T.M.H. Chakera's research while affiliated with Royal Perth Hospital and other places

Publications (30)

Article
We report on paravertebral extravasation of water soluble contrast medium seen during lumbar myelography and/or subsequent post myelogram CT in 10 patients. This is an uncommon feature of lumbar myelography occurring in less than 1% of cases in our experience and which has not been previously documented.
Article
SUMMARYA case of traumatic transection of the optic chiasm diagnosed by magnetic resonance imaging is reported.
Article
The association of post-stroke depression (PSD) and site of cerebral lesion was investigated in 117 patients with first-ever stroke in the Perth Community Stroke Study, who were depressed 4 months post-stroke. The site of lesion was previously localised by studying the CT scan in conjunction with the atlas of neuroanatomy and cranial computed tomog...
Article
The CT appearance of herpes simplex encephalitis (HSE) is well documented. The late features are usually those of atrophy, often bilateral and commonly affecting both frontal and temporal lobes. Gyriform calcification occurs rarely following HSE in infants but calcification in adults has not been described. We present a case of acute HSE in whom de...
Article
Evaluation of the relative efficacy of three screening instruments for depression and anxiety in a group of stroke patients was undertaken as part of the Perth community stroke study. Data are presented on the sensitivity and specificity of the Hospital Anxiety and Depression Scale (HAPS), the Geriatric Depression Scale and the General Health Quest...
Article
Full-text available
The Perth Community Stroke Study (PCSS) was a population-based study of the incidence, cause, and outcome of acute stroke. Subjects from the study were assessed initially, by examination and interview, and at four- and 12-month follow-ups to determine differences in prevalence of depression between the sexes and between patients with first-ever and...
Article
Full-text available
The prevalence of anxiety disorders in 294 patients who survived to four months in the Perth Community Stroke Study (Perth, Australia), and a follow-up of these patients at 12 months, are presented. Diagnoses are described both in the usual DSM hierarchic format and by a non-hierarchic approach. Adoption of the hierarchic approach alone greatly und...
Article
Full-text available
In a population based register of stroke (n = 536) compiled in Perth, Western Australia during an 18 month period in 1989-90, 60 cases (11%) of primary intracerebral haemorrhage were identified among 56 persons (52% men). The mean age of these patients was 68 (range 23-93) and 46 (77%) events were first ever strokes. The crude annual incidence was...
Article
To determine the age and sex specific incidence, and case fatality of stroke in Perth, Western Australia. A population-based descriptive epidemiological study. All residents of a geographically defined segment of the Perth metropolitan area (population 138,708) who had a stroke or transient ischaemic attack between 20 February 1989 and 19 August 19...
Article
To determine the incidence and case fatality of seven distinct subtypes of stroke in Perth, Western Australia. A population-based descriptive epidemiological study. All residents of a geographically defined segment of the Perth metropolitan area (estimated population 138,708 persons) who had a stroke or transient ischaemic attack between 20 Februar...
Article
The first aim of the study, to see every case of stroke and TIA which has occurred in a representative population, unbiased by hospital admission and with high pathological documentation, is being achieved. To date, the incidence rates for stroke in Perth are strikingly similar to those in other major population-based studies in the Western world....
Article
We reviewed the records of 28 patients with 30 burst-dispersion spinal fractures treated since the introduction of CT facilities in Western Australia. Twenty-five patients showed spinal canal deformity and stenosis with bone fragments protruding into the canal on the initial scan. Of these, 22 patients were treated nonsurgically. Fifteen of the con...
Article
Full-text available
Radiographs and medical and surgical records of 51 patients following spinal injury have been reviewed. All the patients had been paraplegic for 20 years or more at the time of the survey. The reason for the survey was to assess the incidence of degenerative change of the hips, sacroiliac and shoulder joints in patients following spinal injury. Our...
