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Article: Dumbbell-shaped solid-cystic hypoglossal schwannoma: An unusual case report.

Trifa, Amine / Maamri, Kais / Cherif, Ines / Elkahla, Ghassen / Darmoul, Mehdi

2022 Volume 17, Issue 3, Page(s) 967–969

Abstract: Hypoglossal Schwannomas are extremely rare benign slow-growing neoplasms, which originate from the 12th cranial nerve. To date, and to the best of our knowledge, only 40 cases of dumbbell-shaped Hypoglossal Swchannomas have been published in the world ... ...

Abstract	Hypoglossal Schwannomas are extremely rare benign slow-growing neoplasms, which originate from the 12th cranial nerve. To date, and to the best of our knowledge, only 40 cases of dumbbell-shaped Hypoglossal Swchannomas have been published in the world literature. We report our experience with a 66 years old male patient, who was diagnosed with a solido-cystic lesion at the right cerebello-pontine angle arising from XIIth cranial nerve. He was treated with surgery via midline suboccipital approach which led to sub-total removal of the tumor and improvement of the symptoms within 3 months. This case highlights the importance of an accurate suspicion diagnosis of hypoglossal schwannoma as well as the treatment options including surgery and radiosurgery.
Language	English
Publishing date	2022-01-18
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2021.12.044
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Pediatric head injuries: particularities and neurosurgical experience in a lower-middle income country.

Trifa, Amine / Rkhami, Mouna / Maamri, Kais / Elkahla, Ghassen / Zammel, Ihsen / Darmoul, Mehdi

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2023 Volume 40, Issue 4, Page(s) 1193–1198

Abstract: Purpose: To the best of our knowledge, this is the first study conducted in Tunisia on the neurosurgical management of child cranial trauma. The objectives of the present work were to identify the causes of pediatric head injuries, explore ... ...

Abstract	Purpose: To the best of our knowledge, this is the first study conducted in Tunisia on the neurosurgical management of child cranial trauma. The objectives of the present work were to identify the causes of pediatric head injuries, explore epidemiological and clinical specificities, and analyze the short- and long-term postoperative evolution. Methods: A retrospective review was conducted on one hundred children with head injuries over a five-year period at one of the largest neurosurgery departments in Tunisia. The collected data encompassed demographic information, clinical presentation features, neuroimaging characteristics, surgical management, complications, and outcomes. Results: Over a five-year period, we have found 118 children who have undergone surgery, representing an annual incidence of twenty-four children per year. The average age was 10 years. Falls emerged as the primary cause of childhood head injuries in our series, followed by road traffic accidents. The most frequently encountered initial sign was the loss of consciousness (52%), followed by headaches (28%), vomiting (25%), and seizures (8%). The average time between the accident and admission to the operating unit was 10 h. Various neurosurgeries were performed, with the evacuation of an epidural hematoma being the most common procedure. At a median follow-up of 24 months, the outcomes were favorable in 88% of cases. Conclusion: The main prognostic factors for head trauma in children included age, circumstances of the accident, association with polytrauma, the initial Glasgow Coma Scale, the nature of the initial cerebral lesions, and the timeliness and quality of initial management.
MeSH term(s)	Child ; Humans ; Developing Countries ; Craniocerebral Trauma/epidemiology ; Hematoma, Epidural, Cranial/complications ; Retrospective Studies ; Hospitalization ; Glasgow Coma Scale
Language	English
Publishing date	2023-12-30
Publishing country	Germany
Document type	Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-023-06271-x
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Article ; Online: Remote cerebellar hemorrhage after the evacuation of a subdural hematoma: a case report.

Taieb, Mohamed Amine Hadj / Maamri, Kais / Trifa, Amine / Elkahla, Ghassen / Hadhri, Mohamed Maher / Darmoul, Mehdi

The Pan African medical journal

2022 Volume 41, Page(s) 24

Abstract: Remote intracranial hemorrhage is postoperative bleeding that occurs away from the surgical site. Remote cerebellar hemorrhage (RCH) is a cerebellar hemorrhage that may occur in 0.04-0.8% of cases after supratentorial and spinal procedures. We report a ... ...

