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Biomedical subjects

A K Mahapatra

Publications and source records attributed to A K Mahapatra.

At least 145 records · Page 8Linked to original sources
PubMed1990

Does optic nerve injury require decompression?

Forty patients with indirect optic nerve injury were prospectively analysed. Ultimate outcome on conservative management were correlated to their visual evoked potential (VEP) finding and the need for optic nerve decompression was questioned. An associated indirect optic nerve injury was observed in 2% of all head injuries. Ethmoid fracture was recorded in 2 patients and optic canal fracture was recorded in one patient. CT scanning for optic canal and for the orbit revealed abnormality in none of these patients. All the patients were managed conservatively and received intravenous dexamethasone for 48 hours followed by oral prednisolone therapy. Optic nerve decompression was not undertaken. VEPs were present in 18 patients of whom 4 had normal VEPs. Twenty patients had visual improvement. Amongst the patients with positive VEPs 89% had visual improvement. It is concluded that VEP study may help in avoiding unnecessary decompression of the optic nerve.

Adolescent↗
PubMed1990

Evoked potentials in severe head injuries: a prospective study of 40 cases.

Evoked potential (EP) studies were performed in 40 severe head injury patients with Glasgow Coma Scale 8 or below. CT scans were performed in all to evaluate the intracranial pathology. EP studies were performed within 48 hours of admission and outcome was correlated to the initial EP findings. Normal brainstem auditory evoked potentials (BAEP) and sensory evoked potentials (SEP) were recorded in 23 and 17 cases with a good recovery in 86.9% and 82.3% respectively. Absent BAEP and SEP were recorded in 6 and 10 cases with a good recovery in 33% and 50% respectively. When both were normal good outcome was recorded in 92.8% cases. All the patients in whom both BAEP and SEP were absent had a poor outcome. In this study BAEP had a better predictive value than SEP.

Adolescent↗
PubMed1989

Cystic medulloblastoma.

In children medulloblastoma is a commonly encountered posterior fossa midline tumour in which cystic degeneration is not uncommon. A cystic medulloblastoma without solid component has, however, not been described. We report a 12-year-old boy with a posterior fossa midline cystic lesion on CT with surgical and histological confirmation of the diagnosis.

Cerebellar Neoplasms↗
PubMed1989

Post-traumatic intradiploic pseudomeningocele in children.

Eight children with post-traumatic pseudomeningocele are reported. In this paper the mean age at the time of injury was one year and ten months. All of them gave a history of a fall from a height. In six patients the meningocele was located in the parieto-occipital region. The frontal bone was involved in one and the roof of the orbit in another. All these patients had localized progressive swelling of the skull associated with a bony defect. Four patients had a history of convulsion and three had hemiparesis. The meningocele was excised, the dural defect repaired and a cranioplasty was performed in all. Good recovery was observed in all of them.

Adolescent↗
PubMed1989

Predictive value of visual evoked potentials in unilateral optic nerve injury.

Forty-five patients with posttraumatic unilateral blindness were prospectively analyzed. The computed tomography scan was normal in all and an optic canal fracture was recorded in only one patient. Visual evoked potentials were performed within 48 hours of initial evaluation and repeated within 7 to 10 days. Five patients had normal visual evoked potentials and 15 patients had abnormal responses. No visual evoked potentials were recorded in 25 patients. Five patients with normal visual evoked potentials had good visual recovery. Thirteen of the 15 patients with abnormal responses also showed significant visual improvement. This study showed that positive visual evoked potentials were reliable in predicting the visual outcome; 90% of the patients with positive visual evoked potentials had complete or partial visual recovery.

Adult↗
PubMed1989

Medullomyoblastoma. A case report.

A case of medullomyoblastoma was studied by light and electron microscopy and by immunohistochemistry. It showed glial and neuronal differentiation in the medulloblastoma areas and rhabdomyoblastic differentiation in the intervening areas.

Cerebellar Neoplasms↗
PubMed1989

Transfusion malaria amongst operated neurosurgical patients--a prospective study of 22 cases.

Twenty two patients with transfusion malaria were studied over a one year period. They constituted 75% of all neurosurgical patients receiving blood transfusions during surgery or in the immediate postoperative period. Malaria parasites could be demonstrated in the peripheral blood smears of only eight patients, and the rest (14) were diagnosed on clinical grounds, further supported by their prompt response to chloroquine therapy. In all the patients, investigations for local and systemic infections were normal. Cerebrospinal fluid examination did not reveal any abnormality. Patients under 30 years of age had significantly higher incidence.

Adolescent↗
PubMed1987

Brainstem auditory evoked response and vestibulo-ocular reflex in severe head injury patients. A prospective study of 60 cases.

Brainstem auditory evoked response (BAER) performed in 60 serious head injury patients, over the last two year period at All India Institute of Medical Sciences, New Delhi have been analysed, to correlate the findings with ultimate outcome. All patients included in this study were unconscious, not following any command at the time of initial evaluation, mostly within 48 hours of injury. Repeat studies were performed in surviving patients. Computerized cranial tomography was performed to establish the nature of the intracranial pathology. The clinical status and cold caloric responses were recorded in all. The patients were followed up for 1 to 24 months. Three patients had extradural haematoma, 2 patients had subdural haematoma and 30 patients had intracerebral contusion/haematoma. Brain oedema was recorded in 14 cases. BAER was normal in 32 patients and 26 of them had good recovery (81%). Three patients with normal BAER died. Abnormal BAER was recorded in 21 patients and only 50% of them had good recovery and 25% of them died. In 7 patients BAER was absent and only 2 (29%) had a good recovery. Thus 48 out of 60 patients (66%) had a good recovery and 11 (18%) died. When compared to cold caloric response, 87% patients with normal caloric response had a good recovery and 5 out of 6 patients with absent caloric response died and remaining 1 left in a vegetative state. Thus the caloric response is at least as good a prognostic factor as BAER.

Adolescent↗
PubMed1987

Salmonella intracerebral and subdural abscess--report of two cases.

Two cases of the rarely encountered Salmonella typhi subdural empyema are reported. The first was in an 11 month old infant and the second in a 25 year old adult. Neither of them suffered from typhoid fever. The causative organism was not suspected until the culture report was obtained. Both patients responded satisfactorily to therapy.

Adult↗
PubMed1985

Medullomyoblastoma. A teratoma.

Three cases of medullomyoblastoma in children are reported. The second case is unique in that in addition to areas of medulloblastoma and rhabdomyosarcoma, there were areas of well-differentiated teratoma containing all mature elements. This observation lends support to the teratomatous nature of medullomyoblastoma.

Cerebellar Neoplasms↗
PubMed1985

Bilateral decerebration in head-injury patients. An analysis of sixty-two cases.

The factors that contributed to recovery were reviewed in 62 head-injured patients with bilateral decerebration. The most important prognostic variables were age, mode of accident, time interval since injury, results of initial neurological evaluations, and the type of intracranial mass lesion. A higher survival rate was recorded in patients less than 20 years of age, those involved in nonvehicular accidents, those admitted within 6 hours of the accident, and where the vestibuloocular reflexes were preserved. Patients with extradural hematomas and those with nonsurgical intracerebral mass lesions also had a relatively better prognosis. In no patient was elective ventilation, steroid, or megadose barbiturate therapy utilized. Twenty patients (32%) of the 62 survived, and 11 patients had a good functional recovery.

Adolescent↗