A carotid endarterectomy is performed in a sterile surgical suite or standard operating room. You may go home the same day or stay 1–2 nights after the procedure depending on your medical condition. You receive a local anesthetic or general anesthesia. Your vascular surgeon makes an incision at the front of your neck. After removing the plaque from the artery your vascular surgeon repairs the artery by stitching in a natural graft (formed from a piece of vein from elsewhere in your body) or a woven patch. The incision is closed

What is an Aneurysm? A cerebral or intracranial aneurysm is an abnormal focal dilation of an artery in the brain that results from a weakening of the inner muscular layer (the intima) of a blood vessel wall. The vessel develops a "blister-like" dilation that can become thin and rupture without warning. The resultant bleeding into the space around the brain is called a subarachnoid hemorrhage (SAH). This kind of hemorrhage can lead to a stroke, coma, and/or death. Aneurysms are usually found at the base of the brain just inside the skull, in an area called the subarachnoid space. In fact, 90 percent of SAHs are attributed to ruptured cerebral aneurysms and the two terms are often used synonymously.

Zinc deficiency symptoms include growth and development problems, hair loss, diarrhea, impotence, eye and skin conditions, and loss of appetite. Other symptoms may include weight loss, delayed wound healing, taste changes, and mental slowness.

DMC specialist Dr. Andrew Xavier treats a patient's stroke and aneurysm at DMC Detroit Receiving Hospital.. ~ Detroit Medical Center

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Biceps tenodesis is a common procedure performed for tendinopathy of the long head of the biceps brachii (LHB). Indications include partial-thickness LHB tear, tendon subluxation with or without subscapularis tear, and failed conservative management of bicipital tenosynovitis. Biceps tenodesis may also be performed for superior labrum anterior to posterior tears.

There are several approaches to scoliosis surgery, but all use modern instrumentation systems in which hooks and screws are applied to the spine to anchor long rods. The rods are then used to reduce and hold the spine while bone that is added fuses together with existing bone.

A nonsurgical method of treating a ganglion is to drain the fluid from (aspirate) the ganglion sac. Your doctor can do this in the office using the following procedure: The ganglion area is cleaned with an antiseptic solution. A local anesthetic is injected into the ganglion area to numb the area. When the area is numb, the ganglion sac is punctured with a sterile needle. The fluid is drawn out of the ganglion sac. The ganglion collapses. A bandage and, in some cases, a splint are used for a few days to limit movement and prevent the ganglion sac from filling again. Treating a ganglion by draining the fluid with a needle may not work because the ganglion sac remains intact and can fill again, causing the ganglion to return. For this reason, your doctor may puncture the sac with the needle 3 or 4 times so the sac will collapse completely. Even then, the ganglion is likely to come back.

If the artery were severed, blood would flow out unimpeded, although the artery wall would contract in an effort to stop the bleeding. After losing >30% of one's blood volume blood pressure would start dropping, and with less pressure the rate of bleeding would go down. At this stage if the blood loss wasn't replaced the person could die. Losing halve to two thirds of one's blood volume is considered to be fatal even if later on blood transfusion is attempted. One's total blood volume at 70ml/kg is estimated to be between 5 to 7 liters, so that makes a blood loss of between 2,5 to 4,7 L.

In as many as 80% of cases, doctors don’t find the exact reason for a curved spine. Scoliosis without a known cause is what doctors call “idiopathic.” Some kinds of scoliosis do have clear causes. Doctors divide those curves into two types -- structural and nonstructural. In nonstructural scoliosis, the spine works normally, but looks curved. Why does this happen? There are a number of reasons, such as one leg’s being longer than the other, muscle spasms, and inflammations like appendicitis. When these problems are treated, this type of scoliosis often goes away.

CMV is a common virus in the same family as herpesvirus, and it can infect anyone. CMV is spread by direct contact of body fluids, such as saliva, blood, urine, semen, vaginal fluids, and breast milk. Thus breastfeeding, blood transfusions, organ transplants, and sexual contact are possible modes of transmission. Most healthy people do not experience any symptoms when infected with CMV, and it does not pose a serious health concern. A majority of adults have antibodies consistent with past infection. Most healthy children and adults who do have symptoms will recover from CMV infection without complications and do not require antiviral treatment. However, in those with a weakened immune system, CMV can cause serious disease (retinitis, hepatitis, colitis, pneumonia, or encephalitis).

