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Biomedical subjects

A Jamjoom

Publications and source records attributed to A Jamjoom.

At least 19 recordsLinked to original sources
PubMed2000

Spinal aspergillosis in nonimmunocompromised host mimicking Pott's paraplegia.

The aim of this report is to highlight the less-known aspergillus spondylitis (AS) that may completely mimic Pott's paraplegia, leading to occasional but expensive diagnostic error, as the chemotherapeutic management of the two is different. A case of a patient with the diagnosis of Pott's paraplegia who turned out to have aspergillus spondylitis is described. Issues and difficulties regarding the differentiation between these two forms of spine infection and their therapeutic implications are discussed. We conclude that differential diagnosis of spinal tuberculosis (TB) should include aspergillus spondylitis, as cure of spinal aspergillosis, especially in early stages, is possible with surgery and/or antifungal agents, and morbidity and mortality are high in neglected cases.

Adult↗
PubMed1999

Atypical forms of spinal tuberculosis: case report and review of the literature.

OBJECTIVE: The object of this report is to highlight some of the less known atypical features of spinal tuberculosis (TB) in the hope of facilitating early diagnosis. Pure neural arch and sacral TB is rare and the co-existence of these two as widely separated skip lesions in the same patient is even rarer. CLINICAL PRESENTATION: An unusual case of tuberculous process affecting the sacrum as well as the neural arches of upper cervical vertebrae is presented. Neither the clinical features nor the imaging techniques, including radiography, bone scintigraphy, computed tomography, and magnetic resonance imaging, were helpful in establishing the diagnosis. The destructive lesion of the sacrum with a rectally palpable presacral mass was thought to be a chordoma or chondrosarcoma until the patient developed upper cervical cord compression with an extradural myelographic block. Development of this second destructive lesion involving the posterior spinal elements (the neural arch) led to a diagnosis of malignant spinal metastasis. The true diagnosis was only revealed by the histology of the solid tumor-like extradural mass in the upper cervical region and demonstration of acid-fast bacilli (AFB) in the lesion. Anti-TB chemotherapy resulted in complete resolution of sacral and cervical lesions as well as the neurologic deficits. CONCLUSION: Differential diagnosis of the obscure spinal lesion should include tuberculosis, specifically the atypical forms; especially because complete cure is possible with early treatment and neurologic morbidity is high in neglected cases.

Adult↗
PubMed1997

Orbito-cranial injury caused by penetrating metallic foreign bodies: report of two cases.

Two cases of orbito-cranial injury caused by foreign bodies (FBs) penetrating the lateral wall and roof of the orbit are described. In the first patient, a long rusted nail acted as a missile and was only detected by X-rays and CT scan. The nail penetrated the orbit, the eyeball, the lateral orbital wall, and the temporal lobe of the brain. Lodged partly in the orbit and partly in the brain, this nail caused leakage of cerebrospinal fluid (CSF) through eye and led to orbital cellulitis and localized meningitis. The foreign body (FB) was removed through an extradural pterional approach with rapid resolution of orbital cellulitis and meningitis. In the second patient, large metallic FB, having penetrated the orbital roof was lodged intracranially above the chiasma. This was removed via frontal craniotomy. Mechanism of such injuries and appropriate surgical approaches are described as well.

Adult↗
PubMed1997

Neural arch tuberculosis: radiological features and their correlation with surgical findings.

Radiological features of 17 cases of neural arch tuberculosis (NAT), treated surgically by the authors, are reviewed and correlated with the operative and histopathological findings. The diagnostic accuracy of different imaging modalities in the evaluation of this rare, atypical form of spinal tuberculosis was found to be very low. Thus, the initial diagnosis was in error in 15 out of 17 of our cases. Recognition of the radiological diagnostic features of NAT is important, not only because they may mimic primary or metastatic spinal neoplasms, but also because of the surgical implications. Computed tomography (CT) and magnetic resonance imaging (MRI) features correlated most closely with the surgical findings, whereas plain spinal radiographs and myelograms were found to be non-specific and non-diagnostic.