Abstract	Remote intracranial hemorrhage is postoperative bleeding that occurs away from the surgical site. Remote cerebellar hemorrhage (RCH) is a cerebellar hemorrhage that may occur in 0.04-0.8% of cases after supratentorial and spinal procedures. We report a case of a 73-year-old male who developed signs of increased intracranial pressure two days after the evacuation of a subdural hematoma. Brain computed tomography showed RCH with the "zebra sign" and triventricular hydrocephalus that indicated the placement of external ventricle drain in emergency. Therefore, surgeons must pay special attention to this rare postoperative complication because it can be devastating in terms of patient outcome especially due to its possible complications requiring surgical treatment.
MeSH term(s)	Aged ; Cerebellum ; Drainage/adverse effects ; Hematoma, Subdural/diagnostic imaging ; Hematoma, Subdural/etiology ; Hematoma, Subdural/surgery ; Humans ; Intracranial Hemorrhages ; Male ; Postoperative Complications/surgery ; Postoperative Hemorrhage/etiology
Language	English
Publishing date	2022-01-11
Publishing country	Uganda
Document type	Case Reports
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.2022.41.24.32799
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Article: Spinal clear cell meningioma without dural attachment: a case report and literature review.

Maamri, Kais / Hadj Taieb, Mohamed Amine / Trifa, Amine / Elkahla, Ghassen / Njima, Manel / Darmoul, Mehdi

Radiology case reports

2022 Volume 17, Issue 5, Page(s) 1760–1764

Abstract: Clear cell meningiomas (CCM) are a very rare histologic subtype of meningioma usually affecting younger patients. The reported data on spinal CCM are extremely rare. Until today, only 89 cases have been reported. Furthermore, CCM without dural attachment ...

Abstract	Clear cell meningiomas (CCM) are a very rare histologic subtype of meningioma usually affecting younger patients. The reported data on spinal CCM are extremely rare. Until today, only 89 cases have been reported. Furthermore, CCM without dural attachment is even rarer since only 19 cases have been reported in English literature. In this article, we present the twentieth case of a spinal CCM without dural attachment. Our patient was a 58-year-old female who was presented with pain in her lower back and bilateral sciatica for 6 months. Magnetic resonance imaging showed an intra-dural well-demarcated lesion at L3. Via a posterior approach, total resection was possible due to the lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma.
Language	English
Publishing date	2022-03-25
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2022.02.052
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Article ; Online: Hydatid cyst in the third ventricle of the brain: case report of an exceptionally rare condition.

Maamri, Kais / Cherif, Ines / Trifa, Amine / Nessib, Nessrine / Elkahla, Ghassen / Darmoul, Mehdi

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2022 Volume 38, Issue 8, Page(s) 1637–1641

Abstract: Hydatid disease is an endemic zoonotic disease caused by the cestode Echinococcus multilocularis and Echinococcus granulosus. Intra-ventricular hydatid cysts are extremely rare. Even more rarely, and to the best of our knowledge, only three cases of ... ...

Abstract	Hydatid disease is an endemic zoonotic disease caused by the cestode Echinococcus multilocularis and Echinococcus granulosus. Intra-ventricular hydatid cysts are extremely rare. Even more rarely, and to the best of our knowledge, only three cases of third ventricle involvement have been reported. Herein, we present the fourth case of an intraventricular hydatid cyst in a pediatric patient located in the third ventricle. It is about a 7-year-old girl, of a rural origin, admitted for intracranial hypertension, deterioration of the general status, and weakness on the right side of her body. A cerebral magnetic resonance imaging (MRI) showed the presence of a rounded cystic formation in the third ventricle. The patient was operated through a transfrontal transventricular approach, and the cyst was removed. Postoperative course was uneventful. Hydatid disease should be considered part of the differential diagnosis for cystic lesions of the central nervous system, especially in endemic regions. Total removal of the cysts without rupture is a challenge, but best treatment remains an active nationwide prevention.
MeSH term(s)	Animals ; Brain/diagnostic imaging ; Brain/surgery ; Child ; Echinococcosis/diagnostic imaging ; Echinococcosis/surgery ; Echinococcus ; Female ; Humans ; Magnetic Resonance Imaging ; Third Ventricle/diagnostic imaging ; Third Ventricle/surgery
Language	English
Publishing date	2022-02-09
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-022-05460-4
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Article: Primary mucinous adenocarcinoma of the orbit: A rare clinical entity.