Article
A retrospective study of 75 consecutive cases of spontaneous cerebellar haemorrhage was undertaken in order to evaluate the clinical features and natural history of this condition. A wide spectrum of clinical findings contributed to the poor clinical diagnostic accuracy of 23 per cent, with common misdiagnoses including brainstem stroke and vestibu...
Article
At present CT air meatography is the examination of choice for all patients suspected of having a small acoustic neuroma not demonstrated by high resolution contrast enhanced computed tomography. Several publications have indicated that the examination is innocuous and can be carried out on an outpatient basis. An analysis of the side effects of th...
Article
Abstract In contrast to the scarcity of recorded cases of radiologically studied venous angiomas, venous angiomas are the most common of the four basic types of congenital intracranial vascular malformations encountered incidentally at autopsy. Their clinical significance remains unclear. When symptomatic, they are associated mainly with hemorrhage...
Article
18 cases of syringomyelia examined over the last 3 years are reviewed. 9 cases were post-traumatic (PT) and 9 were non-traumatic (NT). Of the 9 NT cases, 5 were secondary to Arnold-Chiari malformation, 1 was associated with Astrocytoma of the cord, and 3 were designated idiopathic. The appearances of syringomyelia on myelogram CT (MCT) – the accumu...
Article
Certain clinical features are known to correlate with patient outcome in acute stroke, but the potential of cranial CT scan as an aid to predicting recovery after stroke remains unclear. In a prospective study, 178 acute stroke patients admitted to Royal Perth Hospital were assessed by 4 neurologists; 150 cranial CT scans were performed and these w...
Article
Eleven patients with large pituitary tumours and with extrasellar extension were studied prospectively to assess the response of these tumours to bromocriptine. Five out of the six patients with high serum prolactin due to prolactinomas showed rapid and dramatic reduction in tumour size when treated with bromocriptine. In contrast, none of the five...
Article
To determine whether prolactin secreting and non-functioning pituitary tumours respond differently in terms of shrinkage to bromocriptine, we prospectively studied ten consecutive patients (five with prolactinomas and five with non-functioning tumours) complicated by extra-sellar extensions. No patient had received prior radiotherapy or bromocripti...
Article
A patient with symptomatic hydrocephalus, due to an elongated and ectatic basilar artery and involving the third ventricle, is described. Characteristic CT scan features are outlined and were sufficient to confirm the diagnosis without resort to pneumoencephalography or angiography. The intraventricular CSF pressure was normal and a ventriculoperit...
Article
A patient with a brainstem stroke was found to have an atlanto-axial dislocation and a vertebral artery aneurysm at the C1/C2 level. The authors postulate that the aneurysm was caused by chronic arterial trauma due to excessive movement at the C1/C2 level. The aneurysm had reduced in size on a repeat angiogram 18 months after stabilisation of the n...
Article
Angiographic studies were performed on 60 normal and diseased gallbladders obtained from cholecystectomy specimens and necropsy examinations. The normal macro and microangiographic pattern was confirmed, as was the reduction in the number of blood vessels in chronic cholecystitis and cholelithiasis. Histological correlation however showed that the...
Article
Detailed analysis of complications in 363 patients undergoing myelography with metrizamide is presented. Patients have been separated into three groups: those who had lumbar myelograms via lumbar puncture; patients who had cervical myelograms via lumbar route and patients who had cervical myelograms via cervical puncture (lateral C1/C2. approach)....
Article
A number of different materials are used for transcatheter embolization because no single substance is suitable for all situations (Berenstein and Krischeff, 1979). In general, it should be possible to control the depth of vessel penetration and to avoid remote embolization or reflux. The material should have low histo-toxicity and be easy to deliv...

Citations

... Studies reported that there is a steep rise in incidences of depression after the initial weeks of stroke up to three to four months. Though there is a marked improvement in physical disabilities, psychological symptoms continue to progress and deter rehabilitation of stroke patients (Paolucci, 2008;Burvill et al., 1996;Paolucci et al., 2019). About 80 % of PSD patients are diagnosed as minor depression with dysthymia (persistent depression) (Paolucci et al., 2006). ...
