http://www.nucleushealth.com/ - This 3D medical animation depicts two operations, called craniotomy and craniectomy, in which the skull is opened to access the brain. The normal anatomy of the skull and tissues surrounding the brain are shown, including arteries and veins. The animation lists the common reasons for these procedures, and briefly introduces intracranial pressure.

Video ID: ANH13109


Transcript:

Your doctor may recommend a craniotomy or a craniectomy procedure to treat a number of different brain diseases, injuries, or conditions.

Your skull is made of bone and serves as a hard, protective covering for your brain. Just inside your skull, three layers of tissue, called meninges, surround your brain. The thick, outermost layer is the dura mater. The middle tissue layer is the arachnoid mater and the innermost layer is the pia mater. Between the arachnoid mater and the pia mater is the subarachnoid space, which contains blood vessels and a clear fluid called cerebrospinal fluid. Blood vessels, called bridging veins, connect the surface of your brain with the dura mater. Other blood vessels, called cerebral arteries, bring blood to your brain.

Inside your skull, normal brain function requires a delicate balance of pressure between the blood in your blood vessels, the cerebrospinal fluid that surrounds your brain, and your brain tissue. This is called normal intracranial pressure. Increased intracranial pressure may result from: brain tumors, head injuries, problems with your blood vessels, or infections in your brain or spinal cord. These conditions put pressure on your brain and may cause it to swell or change shape inside your skull, which can lead to serious brain injury.

Your doctor may recommend a craniotomy to remove: abnormal brain tissue, such as a brain tumor, a sample of tissue by biopsy, a blood clot, called a hematoma, excess cerebrospinal fluid, or pus from an infection, called an abscess.

A craniotomy may also be done to: relieve brain swelling,
stop bleeding, called a hemorrhage, repair abnormal blood vessels, repair skull fractures, or repair damaged meninges.

Finally, a craniotomy may also be done to: treat brain conditions, such as epilepsy, deliver medication to your brain, or implant a medical device, such as a deep brain stimulator.

The most common reason for a craniotomy is to remove a brain tumor.

#Craniotomy #Craniectomy #BrainSurgery

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The fetal circulation is the circulatory system of a human fetus, often encompassing the entire fetoplacental circulation that also includes the umbilical cord and the blood vessels within the placenta that carry fetal blood.

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Patient Glenn Williams had a hernia measuring 20cm x 30cm. Consultant Graham Offer has performed ground breaking surgery to help Glenn.

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Internal hemorrhoids and loose rectal mucosa may block the exposure during the purse string suturing in stapled hemorrhooidopexy, and this may cause some complications. To retract the prolapsing rectal mucosa we modified the purse string anoscope of the PPH01 kit (Ethicon-Endosurgery, Cincinnati, O...H, USA) and produced a special anoscope. The open part of the purse string suture anoscope is covered by transparent acrylic (Orthoacryl�, Dentaurum, Pforzheim, Germany). The covering material had complete cylindrical outer and inner surfaces and was thin enough to let the anoscope easily rotate in the anal dilator and to let the 26 mm curved, round bodied needle of the 2/0 polypropilene suture move in the anoscope. A window, 3 cm long and 3-4 mm wide, was opened at the angled part of the anoscope 2 cm to the tip of the anoscope. This special anoscope was used for the purse string suture during stapled hemorrhoidopexy procedure in five patients. No postoperative complications, early or late, were encountered, and we propose that stapled hemorrhoidopexy procedure can be applied more easily by using this special anoscope.

Excision of breast cancer that is visible only on mammogram. diagnosis is typically established on stereotactic biospy and excision is done with wire localization. This techniques involves localization by sonography of the hematoma that is left behind at the time of biopsy. It provides not only accu...rate location of the tumor but ensures adequate margins of excision.