Maamri, Kais / Ben Fredj, Rihab / Nessib, Nesrine / Trifa, Amine / Hadhri, Maher / Elkahla, Ghassen / Ben Nsir, Atef / Darmoul, Mehdi

Clinical case reports

2022 Volume 10, Issue 2, Page(s) e05472

Abstract: Primary mucinous adenocarcinoma is an exceptionally rare neoplasm with a propensity for local recurrence and metastasis. We report the second case in the world literature of a primary mucinous adenocarcinoma of the orbit in a 66-year-old man suffering ... ...

Abstract	Primary mucinous adenocarcinoma is an exceptionally rare neoplasm with a propensity for local recurrence and metastasis. We report the second case in the world literature of a primary mucinous adenocarcinoma of the orbit in a 66-year-old man suffering from pain, progressive protrusion of left eye, and a deep drop in vision on the left for several weeks. His first external examination revealed significant proptosis with downward displacement of the left globe with no signs of lagophthalmos. A limitation of abduction was also noted. A CT of the orbit with and without contrast showed intra- and extra-conical solid expansive process. MRI of the orbit with contrast and without contrast has shown a process of the supero-internal angle of the left orbit. The patient was operated via a combined approach, and complete enucleation was done. The final pathologic diagnosis was mucinous adenocarcinoma of the orbit. The postoperative neuroimaging showed a complete resection of the tumor. The patient is referred for adjuvant radiotherapy. A CT of the orbit was made 3 months postoperatively and did not show any local recurrence.
Language	English
Publishing date	2022-02-16
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.5472
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Article ; Online: Dexmedetomidine as an adjunct for caudal anesthesia and analgesia in children.

Trifa, Mehdi / Tumin, Dmitry / Tobias, Joseph D

Minerva anestesiologica

2018 Volume 84, Issue 7, Page(s) 836–847

Abstract: Introduction: The aim of this review was to evaluate the current evidence regarding the use of dexmedetomidine as an adjuvant to local anesthetic agents (LAA) for caudal blockade anesthesia and analgesia in children.: Evidence acquisition: A ... ...

Abstract	Introduction: The aim of this review was to evaluate the current evidence regarding the use of dexmedetomidine as an adjuvant to local anesthetic agents (LAA) for caudal blockade anesthesia and analgesia in children. Evidence acquisition: A literature search was performed of the Medline, Embase, and CINAHL databases using the keywords "dexmedetomidine" and "caudal". We included all studies that used caudal dexmedetomidine as an adjuvant to a LAA in children, excluding case reports, reviews, expert opinions, and animal studies. Evidence synthesis: Twenty-one publications met the inclusion criteria and included 1590 children. Fourteen compared the efficacy of adding dexmedetomidine to a LAA alone and seven compared dexmedetomidine to other adjuvants in combination with a LAA. The duration of postoperative analgesia was significantly longer in patients receiving a caudal epidural block with a LAA plus dexmedetomidine when compared to a LAA alone. Only one study demonstrated improved analgesia with a dose of dexmedetomidine ≥1 µg/kg. Dexmedetomidine provided longer postoperative analgesia than fentanyl and morphine, while the quality of postoperative analgesia was similar to dexamethasone or clonidine. Although higher sedation scores were associated with caudal dexmedetomidine in the majority of the trials, postoperative behavior scores were improved in these children. There were no reports of respiratory depression. Significant hemodynamic effects were uncommon, and occurred most commonly in patients receiving a higher dose of caudal dexmedetomidine (2 µg.kg-1). Conclusions: There is sufficient evidence to recommend the addition of caudal dexmedetomidine to the LAA in patients undergoing lower extremity and infra-umbilical surgical procedures.
MeSH term(s)	Analgesia/methods ; Analgesics, Non-Narcotic ; Anesthesia, Caudal/methods ; Anesthetics, Combined ; Child ; Dexmedetomidine ; Humans
Chemical Substances	Analgesics, Non-Narcotic ; Anesthetics, Combined ; Dexmedetomidine (67VB76HONO)
Language	English
Publishing date	2018-02-22
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	123584-9
ISSN	1827-1596 ; 0026-4717 ; 0375-9393
ISSN (online)	1827-1596
ISSN	0026-4717 ; 0375-9393
DOI	10.23736/S0375-9393.18.12523-5
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Article: Advances in the Management of Acute Postsurgical Pain: A Review.

