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Biomedical subjects

A H Menezes

Publications and source records attributed to A H Menezes.

At least 91 records · Page 5Linked to original sources
PubMed1981

Management of vein of Galen aneurysms. Report of two cases.

Aneurysms of the great vein of Galen are rare and potentially lethal lesions, especially in early infancy. Sectioning of the feeding arteries and excision of the lesions have been proposed for the best long-term results. An alternative approach was utilized in the two children discussed here. The computerized tomography (CT) scan established the precise diagnosis and demonstrated hydrocephalus and cortical atrophy preoperatively. Parieto-occipital craniotomy with an interhemispheric approach was performed to clip the numerous feeders. The procedure was terminated when the sac collapsed and blood aspirated from the lesion was venous in oxygen saturation. A Doppler probe over the aneurysm then revealed a venous flow. Serial postoperative CT scans demonstrated that the mass had shrunk in size. Follow-up angiography was not thought necessary.

Child, Preschool↗
PubMed1980

Arachnoid cysts in children.

Twenty-seven cases of intracranial arachnoid cysts in children aged 1 to 16 years have been studied with attention to diagnosis, pathologic findings, and surgical treatment. In nine patients, the cyst was located in the posterior fossa. In eight patients, there were other CNS or other organ system abnormalities. No specific symptom complex can be ascribed to arachnoid cysts in that the clinical manifestations are the result of their size and location, secondary complications, and remote effects. This is illustrated in the ten cases reported.

Adolescent↗
PubMed1980

Cranial settling in rheumatoid arthritis.

Cranial settling occurs in about 5-8% of patients with rheumatoid arthritis, sometimes resulting in severe neurological problems or even death. It is caused by collapse of the supporting structures at the craniovertebral junction, mainly the lateral masses of C1. Twelve cases are presented; 2 patients with severe neurological problems were treated surgically.

Adult↗
PubMed1980

Abnormalities of the cranio-vertebral junction with cervico-medullary compression. A rational approach to surgical treatment in children.

8 children with cranio-vertebral abnormalities and neurological deficits are reviewed. The specific treatment is dependent on etiology, mechanisms of compression, and whether the bony abnormality can be reduced to its normal position. Irreducible ventral compression of the cervico-medullary junction was relieved by transoral removal of the odontoid-clivus complex in 3 patients. Primary posterior decompression was done in 4 children with dorsal encroachment. A reducible C1-C2 dislocation in 1 child with juvenile rheumatoid arthritis underwent primary posterior fusion. A detailed surgical physiological approach is described.

Adolescent↗
PubMed1980

Craniocervical abnormalities. A comprehensive surgical approach.

Guidelines are proposed for surgical management of symptomatic abnormalities of the craniocervical junction. Experience with 17 recent cases is described. Gas or metrizamide (Amipaque) myelograms with pluridirectional tomograms revealed the etiology and mechanisms of compression of the cervicomedullary junction, as well as its reducibility. Stabilization was the goal in treatment of reducible lesions. Decompression of the cervicomedullary junction was paramount in irreducible cases. Ventral compression was treated in nine patients by transoral transpalatine resection of the odontoid-clivus complex, and all nine improved. A posterior decompression was carried out when bone impingement was present from the dorsal aspect. Fusion was performed in cases in which stability was not achieved by either procedure.

Adolescent↗
PubMed1980

Acute pancreatitis in Reye's syndrome: a fatal complication during intensive supportive care.

Acute pancreatitis was an unexpected complication during the course of intensive supportive management in five patients with Reye's syndrome. Four of the five patients died and one survived with transient neurologic deficits. Although corticosteroid therapy, fluid restriction, and hypothermia may have contributed to the development of this complication, acute pancreatitis may represent a severe manifestation of visceral metabolic dysfunction in Reye's syndrome.

Acute Disease↗
PubMed1979

The complementary nature of computed tomography and angiography in the diagnosis of cerebellar hemangioblastoma.

Cerebellar hemangioblastomas were seen in seven persons, five being members of the same family. All were studied with constrast enhanced CT scans and vertebral angiograms. The CT scans were superior for demonstrating the cystic component of the tumors and associated hydrocephalus, features not usually evident on the angiograms. The angiograms were superior for revealing the vascular nature, supply and drainage of the tumors. In several patients the angiograms revealed more tumors than could be seen by CT. Both CT and angiography contribute important information in the diagnosis of these neoplasms.