Surgical technique: A 3cm skin incision under spinal or general anesthesia, depending on the patients’ preference, starts half way the line between the superior anterior iliac spine towards the midline in a 30° angle to the pubic tubercle. Scarpa’s fascia is opened as well as the external obliq...ue aponeurosis. By using this skin line incision the internal ring will be immediately visualized. Although it is important to look for both direct and indirect hernias evaluating the groin, we do not taper the cord and directly evaluate the ring for indirect hernias. In case of an indirect hernia the sac is reduced or resected according to the preference of the surgeon and the preperitoneal space is entered bluntly through the dilated internal ring. In case of a direct hernia the approach slightly differs. One could prefer to open the transversalis fascia through the internal ring over a few centimeters or you can open the fascia more medially, at the site of the direct hernia. As primary point of concern the epigastric vessels should be identified and retracted softly upwards. Then a gauze can be introduced into the preperitoneal space and by doing so most of the space needed medially will be created. Then one can already palpate Cooper’s ligament and the pubic bone. Laterally to the internal ring more digital dissection is needed to create just the appropriate space for the mesh. By placing the mesh it is important not to introduce the mesh too medially. Laterally of the internal ring an adequate overlap of the mesh is necessary, especially in indirect hernias. No splitting of the mesh seems necessary. The patient will be asked to strain and push on the ring to control its place and to check adequate spreading of the mesh to cover the whole myopectineum of Fruchaud. One single stitch of vicryl 3/0 is placed taking both the fascia transversalis and the mesh.

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Scleral fixated IOLs in case of inadequacy of capsular support and scleral sutured capsular tension rings when adequate zonular support is inavailable have been recently used in cataract surgery. In these techniques, polypropylene suture is used and the suture ends over the sclera after the knot ha...s been formed, may erode the conjunctiva and become exposed. Thus, the erosion may lead to the development of endophtalmitis. In order to prevent the aforementioned complication, scleral flaps, otologous cornea, duramater or fascia lata patches have been used to cover the knot and rotation of the knot into the tissues has been described.

Purpose: To evaluate the results of LASIK and IntraLASIK treatment in myopic patients with nystagmus. Methods: Eight patients with congenital nystagmus (16 eyes), from 23 to 49 years of age, underwent LASIK surgery. Corneal flaps were created using either the Hansatome microkeratome or the Intral...ase femtosecond laser. The ablations were performed with the Bausch & Lomb excimer laser with an active tracking system. In some patients, the eyes were fixated with forceps or a fixation ring during the laser ablation. Results: The refractive errors were corrected in all cases. There was no decentration or loss of best corrected visual acuity greater than 1 line. In 56% of the eyes, the post-operative uncorrected visual acuity was better than the best spectacle corrected-visual acuity (BSCVA). 62.5% of the eyes improved their BSCVA. The overall visual performance was improved in all the patients. One patient that did not not drive before become eligible to get a driver license after the surgery. Conclusions: Selected patients with myopia and congenital nystagmus may benefit from laser refractive surgery. Laser refractive surgery may be safely and accurately performed by using either the Hansatome microkeratome or the Intralase femtosecond laser and an active tracking system with or without mechanical fixation. Certain patients improve their BSCVA post-operatively.

Choose the site you will use for the injection,Clean your skin with an alcohol pad in a circular motion. Let the alcohol dry.

Some bodybuilders, particularly at professional level, use substances such as "site enhancement oil", commonly known as synthol, to mimic the appearance of developed muscle where it may otherwise be disproportionate or lagging. This is known as "fluffing". Synthol is 85% oil, 7.5% lidocain, and 7.5% alcohol.Use is legal and many brands are available on the internet.The use of injected oil to enhance muscle appearance had previously been used in the late 19th century before being abandoned due to health risks such as sclerosing lipogranuloma. Its use was revived more recently by bodybuilders. Use can cause pulmonary embolisms, nerve damage, infections, stroke, and the formation of oil-filled oleomas, cysts or ulcers in the muscle. Sesame oil is often used, which can cause allergic reactions such as vasculitis. An aesthetic issue is drooping of muscle under gravity. Surgical methods are also often employed to remove steroid-related gynecomastia in male bodybuilders, and breast implants in female bodybuilders who wish to retain a feminine physique, which can be compromised in terms of breast reduction by intense dieting.

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