داکتر محمد صمیم سردار M.Samim sardar

19/07/2025

Performing Joint Aspiration @(Knee)@

:
1. Position the patient comfortably to access the effusion.
2. Clean the knee with povidone-iodine for 10 minutes, covering 2–3 inches above and below the knee.
3. Draping is optional but reduces infection risk.
4. Prepare a sterile field with necessary equipment (syringes, needles, hemostat, sterile cup).
5. Don sterile gloves, drape if desired, and locate the superior pole of the patella.

:
6. Identify joint space by palpating for fluid lateral to the patella.
7. Prepare 3–5 mL of 1% lidocaine with a 25-gauge needle for anesthesia.
8. Mark entry at the lateral patella margin intersecting the superior patella line. Inject lidocaine subcutaneously at a 45° sagittal and 30° frontal angle, directing caudally.
9. Advance the needle to desired depth, aspirating for blood to confirm placement.
10. Administer anesthesia while withdrawing the needle.

:
11. Replace with an 18-gauge needle attached to a 20–30 mL syringe.
12. Insert the needle medially and caudally at 45° lateral and 30° caudal angles. Aspirate synovial fluid as the needle enters the joint space behind the patella.

Dr. Mohammad Samim Sardar

18/07/2025

Cauda equina Vs Conus medullaris syndrome

16/07/2025

Complications of shunt in patients with HCP.

15/07/2025

خونریزی خارج جمجمه‌ای نوزدان 👶🩸💀

کاپوت ساکسیدانئوم (Caput Succedaneum)
محل: بین پوست و اپی کرانیال آپونوروز
ویژگی: تورم نرم که محدود به استخوان خاصی نیست و طی چند روز خود به خود بهبود میابد.

سفال هماتوم (Cephalohematoma)
محل: بین پریوست و استخوان
ویژگی: برجستگی عمقی و سفت که محدود به استخوانی خاص است.

ساب گالئال (Subgaleal Hematoma)
محل: بین پریوست و اپی کرانیال آپونوروز
ویژگی: محدود به استخوان خاصی نیست و می‌تواند کل سر را درگیر کند. خون زیادی تجمع میابد و تورم به تدریج بزرگتر شده که می‌تواند منجر به شوک شود.

11/07/2025

(( Secondary headaches ))

1. Subarachnoid Hemorrhage (SAH)

Key symptom: Sudden, worst headache of life (“thunderclap headache”)

Diagnosis:
• CT scan shows bleeding
• Spinal fluid (CSF) is yellow (xanthochromic)

Management:
• Control blood pressure (avoid rebleeding)
• Find bleeding spot via CT or angiography
• Repair aneurysm (clip or coil)
• Give nimodipine to prevent vasospasm (stroke risk)

Complications:
• Increased brain pressure (ICP), hydrocephalus
• Rebleeding (within 24h)
• Vasospasm (stroke-like signs 4–10 days later)
• Hyponatremia (low sodium)
• Seizures

2. Cerebral Venous Sinus Thrombosis (CVST)

Key symptom: Gradual or sudden headache

Diagnosis:
• Papilledema (eye swelling)
• CT/MRI: “Dense triangle” or “cord” sign

Management:
• Start heparin (blood thinner)
• If treatment fails: endovascular therapy

Complications:
• Increased brain pressure
• Brain swelling or bleeding
• Seizures

3. Brain Abscess

Key symptom: Headache + fever + brain symptoms

Diagnosis:
• MRI: Ring-enhancing lesions
• Positive blood cultures

Management:
• Antibiotics
• Surgery if mass is large
• Steroids if pressure is high

4. Meningitis

Key symptom: Headache, fever, neck stiffness, confusion

Diagnosis:
• CSF: Very high WBCs, low glucose, high protein, bacteria stain positive

Management:
1. Do lumbar puncture (if no brain mass)
2. Start antibiotics right away (ceftriaxone + vancomycin + acyclovir ± ampicillin)
3. Dexamethasone for Strep pneumoniae
4. Manage brain pressure

Complications:
• Brain damage
• Hearing loss
• Seizures

5. Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)

Key symptom: Headache + vision problems

Diagnosis:
• Papilledema
• CT: normal
• CSF: high pressure, but normal fluid

Management:
• Weight loss, stop trigger meds (e.g., tetracyclines)
• Acetazolamide/topiramate
• If severe vision loss: steroids, repeat spinal taps, surgery

Complication:
• Permanent vision loss if untreated.

08/07/2025

(cervical radiculopathy)
A pinched nerve is a damaged or compressed nerve. It develops when a nerve root is injured or inflamed. The nerve root is the part where a nerve branches off from the spinal cord.

A pinched nerve in the neck may feel like pins and needles. It might also cause pain and weakness in the shoulder, arm, or hand.

Exercises for a C7 pinched nerve (cervical radiculopathy) focus on reducing pressure on the nerve and improving neck and arm mobility.



Common symptoms include:

●pins and needles
●muscle weakness
●burning sensation
●numbness
●pain that radiates outward
●pain when moving your neck or head
●poor neck range of motion.