Adolescent↗
PubMed1977

Spinal cord abscess: a review.

The literature on abscesses in the spinal cord has been reviewed. A total of 54 cases was reported. A digest is made of information on the subject including the diagnosis, pathology, treatment and the results to be expected. The best results have been achieved by operation plus antibiotic therapy. It is essential that the abscess be drained after aspiration. A case of ours showing the salient features and management of a subacute cervical spinal cord abscess is also reported.

Abscess↗
PubMed1977

Hypothalamic tumors in children. Their diagnosis and management.

17 intrinsic hypothalamic tumors in infancy and childhood occurring between 1963 and 1973 were analyzed in detail because of the consistent mode of approach to diagnosis, therapy and follow-up care. Careful examination of the symptom-time sequence and location provided anatomical-clinical correlations and was even suggestive of the probable histologic type of lesion present. The postoperative and long-term management problems have led to significant conclusions. The best results were obtained with those patients who underwent craniotomy and biopsy, followed by irradiation therapy.

Adolescent↗
PubMedDate not supplied

Bobble-head doll syndrome: review of the pathophysiology and CSF dynamics.

The bobble-head doll syndrome is a rare movement disorder; fewer than 40 cases have been reported. It is usually associated with cystic abnormalities in the region of the anterior third ventricle. Various physiologic mechanisms have been proposed but none of them has been substantiated. We report a patient with this syndrome produced by a suprasellar arachnoid cyst. The CSF dynamics were investigated with CT cisternography. The phenomenon was apparently the result of intermittent obstruction at the foramina of Monro, a feature which has not previously been reported in this condition. The head movement served to partially relieve intraventricular obstruction, by both a posterior displacement of the cyst away from the foramina of Monro and a reduction in cyst size. This finding supports the concept that the bobble-head syndrome may be a "learned" behavior which lessens the symptomatology of hydrocephalus related to foramina of Monro obstruction.

Adolescent↗
PubMedDate not supplied

Pen injury: a rare complication.

An 18-month-old male sustained an intra-oral injury after falling on a pen. The internal carotid artery was occluded without evident neurologic deficit. The pen tip was surgically removed from the cerebellum.

Carotid Artery Injuries↗
PubMedDate not supplied

Lumbar epidural chordoma: MR findings.

Chordomas derive from persistent nests of notochordal cells that do not regress. They usually arise from the midline within bone of the skull base or spinal column. Typical radiographic findings of chordomas include midline location and bony destruction. We report an unusual epidural chordoma of the lumbar spine.

Adolescent↗
PubMedDate not supplied

Chiari I malformations and hydromyelia--complications.

The Chiari I malformation is associated with a hydromyelic cavity in 55-75% of patients. In the author's series (1977-1991), hydromelia occurred in 111 of 131 patients (85%). There were 35 children. Posterior fossa decompression with duraplasty and fourth ventricle to subarachnoid shunt was made in all patients with Chiari I malformation with hydromyelia. The obex connection to the cervical cord central canal was closed with muscle, if widely patent. Eighty-five percent showed sustained objective improvement. The precautions taken to avoid complications and a literature review are tabulated for easy reference.

Adult↗
PubMedDate not supplied

Complications of surgery at the craniovertebral junction--avoidance and management.

The pathology encountered at the craniovertebral junction is extensive. It includes congenital, developmental and acquired abnormalities which ultimately compromise the cervicomedullary junction. The pediatric age group is particularly vulnerable as the muscular support is not fully developed. Numerous surgical approaches have been developed to relieve compression, as well as to stabilize this region. The complications described are from a review of the literature and the author's personal experience.

Cervical Vertebrae↗
PubMedDate not supplied

Cervicomedullary compression by separate atlantal lateral mass.

Compression of the cervicomedullary junction can result from a variety of congenital craniovertebral anomalies. We report an unusual case of cervicomedullary compression by a free lateral atlantal mass associated with contralateral occipito-atlantal fusion.

Brain↗