Narmer I Azzam

Publications (2)2.01 Total impact

• Article: Endoscopy in the management of intra-ventricular lesions: preliminary experience in the Middle East.

  Marwan W Najjar, Narmer I Azzam, Tarafa S Baghdadi, Ali H Turkmani, Ghassan Skaf
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  ABSTRACT: The study is aimed at evaluating neuroendoscopic procedures in the management of various intra-cranial intra-ventricular lesions. We retrospectively review 24 consecutive patients harboring various intra-ventricular lesions with or without associated hydrocephalus, operated and managed by the authors between December 2002 and December 2007. Depending on the preoperative imaging and working diagnosis, endoscopic biopsy or endoscopic resection/debulking, along with concomitant treatment of hydrocephalus via third ventriculostomy or fenestration of the septum pellucidum and ventriculo-peritoneal shunting, were done. The single endoscopic procedure was successful in most of the patients (22/24), where the goals of surgery in attaining a diagnostic biopsy or resection, and simultaneous treatment of hydrocephalus, were attained helping guide further therapy. The endoscopic procedure was the only procedure needed in most of the patients. The endoscopic procedures carried a high success rate in the management of intra-ventricular lesions, and were especially valuable in patients harboring chemo and/or radiosensitive deep seated tumors.
  Clinical neurology and neurosurgery 09/2009; 112(1):17-22. · 1.30 Impact Factor
• Article: Pseudotumor cerebri: disordered cerebrospinal fluid hydrodynamics with extra-axial CSF collections.

  Marwan W Najjar, Narmer I Azzam, Maher A Khalifa
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  ABSTRACT: Pseudotumor cerebri is uncommon in the pediatric age group and presents with clinical characteristics different from the adult form. We report a 5-year-old boy who presented with--seemingly spontaneous--alternating subdural CSF collections before progressing to develop pseudotumor cerebri. To our knowledge, this is the first report of such a presentation. In the prepubertal pediatric age group, pseudotumor cerebri may be associated with multiple etiologic factors (more than in the adult population). The exact common mechanism behind such a disorder is not known. Pseudotumor cerebri may be a disorder of CSF hydrodynamics. It may also be linked to other disorders of CSF hydrodynamics, as in our case. The exact link and mechanistic differences between these apparently related disorders deserve further analysis and investigation, possibly through dynamic MRI techniques.
  Pediatric Neurosurgery 41(4):212-5. · 0.70 Impact Factor