■ Gentle Stretches:
》Cervical Retraction (Chin Tucks):

》Neck Tilts:

》Neck Extensions
》Shoulder Blade Squeezes

》Shoulder Rolls

■ Nerve Glides
》Median Nerve Glide

》Ulnar Nerve Glide

■ Strengthening Exercises:
》Scapular Rows
》Wall Angels
》Deep Neck Flexor Exercises
》Chin Tuck with Neck Extension
》Shoulder Rolls

■ Others
》rest
》soft cervical collar
》hot or cold compress
》practicing good posture
》nonsteroidal anti-inflammatory drugs (NSAIDs)
》acupuncture
》massage
》yoga

04/07/2025

Spinal Nerve Compression
تحت فشار قرار گرفتن جذور عصبی در فقرات در چهار نواحی ذیل بوجود می آید.
۱. در سویه دیسک بین الفقری در نتیجه فتق دیسک بین الفقری بوجود می آید.
۲. درناحیه lateral recess که از سبب هایپرتروفی لیگامنت زرد ،ارتروز مفصلی و فتق دیسک میباشد .
۳.درناحیه foramen intervertebral در نتیجه ارتروز مفصلی ،فتق دیسک بین الفقری و لغزش یا listhesis فقرات بوجود می آید.
۴.خارج از فوحه بین الفقری یا Extra foraminal این حالت نادرا ازباعث مهاجرت و فتق دیسک بین الفقری بطرف وحشی بوجود می آید.
در این نواحی ممکن چندین پتولوژی باهم یکجا باعث تحت فشار دادن جذر عصبی شوند و یا تنها فتق دیسک در چندین نواحی باعث زیر فشار گرفتن جذر عصبی شده میتواند .

که باعث ایجاد درد های شدید در ناحیه گردن .کمر و درد های دست و پا که بعضا با بی حسی و کرختی نیز همراه میباشد ، میشود .

داکتر محمد صمیم سردار
متخصص جراحی اعصاب و ستون فقرات

What's up # 0707602512

29/06/2025

23/06/2025

*Ossification*
is the process of *bone formation*. It converts *cartilage or fibrous tissue into bone*, and occurs in two main types:
---
🔹 *1. Intramembranous Ossification*
- Direct bone formation from *mesenchymal tissue*
- Occurs in *flat bones* (e.g., skull, mandible, )
---
🔹 *2. Endochondral Ossification*
- Bone replaces a *cartilage model*
- Occurs in *long bones* (e.g., femur, humerus), vertebrae, and base of skull
---
🦴 *Where It Happens:*
- During *fetal development*
- In *growth plates* during childhood
- In *fracture healing*

---
داکتر محمد صمیم سردار
متخصص جراحی اعصاب و ستون فقرات

21/06/2025

د پلار له‌خوا تجربه شوی فشار (استرس) کولی شي د هغه د سپرم (نطفې) په حجراتو کې داسې بدلونونه رامنځته کړي چې د ماشومانو پر فزیکي (جسماني) او احساسي (رواني) ودې اغېز کولی شي.
مهم ټکی دا دی چې دا بدلونونه د DNA ترکیب نه بدلوي، خو کولای شي هغه طریقه بدله کړي چې جینونه کار کوي، یعنې دا بدلونونه اپی‌ژنتیکي دي.

رواني فشار د پلار په وجود کې داسې بدلونونه رامنځته کوي چې له لارې یې ماشومان هم اغېزمنېږي — دا یعنې دا چې د یوه انسان رواني روغتیا نه یوازې د هغه شخص پورې اړه لري، بلکې د راتلونکو نسلونو پر روغتیا هم اغېزه لري.

پایله:
رواني فشار یوازې شخصي ستونزه نه ده، بلکې د راتلونکو نسلونو لپاره هم مهمه ده، ځکه د مور و پلار رواني حالت ممکن د ماشومانو راتلونکې هم بدله کړي.

11/06/2025

Rip😪
Gazi Yaşargil
The best neurosurgeon in the world during the century passed away today 11 june 2025
May God bless his soul

11/06/2025

Five Types of Intracranial Hemorrhages
Intracranial hemorrhage has five types:

1. Intracerebral hemorrhage and intracerebral hematoma (ICH).
ICH is a commonly used term for tissue hemorrhage or a hematoma in the brain tissue. The hemorrhage or hematoma may be in the cerebral lobes, , basal ganglion, , and corpus callosum. It can also be called intraparenchymal hemorrhage or hematoma (IPH). The causes of this type of hemorrhage are mostly an external to the head and a cerebrovascular accident. CVA-induced intracerebral hemorrhages comprise the following.
(a) Deep hemorrhage is hemorrhage at the , nucleus, , and the brainstem. The leading cause is hypertensive .
(b) Lobar hemorrhage is hemorrhage at the /subcortex of , , , or lobes. The leading cause is amyloid angiopathy. AVM and are also common causes.

2. Subdural hematoma (SDH)

3. Epidural hematoma (EDH)
SDH and EDH are both extracerebral and are mainly
caused by head injury. Other causes include AVM, , and AV . Because is generally present during observation of CT and MRI
imaging, SDH and EDH are referred to as subdural or epidural “hematoma,” not subdural or epidural
“ .”

4. Subarachnoid hemorrhage (SAH).
SAH is referred to as” hemorrhage” rather than subarachnoid “hematoma” because hematoma does not form from SAH.
SAH is further divided as follows:
(a) Primary SAH or spontaneous SAH is mainly caused my exby a ruptured aneurysm.
(b) Secondary SAH develops from ICH flowing into the space.
(c) Traumatic SAH is caused by head injury.

5. Intraventricular hemorrhage (IVH).
Most instances of IVH result from ICH breaking into ventricles or from a injury. The incidence of primary IVH is low. AVM rupture is a cause of primary IVH.