Karam Chand Sharma's Blog (24)

see more pictures in my previous blog- utility of image guided system

I have added images of 2 more patients in my blog pertaining to image guided system. As you get more experience, extratime taken comes down.

Added by Karam Chand Sharma on July 10, 2010 at 6:00am — No Comments

Utility of Image Guided System

A small left posterior frontal meningioma.

The meningioma was excised in toto. Although it was planned to be done with image guidance but since this equipment was being used in other case author made a 5cm trephine craniotomy by giving a straight left paramedian incision( anterior to posterior) and surgery was done without any complications.…


Added by Karam Chand Sharma on July 10, 2010 at 4:00am — 2 Comments

No hope

This is a male patient having Ca lung with multiple metastasis in brain. I told his relalatives that there is no point in doing any surgery with these multiple metastasis and it is better to take him home and just give pain killers and some other symptomatic treatment. Would you like to do something like aspiration of fluid from cystic lesions , X-knifeor cyberknife tretment to this… Continue

Added by Karam Chand Sharma on June 9, 2010 at 8:48am — 3 Comments

Heavily calcified frontal tumour in a 61 years old male

A 61 years old man had generalised seizures 2 years back for the first time in his life. He continued to have repeated seizures despite good drug compliance. A CT Scan head showed a heavily calcified tumour in right frontal lobe with mass effect. This picture is diagnostic of oligodendroglioma. He will be operated in next few days.

CECT and NCCT head showing large right frontal heavily calcified… Continue

Added by Karam Chand Sharma on May 13, 2010 at 8:47am — 1 Comment

Extruded and upward migrated L4L5 disc in a 50 years old male

A 50 years old male presented with acute onset back pain radiating to left lower limb. His MRI shows extruded and upwardly migrated L4L5 disc on left side. He is awaiting surgery.…


Added by Karam Chand Sharma on May 12, 2010 at 8:39am — No Comments

Calvarial moulding

A young man sustained head injury as result of roadside accident. Examination and investigations revealed he had developed a midline frontal compound depressed fracture which was treated conservatively. He recovered well, but has developed post-traumatic epilepsy. The calvarial reshaping has occured over a period of time. See his CT head at time of injury and recent CT head.…


Added by Karam Chand Sharma on April 29, 2010 at 9:23am — No Comments

Cosmetic Neurosurgery

No body wants to see scars of surgery on visible parts of body. Forhead, face and neck are the areas where absolute attention must be paid about the appearnce post surgery. If the pathology is in frontal region bicoronal skin flaps is the answer. The bottom part of bicoronal skin incision should be behind the ears rather than infront of ears. Receding hairline in males is another consideration which should be taken into account. Burr holes over the forhead must be avoided at any cost.…


Added by Karam Chand Sharma on April 22, 2010 at 8:23am — No Comments

Total 21 patients have been operated with Karam Chand minimally invasive technique for drainage of chronic subdural haematomas

In last 1 week I treated 2 more patients with chronic subdural haematomas using my technique of tangential drill hole and closed drainage of chronic subdural haematomas using 10 or 12 no Foley's catheter and sterile bag. So the total no of patients treated so far is 21. I have achieved 100percent success with this technique. You can try it at your place and let me know the feedback.

Isodense right hemispheric chronic subdural… Continue

Added by Karam Chand Sharma on April 19, 2010 at 7:53am — 2 Comments

The best way to operate gliomas around eloquent areas of brain

We can be quite accurate in localing gliomas where they are situated in brain with frameless neuronavigation or frame based approach. fMRI is useful but is not accurate to localise speech. The peroperative localisation has therfore become imporatantand is really helpful. The normal position of motor strip and speech area can be marked on scalp but because of shift by tumour these landmarks also change.

The best way to deal with this is doing surgery in awake patient. I have done 40…


Added by Karam Chand Sharma on February 14, 2010 at 4:08am — 2 Comments

For a wedding in New Zealand

I am fascinated by natural beauty of earth

in New Zealand. Last year I went to Auckland after 17 years and Auckland had changed a lot and like everywhere else lot of construction had taken place. The road leading to underwater world was no more lonely and lot ofbuildings had come up. Despite all that the city was as beauiful as ever. Bungy jumping was possible even at the city centre. That time they were thinking of one central agency for all subarbs… Continue

Added by Karam Chand Sharma on January 21, 2010 at 9:55am — No Comments

Neatly trephined bone in a case of cerebellopontine meningioma.

For posterior fossa lesions also only craniotomy should be done. Karam Chand trephine is available in various sizes and it has an adjustable dura guard.

Added by Karam Chand Sharma on January 12, 2010 at 8:09am — No Comments

China making real progress

In hard times China and India have shown resilience and have made good progress. China has done much better than India. Stereotaxic radiosurgery using gamma rays has become popular in China because they have invented their own systems. Window of world in one of chinese cities has replicated most of prominent landmarks in the world.…


Added by Karam Chand Sharma on January 4, 2010 at 5:07am — No Comments

A visit to Israel in 2009, Let us pray for world peace!

A group of us went for a trauma course at Rambag Hospital in Haifa. We travelled to most of cities in Israel. From haifa border of Lebanon is not for off. In times of conflict let us all pray for world… Continue

Added by Karam Chand Sharma on December 30, 2009 at 7:00am — No Comments

No these are not burr holes, these are 1.5 cm trephines.

This patient has been positioned in sitting position, 2 small trphines have been made on either side of midline in preparation for craniotomy for approacing posterior 3rd ventricular tumour by supracerebellar approach. You can see the transverse sinus on either side.

Added by Karam Chand Sharma on December 30, 2009 at 3:18am — No Comments

Largest MCA aneurysm

What wil you do to this patient who presented with mass effect?

Added by Karam Chand Sharma on December 29, 2009 at 7:50am — No Comments

Compensated hydrocephalus having bilateral subdural collections after right ventriculoperitoneal shunt

The subdural collections resolved after shunt was ligated

Added by Karam Chand Sharma on December 29, 2009 at 4:54am — No Comments

Disposable stereotaxy for whole body

I am going to change the way pathology is going to be reported in imaging. The imaging specialist will not only report on CT or MRI films but will also suggest the way to approach it and do a surface marking, all for a very low cost. No patient will need to wear a frame.
This will not only help in biopsies, abscess drainage, it will allow us to deliver intratumoural chemotherapy and will also help in focussind radiation beams etc.
Come and work with me!

Added by Karam Chand Sharma on December 27, 2009 at 2:58am — 1 Comment

spectacle Trephines

A 40 years old male was operated by rt subfrontal approach for large pituitary adenoma. Postop he developed rt temporal venous infarct with mass effect. Same night rt temporal trephine was made and pulped temporal tip removed. S

ubsequently he made wonderful recovery. His vision is normal.

Added by Karam Chand Sharma on December 26, 2009 at 11:08am — 1 Comment

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