... There are many complications related to shunt dependency. In 10.9–29% of cases complications (other than mechanical obstruction) occur, the majority of which is a shunt infection [9, 14, 18]. Mechanical complications in shunts including late shunt malfunction may even occur in up to 45.9% in the first postoperative year and up to 81% of patients at 12 years follow-up [8, 9, 18] . ...
... Surgical intervention is also the most effective method for achieving the relief of spinal cord edema and compression, control of intraextramedullary hemorrhage, removal of bone fragment or intervertebral disc material from the vertebral canal, realignment and stabilization of the vertebral column within optimal time period for recovery of spinal cord function (Sturges and Le Counter 2003). Removing of small bone fragments is also controversial and it has been suggested unnecessary (Chakera et al. 1988;Dai 2001;Leferink et al. 2003). ...
... Narrowing of the joint space in the shoulder, another common anatomical abnormality among active wheelchair users, may also lead to impingement and injury of the rotator cuff. 36 Chronic forceful activities in manual wheelchair users such as transfers and propulsion can cause muscle imbalances that can eventually lead to shoulder joint dysfunction. 37 A study comparing the number of magnetic resonance imaging (MRI) abnormalities in the shoulder and an individual's weight found a positive relationship between more image abnormalities and increased weight. ...
... A previous study reported that only 4 of 28 patients who were operated on (14%) had a favorable outcome at 49 months post-surgery, and another reported that 57 patients who were operated on showed a 25% mortality rate and only a 47% favorable outcome rate [5,22]. The overall clinical outcome of patients in the present study therefore falls within the range of the other large series of surgically treated patients with a spontaneous cerebellar hemorrhage [3,12,23]. Taken together, the results suggest that an acute cerebellar hemorrhage remains associated with high rates of mortality and morbidity, although the majority of patients who do survive subsequently experience a good outcome with the ability to function independently. ...
... Furthermore, stroke volume can be a clinically relevant prognostic variable for counseling patients and their families on outcomes. [3][4][5][6][7][8][9][10][11] Stroke volume can also predict those patients who are likely to have postthrombolysis hemorrhage or malignant edema. [12][13][14][15][16] Thus, outside of the research setting in which stroke volumes are measured using computer planimetry in a post hoc fashion, clinicians do not have this information at hand for patient selection for acute treatment, 17 counseling patients, 18 anticipating complications, or enrolling patients in trials. ...
... The maximum dose aimed for was in most studies subjectively selected based on results from previous literature. In other reports the maximum dose used was the one that normalized prolactin levels (26) (effect obtained at low doses in many NFPA cases with disconnection hyperprolactinemia) or dose was increased according to tolerance (27,31). ...
... Medical therapy with dopamine agonists and somatostatin analogues have varied response. Monitoring for treatment failure, tumor progression, and side effects is critical [82][83][84][85][86][87]. ...
... The bifurcation of the basilar artery was above the level of suprasellar cistern and bifurcates at the level of floor of third ventricle causing indentation leading to hydrocephalus more clearly seen on MIP images of TOF ( Figure- 4.5mm [4]. The degeneration of the vascular wall due to atherosclerosis alone or in association with arterial hypertension or congenital cause is suggested as the pathogenetic factor [2].Dolichoectatic basilar artery can cause symptomatic hydrocephalus [1], cranial nerves dysfunction [3] as was seen in our case. ...
... Complications associated with metrizamide (headache, nausea, emesis, hallucinations, photophobia, psychic disturbances, generalized seizures, motor deficits, and visual disorders) develop within 4-6 hr after myelography and coincide with CT demonstration of penetration into the brain and spinal cord [1][2][3][4][5][6] . Cervical myelograms have a greater incidence of complications than do lumbar myelograms because lumbar procedures keep contrast material away from the brain and metrizamide is absorbed while in a caudal location (half-life in the subarachnoid space is 4 hr) [7]. It has been reported that 66% of contrast material can be recovered by aspiration after lumbar myelography [8] . ...