoma in left cerebello-pontine angle. CT angio brain revealed large aneurysm at junction of left vertebral artery - pica jn. Aneurysm was operated successfully via far lateral approach at ivy mohali with good outcome .
1 CT angio brain showing aneurysm at left vertebral artery -pica jn.
2. Post operative CT head showing aneurysm clip in left cp angle.

Rare orbital tumour

RARE M2-M3 JUNCTION ANEURYSM OPERATED AT IVY HOSPITAL MOHALI BY DR VINEET SAGGAR

Most of the aneurysms occur at the bifurcation  of major vessels as we all know.  MCA aneurysms  generally  occur at bifurcation  of  MCA (MIDDLE CEREBRAL ARTERY) . However  this aneurysm was at further branching  of frontal division of MCA at M2-M3 junction and supplying frontal lobe  . It posed a different  challenges  as aneurysm  was embedded in frontal lobe paren chyma . Also vessels beyond bifurcation are very delicate and frontal and temporal trunks generally  trifurcate or more hence aneurysm  is surrounded by multiple  delicate 1-2mm vessels . Clipping  some times carries risk of kinking these vessels . In this case aneurysm  was bilobed and was clipped using two clips to avoid kinking of trifurcation. Patient  had uneventful  recovery.

CT ANGIO  SHOWING RIGHT SIDED M2-M3 JUNCTION ANEURYSM. 

POST OPERATIVE  SCANS  OF THE PATIENT AFTER 48 HRS