-
[show abstract]
[hide abstract]
ABSTRACT: Progressive post-traumatic cystic syringomyelia is an uncommon and increasingly recognized cause of morbidity following spinal cord injury. We hereby report a 35-year-old gentleman who sustained wedge compression fracture of L-1 vertebral body 15 years back and had complete paraplegia with bowel/bladder involvement. The neurological deficit recovered with minimal residual motor deficits and erectile dysfunction. He presented now with increasing neurological deficits associated with pain and paresthesia. The MRI spine showed a syrinx extending from the site of injury up to the medulla. He underwent a syringo-peritoneal shunt and at followup his pain and motor functions had improved but erectile dysfunction was persisting.
Indian Journal of Orthopaedics 10/2007; 41(4):398-400. · 0.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Subdural empyema is a collection of purulent material between the dura mater and the arachnoid mater. It is a life-threatening complication of paranasal sinusitis, otitis media, or mastoiditis. The classic clinical syndrome is characterized by acute febrile illness that is punctuated by rapid progressive neurological deterioration, and, if left untreated, it will eventually lead to coma with fatal outcome. High-resolution contrast-enhanced computed tomographic scanning has revolutionized the diagnosis of subdural empyema; however, gadolinium-enhanced magnetic resonance imaging provides greater clarity of morphological detail. Treatment of patients with subdural empyema consists of immediate surgical evacuation only in rare circumstances where there are contraindications to surgery or significant mortality risks avoided; conservative treatment is advised. The antibiotics should be given for a period of 3 to 6 weeks with close monitoring of clinical status. Aggressive management of subdural empyema has reduced the mortality rate; still, it is associated with the high incidence of morbidity (ie, neurological deficits) because very ill patients who would have died in the past now survive with deficits. We discuss the etiopathology and diagnosis of subdural empyema and its management.
Infectious Disease in Clinical Practice 04/2007; 15(3):149-153.
-
[show abstract]
[hide abstract]
ABSTRACT: Extracranial meningioma is a rare tumor, and most of the time only after histopathologic examination is diagnosis possible.
A 40-year-old right-handed woman presented with progressive swelling over the right side of the forehead and temporal region associated with proptosis and visual loss. Incisional biopsy of the lesion was reported as spindle cell tumor. Computed tomography scan showed large enhancing predominantly extracranial lesion located in the right anterior frontotemporal region extending into the infratemporal fossa and a relatively thin sheet of tumor on the intracranial aspect of the thickened temporal. Intraoperative impression was malignant tumor involving the temporalis muscle, and a near total excision of the lesion was performed. Histopathologic features were suggestive of meningothelial meningioma arising from the temporal bone with predominant extracranial extension.
Preoperative suspicion of a meningioma in this patient would have resulted in a more aggressive surgical approach as these lesions are relatively benign with indolent course.
Surgical Neurology 02/2007; 67(1):102-5. · 1.67 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Leigh syndrome is a rare progressive mitochondrial disorder of oxidative metabolism. Though it has been reported in infancy and childhood, it is rarely described in adults. The authors describe a patient who had clinical and magnetic resonance imaging features diagnostic of Leigh syndrome, with supportive biochemical and muscle histochemistry evidence.
Annals of Indian Academy of Neurology. 01/2007;
-
Neurology India. 01/2007;
-
[show abstract]
[hide abstract]
ABSTRACT: Progressive post-traumatic cystic syringomyelia is an uncommon and increasingly recognized cause of morbidity following spinal cord injury. We hereby report a 35-year-old gentleman who sustained wedge compression fracture of L-1 vertebral body 15 years back and had complete paraplegia with bowel/bladder involvement. The neurological deficit recovered with minimal residual motor deficits and erectile dysfunction. He presented now with increasing neurological deficits associated with pain and paresthesia. The MRI spine showed a syrinx extending from the site of injury up to the medulla. He underwent a syringo-peritoneal shunt and at follow-up his pain and motor functions had improved but erectile dysfunction was persisting.
Indian Journal of Orthopaedics. 01/2007;
-
[show abstract]
[hide abstract]
ABSTRACT: Intraspinal endometriosis is an extremely rare condition with characteristic symptoms, including lower back pain that increases in severity during each menstrual cycle.
Here, we report a case of endometriosis involving the conus cauda region. This patient presented with acute deterioration secondary to hemorrhage. We also review the relevant literature.
Magnetic resonance imaging scans of the dorsolumbar region showed a mass lesion within the spinal canal at the L1-L2 level with evidence of acute hemorrhage. The patient underwent an emergency D12-L2 laminectomy and microdecompression of the lesion. The histological and immunohistochemical features were characteristic of intraspinal endometriosis.
Intraspinal endometriosis must be recognized as a potential cause of periodic neurological signs and symptoms in young and middle-aged women.
Neurosurgery 09/2006; 59(2):E428; discussion E428. · 2.79 Impact Factor
-
Neurology India 55(4):424-5. · 0.96 Impact Factor
-
Neurology India (ISSN: 0028-3886) Vol 55 Num 4.
-
[show abstract]
[hide abstract]
ABSTRACT: Hyperdense middle cerebral artery sign on non-contrast CT scan has been recognized as a marker of thrombus in the middle cerebral artery. It is associated with a subsequent large cerebral infarction and poor outcome despite treatment. This case illustrates the sign and also its grave consequences.
European Journal of General Medicine (ISSN: 1304-3897) Vol 3 Num 1.
-
[show abstract]
[hide abstract]
ABSTRACT: We report a unique and rare case with definite human immunodeficiency virus infection whose initial presentation was stroke and associated finding of asymptomatic Dandy-Walker malformation in an adult.
European Journal of General Medicine (ISSN: 1304-3897) Vol 2 Num 3.