Paladini, Antonella / Rawal, Narinder / Coca Martinez, Miquel / Trifa, Mehdi / Montero, Antonio / Pergolizzi, Joseph / Pasqualucci, Alberto / Narvaez Tamayo, Marco Antonio / Varrassi, Giustino / De Leon Casasola, Oscar

Cureus

2023 Volume 15, Issue 8, Page(s) e42974

Abstract: Despite the millions of surgeries performed every year around the world, postoperative pain remains prevalent and is often addressed with inadequate or suboptimal treatments. Chronic postsurgical pain is surprisingly prevalent, and its rate varies with ... ...

Abstract	Despite the millions of surgeries performed every year around the world, postoperative pain remains prevalent and is often addressed with inadequate or suboptimal treatments. Chronic postsurgical pain is surprisingly prevalent, and its rate varies with the type of surgery, as well as with certain patient characteristics. Thus, better clinical training is needed as well as patient education. As pain can be caused by more than one mechanism, multimodal or balanced postsurgical analgesia is appropriate. Pharmacological agents such as opioid and nonopioid pain relievers, as well as adjuvants and nonpharmacologic approaches, can be combined to provide better and opioid-sparing pain relief. Many specialty societies have guidelines for postoperative pain management that emphasize multimodal postoperative analgesia. These guidelines are particularly helpful when dealing with special populations such as pregnant patients or infants and children. Pediatric pain control, in particular, can be challenging as patients may be unable to communicate their pain levels. A variety of validated assessment tools are available for diagnosis. Related to therapy, most guidelines agree on the fact that codeine should be used with extreme caution in pediatric patients as some may be "rapid metabolizers" and its use may be life-threatening. Prehabilitation is a preoperative approach that prepares patients in advance of elective surgery with conditioning exercises and other interventions to optimize their health. Prehabilitation may have aerobic, strength-training, nutritional, and counseling components. Logistical considerations and degree of patient adherence represent barriers to effective prehabilitation programs. Notwithstanding all this, acute postoperative pain represents a clinical challenge that has not yet been well addressed.
Language	English
Publishing date	2023-08-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.42974
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Article ; Online: Dumbbell-shaped solid-cystic hypoglossal schwannoma

Amine Trifa, MD / Kais Maamri, MD / Ines Cherif, MD / Ghassen Elkahla, MD / Mehdi Darmoul, MD, PhD

Radiology Case Reports, Vol 17, Iss 3, Pp 967-

An unusual case report

2022 Volume 969

Abstract	Hypoglossal Schwannomas are extremely rare benign slow-growing neoplasms, which originate from the 12th cranial nerve. To date, and to the best of our knowledge, only 40 cases of dumbbell-shaped Hypoglossal Swchannomas have been published in the world literature. We report our experience with a 66 years old male patient, who was diagnosed with a solido-cystic lesion at the right cerebello-pontine angle arising from XIIth cranial nerve. He was treated with surgery via midline suboccipital approach which led to sub-total removal of the tumor and improvement of the symptoms within 3 months. This case highlights the importance of an accurate suspicion diagnosis of hypoglossal schwannoma as well as the treatment options including surgery and radiosurgery.
Keywords	Schwannoma ; Hypoglossal schwannoma ; Dumbbell-shaped ; Solid-cystic ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The addition of clonidine to bupivacaine in saphenous/sciatic nerve blocks in children.

Trifa, Mehdi / Engelhardt, Thomas / Ben Khalifa, Sonia

Paediatric anaesthesia

2016 Volume 26, Issue 3, Page(s) 321–322

MeSH term(s)	Analgesics/pharmacology ; Anesthetics, Local/administration & dosage ; Bupivacaine/administration & dosage ; Child ; Child, Preschool ; Clonidine/pharmacology ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Humans ; Infant ; Male ; Nerve Block/methods ; Pain, Postoperative/drug therapy ; Prospective Studies ; Sciatic Nerve/drug effects ; Treatment Outcome
Chemical Substances	Analgesics ; Anesthetics, Local ; Clonidine (MN3L5RMN02) ; Bupivacaine (Y8335394RO)
Language	English
Publishing date	2016-03
Publishing country	France
Document type	Letter ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1086049-6
ISSN	1460-9592 ; 1155-5645
ISSN (online)	1460-9592
ISSN	1155-5645
DOI	10.1111/pan.12793
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