The procedure was performed under wrist block regional anesthesia with tourniquet control. A single Chinese finger trap was used on the thumb with 5 to 8 lb of ongitudinal traction. The arm was held down with wide tape around the tourniquet securing it to the hand table to serve as countertraction. A shoulder holder, rather than a traction tower, was used to facilitate fluoroscopic intervention more easily. The Trapeziometacarpal joint was detected by palpation. Joint distension was achieved by injecting 1 to 3 mL of normal saline (Fig. 1). It is important to distally direct the needle approximately 20 degrees to clear the dorsal flare of the metacarpal base and enter the joint capsule. This course should be reproduced upon entering with arthroscopic sleeve/ trocar assembly to minimize iatrogenic cartilage injury. Fluid distention is important to facilitate this. The incision for the 1-R (radial) portal, used for proper assessment of the dorsoradial ligament, posterior oblique ligament, and ulnar collateral ligament, was placed just volar to the abductor pollicis longus tendon. The incision for the 1-U (ulnar) portal, for better evaluation of the anterior oblique ligament and ulnar collateral ligament, was made just ulnar to the extensor pollicis brevis tendon. A short-barrel, 1.9-mm, 30- degree inclination arthroscope was used for complete visualization of the CMC joint surfaces, capsule, and ligaments, and then appropriate management was done, as dictated by the stage of the arthritis detected (Fig. 2A). A full-radius mechanical shaver with suction was used in all the cases, particularly for initial debridement and visualization. Most of the cases were augmented with radiofrequency ablation to perform a thorough synovectomy and radiofrequency was also used to perform chondroplasty in the cases with focal articular cartilage wear or fibrillation. Chondroplasty refers to thedebridement of the fibrillated cartilage to improve vascularity of the cartilage and enhance the growth of fibrocartilage. Ligamentous laxity and capsular attenu- ation were treated with thermal capsulorraphy using a radiofrequency shrinkage probe. We were careful to avoid thermal necrosis; hence, a striping technique was used to tighten the capsule of the lax joints. The striping technique refers to thermal shrinkage performed in longitudinal stripes on the lax capsule, so as to leave vascular zones between the stripes; hence, thermal necrosis is prevented. Arthroscopic stage I disease was characterized by synovitis without any cartilage wear, wherein a synovectomy coupled with thermal capsulor- raphy as described was performed.

Insulin is a hormone made by the pancreas that allows your body to use sugar (glucose) from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps keeps your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia). The cells in your body need sugar for energy. However, sugar cannot go into most of your cells directly. After you eat food and your blood sugar level rises, cells in your pancreas (known as beta cells) are signaled to release insulin into your bloodstream. Insulin then attaches to and signals cells to absorb sugar from the bloodstream. Insulin is often described as a “key,” which unlocks the cell to allow sugar to enter the cell and be used for energy.

UPDATE 2/6/15: A new version of this animation is now available! https://www.youtube.com/watch?v=E1ljClS0DhM

This 3D medical animation depicts the surgical removal of the appendix (appendectomy) using laparoscopic instruments. The surgery animation begins by showing an inflamed appendix (appendicitis), followed by the placement of the laparoscope. Afterward, one can see the surgical device staple, cut and remove the inflamed appendix. Following the removal of the appendix the abdomen is flushed with a sterile saline solution to ensure all traces of infection have been removed.
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Pericardial window is used diagnostically and, more often, therapeutically for drainage of accumulated pericardial fluid (a condition that most often occurs after cardiac surgery but has many other possible causes). The pericardium envelops the heart like a cocoon; its cardiac filling can be impaired when this cavity fills with excess fluid. When the limited space between the noncompliant pericardium and heart is acutely filled with blood or fluid, cardiac compression and tamponade may result. Pericardial window in combination with systemic chemotherapy may also prevent accumulation of large fluid volumes in patients with neoplastic pericardial disease. [1, 2] Indications The following are indications for a pericardial window [6] : Symptomatic pericardial effusions Asymptomatic pericardial effusions that warrant a pericardial window for diagnosis Hemodynamically stable patients with an undiagnosed pericardial effusion (a thoracoscopic approach is ideal) Coexisting pericardial, pleural, or pulmonary pathology that requires diagnosis or therapy (a thoracoscopic approach is ideal) Known benign effusions that reaccumulate after aspiration Drainage of a purulent pericardial effusion Early fungal or tuberculous pericarditis in which resection of the pericardium is required to prevent future pericardial constriction Use as part of the mediastinal debridement, in patients with descending mediastinitis

Keyhole surgery can be helpful for patients with brain, pituitary and skull base tumors. With cutting edge technology and a proven track record in keyhole and endonasal endoscopic approaches, we make surgery safer, less invasive and more effective.

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Intramuscular (IM) injection Tutorial for Nurses Video

An African traditional healer performing a brain surgery.