Adolescent↗
PubMed1997

Childhood brain abscess in Saudi Arabia.

The characteristics of childhood brain abscess in Saudi Arabia are outlined in this review of 17 consecutive cases treated at King Khalid University Hospital (KKUH) between 1985 and 1994. The data on 20 consecutive adults with brain abscess treated at KKUH during the same period were also analysed. Compared with series from the West, the children were unusual because of the relatively low incidence of cardiogenic and anaerobic abscesses and the relatively high incidence of post-traumatic, infratentorial and staphylococcal abscesses and sterile cultures. Compared with cases of brain abscess in adults, the children showed a much lower incidence of idiopathic abscess, a higher incidence of infratentorial abscess and a much better outcome. Factors accounting for the zero mortality rate in these children are discussed.

Adolescent↗
PubMed1996

Modified coronal computerized tomographic cuts for transsphenoidal surgery. Technical note.

Computerized tomographic (CT) cuts passing through the anterior nasal spine and the most prominent part of the sellar floor (spino-sellar or SS cuts) were found to be useful in minimizing the chances of anatomical disorientation during the transsphenoidal microsurgical approach as well as in preoperative planning and selection of the length and choice of the instruments to be used. Routine preoperative SS cuts of CT scan are advised.

Adenoma↗
PubMed1996

Cranial and intracranial aspergillosis of sino-nasal origin. Report of nine cases.

This paper is an attempt at defining the most efficacious surgical and antifungal therapy for invasive cranial and intracranial aspergillosis, and is based on experience with nine non-immunocompromised patients treated and followed-up by the authors between 1983 and 1994; as well as on the summary of previously reported cases and advances in therapy of this condition. Depending on the degree of aspergillar involvement of the cranial base and intracranial structures, a classification, with implications for treatment and prognosis, is also proposed. Two patients had extracranial skull base erosion; whereas relentlessly progressive granulomas, mimicking malignancy, invaded the skull base and intracranial contents in seven cases. Of these seven patients with cranial and intracranial invasion, two died of acute intracranial haemorrhage due to fungal invasion of cerebral blood vessels. In two patients, complete surgical eradication of the disease proved impossible due to cavernous sinus involvement, while residual aspergillomas are still present in orbit and paranasal sinuses (PNS) in a further two patients in spite of multiple surgical procedures and prolonged antifungal chemotherapy (AFC). What appears to be a cure has been effected in one patient only. Multiple therapeutic strategies were used. Biopsy plus systemic AFC was ineffective, surgical drainage and debridement plus systemic AFC resulted in long-term survivals but no cure. Radical surgery in conjunction with systemic and local (intracavitary) AFC should be considered to improve an otherwise poor prognosis.

Adult↗
PubMed1996

Intestinal obstruction caused by extraperitoneal cerebrospinal fluid collection.

External compression caused by a massive extraperitoneal cerebrospinal fluid collection lead to intestinal obstruction in a 3-year-old child who had previously had a ventriculoperitoneal shunt for treatment of hydrocephalus. Radiological findings and ways of preventing this situation are discussed. A useful diagnostic radiological sign, the "coiling sign', indicating shunt misplacement at the peritoneal level, is also described.

Cerebrospinal Fluid Pressure↗
PubMed1995

Isolated posterior fossa hypertension and brainstem compression caused by entrapped Dandy-Walker cyst: a case report.

Lateral ventricular shunting alone is often considered to be adequate treatment for hydrocephalus caused by Dandy-Walker syndrome. A patient is presented in whom progressive spastic tetraparesis and signs of severe brainstem compression developed due to an entrapped posterior fossa cysts, in spite of an adequately functioning lateral ventricular shunt. Addition of a cystoperitoneal shunt resulted in rapid resolution of symptoms and deficits. This case illustrates that potentially fatal brainstem compression and dangerous posterior fossa hypertension may develop if the posterior fossa cyst does not communicate with the lateral ventricles, where the shunt is placed.

