SBH Neurosurgery

Official Twitter account of the Division of Neurosurgery at SBH Health System. World-class Neurosurgery in the Bronx.

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Happy 250th Birthday, America!

A quarter of a millennium already for the greatest nation on Earth and in the history of mankind ... and the best has yet to come.

#USA
#FourthOfJuly
#GodBlessAmerica
#OneNationUnderGod

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

2026 National Residency Match ...

Some call DO students "underdogs". We call them "future neurosurgeons".

I am extremely proud of our students @SaharSorek and @VincyMathew5, both of whom matched this year. Those kids were incredibly relentless and never took "no" for an answer.

Speaking of relentlessness, it also appeaes that our match rate (for both MD and DO students) stubbornly remains at 100%. 🙂
@SBHNeurosurgery
@NYITCOMDO
Congrats, Sahar and Vincy! Now is the time to start working even harder.

#Neurosurgery
#Education
#Mentorship
#Success
#ProudMentor

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Procedure was technically successful. Gross total tumor resection without intraoperative, perioperative, or early postoperative complications. Patient scheduled to receive adjuvant SRS.

SBH Neurosurgery
#Neurosurgery
#SkullBase
#NeuroOncology
#RahmeChallenge

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

We used contralateral paramedian supracerebellar approach via right suboccipital craniotomy (see postop CT above). Prone position (or semi-sitting), CSF drainage from cisterna magna to relax cerebellum (or lumbar drain), intraop frameless stereo neuronav & neurophys monitoring.

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

In terms of surgical approach, supracerebellar infratentorial corridor provides most direct, brain-sparing, subarachnoid path to lesion. All other approaches would require crossing or manipulating uninvolved, potentially eloquent brain tissue.

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Microsurgical resection + adjuvant SRS would lead to high rate of intracranial oncologic control, provided patient and family are willing to accept significant potential surgical risks.

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Correct Answer: (A)

Given large size of lesion (3.5 cm) and location within left thalamus and midbrain, XRT alone would have led to: (1) limited oncologic control, (2) potential neurologic morbidity (radiation toxicity/necrosis).

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Okay, time's up!
You can see what we did in comment below ...

#RahmeChallenge
@SBHNeurosurgery

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Attention Neurosurgeons!

DIALYSIS DISEQULIBRIUM SYNDROME is real and FREQUENTLY FATAL. It affects no less than 15% of patients with acute intracranial pathology (trauma, stroke, tumor).

@VincyMathew5
@A_ASarpong
@AlexAbramsDO
@SBHNeurosurgery
@CNS_Update
#2024CNS
#CNS2024

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Desperately waiting for MMA embo to prove itself? Wait no more, we got great news for you ...
You can achieve NEAR-ZERO RECURRENCE of chronic SDH by adhering to simple surgical principles.
Come see how we do it!

@VincyMathew5
@SBHNeurosurgery
@CNS_Update
#2024CNS
#CNS2024

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

A LOST ART ...

Come check this one out and learn how we MANUALLY REDUCE CERVICAL FACET DISLOCATIONS.

DISCLAIMER: Not for the faint-hearted!

@VincyMathew5
@SBHNeurosurgery
@CNS_Update

#2024CNS
#CNS2024
#Neurosurgery
#Research

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

NEW ANGIOGRAPHIC VARIANT ALERT ...

Vertebral artery arising from the SCA on one side and the basilar trunk distal to the AICA on the other side.

Come and check it out.

@A_ASarpong
@VincyMathew5
@SBHNeurosurgery
@CNS_Update

#2024CNS
#CNS2024
#Neurosurgery
#Research

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Truly devastating and catastrophic complications of "minimally invasive", "low-risk" percutaneous spine procedures, increasingly performed in the community.

Proper indication and meticulous informed consent are a must.

#2024CNS
#CNS2024
#Neurosurgery
#Research

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Some of the most overused, abused terms in our field are "minimally invasive", "low-risk".

From life-threatening hematomas and plexus injuries to spinal cord injury to anoxic brain injury ...

@VincyMathew5
@A_ASarpong
@AlexAbramsDO
@ArmandoBunjaj
@SBHNeurosurgery
@CNS_Update

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

"FOR THE BRAVE ONLY" ...

Not every Traumatic Epidural Hematoma needs to be rushed to the Operating Room.

To find out more, visit our Poster.

@A_ASarpong
@VincyMathew5
@AlexAbramsDO
@SBHNeurosurgery
@CNS_Update

#2024CNS
#CNS2024
#Neurosurgery
#Research

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Mandatory pre-meeting #Diversity-ish training, an @SBHNeurosurgery tradition ...

Horseback Riding on Saturday.
Gun Range Shooting on Sunday.

Ready to start #2024CNS. Let's do it!

#CNS2024
#TeamBuilding
#Neurosurgery
@CNS_Update

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Howdy Pardner!

Just landed in the Great State of Texas ... All fired up and ready for #CNS2024.

#Neurosurgery
#LiveFreeOrDie
#2024CNS
SBH Neurosurgery

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Thank you, Neurology India, for continuing to believe in the microsurgical treatment of intracranial aneurysms, the Gold Standard when it comes to vessel preservation and durability.

Full Text:

https://t.co/aXHcv26x4i

#Cerebrovascular
#Stroke
#Microsurgery

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

Hot off the Press! How We Do It: Microsurgical Clipping of Medial Paraclinoid ICA Aneurysms via Contralateral Prechiasmatic Interoptic Approach. Step-by-step illustration for young neurosurgeons.

@VincyMathew5
@SaharSorek
@SBHNeurosurgery

https://t.co/pKsbUoHTAr

[Ralph Rahme, M.D., F.A.C.S. @bluecollarneuro]

To all privileged young people (of all races, religions) born in this great nation #America (including my own kids) ...

This immigrant's advice to you on #MemorialDay:
1. Do not take ur blessings for granted.
2. Remember those who made the ultimate sacrifice to make it possible.