Brain Diseases↗
PubMed1994

Clinical characteristics of traumatic extradural hematoma: a comparison between children and adults.

In this study of 43 children who had surgery for traumatic extradural hematoma (EDH) at Frenchay Hospital, England, between 1975 and 1987, the authors attempt to outline the various clinical characteristics of EDH which are different in children (age range 1-15 years) and adults (age range 16-84 years). The results confirm that children with traumatic EDH are less likely to have injury be caused by an RTA, are less likely to remain unconscious from the time of injury to the time of the operation, and are less likely to require immediate surgery (less than 6 hours after injury). In addition, the CT scan is less likely to show in associated intradural injury, and the outcome is significantly better.

Adolescent↗
PubMed1994

Bronchoalveolar lavage: results of sequential, selective techniques in viable murines.

The purpose of this study was to develop an optimal technique for performing sequential bronchoalveolar lavage (BAL) in a murine animal model. Two general anesthetic regimens and four operative techniques of BAL were tested. Anesthesia by intraperitoneal injection of ketamine hydrochloride (100 mg/kg body wt) resulted in death for four of ten subjects, whereas inhalation of diethyl ether led to death for one of ten subjects. BAL using a balloon catheter under bronchoscopic guidance was comparable with postmortal lavage, tolerated better, and resulted in superior cell retrieval with respect to cell differential (macrophages: 95 +/- 2.3; lymphocytes: 3 +/- 1.2; polymorphonuclear lymphocytes [PNL]: 1.2 +/- 1.4) compared with two other techniques using a bent metal tube/polyethylene tubing combination (macrophages: 19.3 +/- 27.4; lymphocytes: 3.8 +/- 4.3; PNL: 35.5 +/- 35.5) and a bronchoscope/polyethylene tubing combination (macrophages: 11.1 +/- 25.5; lymphocytes: 0.7 +/- 1.0; PNL: 55.8 +/- 41.0). The BAL fluid contained significantly more alveolar macrophages and fewer PNL and epithelial cells (p = 0.0001, p = 0.0025, p = 0.02, respectively). We conclude that the technique using a balloon catheter under bronchoscopic guidance during inhalation of diethyl ether is the procedure of choice and results in a representative sample of BAL.

Anesthesia↗
PubMed1994

Results of day-case surgery for lumbar disc prolapse.

Microdiscectomy for lumbar disc prolapse on a day-patient basis was introduced by our department in 1985 and first reported in 1987, but has not been generally adopted in the United Kingdom. We now report our experience of the first 100 patients with lumbar disc prolapse treated by day-case microdiscectomy. Post-operative assessment was in the out-patient clinic and by subsequent postal questionnaire (average follow-up 37 months, range 3-64 months). Complications were few and are described. Only three patients developed a recurrent disc prolapse. Patient feedback was favourable and the majority (85%) said that, if necessary, they would be prepared to have the operation again on a day-case basis. For selected patients, lumbar microdiscectomy is a suitable procedure for day-case surgery.

Activities of Daily Living↗
PubMed1994

Cervical lymph nodes metastases from a pituitary carcinoma.

The authors report a case of a pituitary carcinoma which was locally invasive and which metastasized to cervical lymph nodes more than 9 years after the initial presentation. Cells from the tumour and metastasis immunostained with antibodies to prolactin and growth hormone, even though there was no clinical or biochemical evidence that the tumour was secreting prolactin or growth hormone. In addition, ultrastructural studies showed a monomorphic tumour with secretory granules much smaller than those normally associated with prolactin and growth hormone secretion. The clinical and pathological features suggest that the tumour is probably an acidophil stem cell adenoma, which although known to be aggressive in its clinical behaviour has not been previously reported to metastasize.

Adenoma, Chromophobe↗