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Biomedical subjects

A S Rothman

Publications and source records attributed to A S Rothman.

14 recordsLinked to original sources
PubMed1994

Ependymomas of the third ventricle.

Third ventricular ependymomas are rare tumors that have not been specifically examined. Four cases of these tumors are reported. The presenting symptoms included headache, ataxia, vertigo, and Parinaud's syndrome. All the patients underwent computed tomographic scanning and cerebral angiography, followed by craniotomy and microsurgical resection of the tumor. In addition, all patients had or developed symptomatic obstructive hydrocephalus requiring shunting procedures. Three of the patients are alive with a follow-up of 4 to 12 years. It is remarkable that these tumors are so rare, given that the ependymal surface area of the third ventricle is greater than that of the fourth. The management of these tumors should include aggressive surgical resection, radiation therapy, and cerebrospinal fluid diversion.

Adult↗
PubMed1993

Thoracic herniated discs: review of the literature and 12 cases.

In comparison with herniations of lumbar or cervical intervertebral discs, symptomatic thoracic disc herniation is rare. Between 1986 and 1991, 12 cases of thoracic herniated discs were treated at The Mount Sinai Hospital, New York City. Most patients had back pain or myelopathy. Nine of the disc herniations occurred at the lowest six thoracic interspaces. Eight patients underwent costotransversectomy and discectomy. Seven of these patients improved without complication. One patient was subsequently found to have a spinal arteriovenous malformation below an incidental herniation that had been identified by magnetic resonance imaging. Because of the nonspecificity of the signs and symptoms, as well as the prevalence of incidental herniations on imaging, a careful clinical and radiologic correlation is mandatory when diagnosing this uncommon pathology.

Adult↗
PubMed1991

Intracranial chordoma in a preadolescent. Case report.

Chordomas are rare tumors derived from notochord remnants occurring primarily in the sacrum, clivus, and cervical regions. Exceptionally, these tumors occur in children, though usually in the sacrum. Eight cases of clivus chordoma have been described in preteenagers. In this report, a clival chordoma with unusual radiologic features is described in an 11-year-old boy. The literature regarding this entity is reviewed.

Brain Neoplasms↗
PubMed1991

Spinal Charcot arthropathy.

Charcot joints of the spine are well-documented clinical entities most commonly associated with tabes dorsalis. Spinal neuropathic joints, however, may be produced by other disease processes including syringomyelia. In this review, the authors discuss the cause and treatment of spinal Charcot arthropathy with emphasis on surgical therapy and results.

Arthropathy, Neurogenic↗
PubMed1991

Low back pain in children.

Low back pain is a rare phenomenon in children. The etiology differs from the degenerative and diskogenic disease in adults and is almost never a manifestation of psychological disturbance. Low back pain in children is often the harbinger of serious underlying pathologic changes and should be evaluated by state-of-the-art neuroradiologic tests.

Adolescent↗
PubMed1990

Magnetic resonance imaging and computed tomography of an intraventricular craniopharyngioma.

The computed tomography (CT) and magnetic resonance imaging (MRI) appearances of an intraventricular craniopharyngioma are discussed. The unusual CT appearance of our case is compared to the previous 13 cases in the CT literature. The MRI scan represents the only known description of an intraventricular craniopharyngioma in the current literature. The characteristics of our case are compared to the MRI appearance of suprasellar craniopharyngiomas.

Adult↗
PubMed1990

Leptomyelolipoma: analysis of 20 cases.

Leptomyelolipoma (lumbosacral lipoma) is a common form of spinal dysraphism. The deficits produced include sensory, motor, bowel, and bladder dysfunction, and vary in incidence between the pediatric and adult populations. Twenty patients treated surgically at the Mount Sinai Hospital between 1972 and 1988 are reviewed. Fifty percent were 12 years of age or less and 50% were older than 18 years of age. The surgical approach was designed to accomplish untethering of the conus medullaris, debulking of the lipomatous mass compressing the cord, reconstruction of the dural canal, and reapproximation of the paraspinal muscles and lumbosacral fascia to prevent future trauma. Postoperatively, no patient experienced deterioration of neurological function. Of the symptomatic patients. 67% displayed dramatic improvement or became asymptomatic and 33% experienced stabilization of their deficits. The symptoms most resistant to surgical correction were orthopedic foot deformities and bowel dysfunction, whereas bladder dysfunction, motor weakness, and radiculopathies were most amenable to surgical therapy. Early surgical repair is recommended in these cases to forestall irreversible neurological damage.

Adolescent↗
PubMed1986

Schwannoma presenting as lumbar disc disease in an adolescent boy.

Lumbar disc disease and spinal cord tumors occur relatively rarely in the pediatric age group. We report on a 16-year-old boy who presented with signs and symptoms of lumbar disc disease that failed to respond to conservative treatment. He was diagnosed preoperatively to have schwannoma of the S-1 root.

Adolescent↗
PubMed1986

Ruptured intracranial aneurysms as a cause of subdural haematoma. Potential diagnostic pitfalls and the surgical management of the acute patient.

Seven cases of aneurysms that ruptured into the subdural space and were treated surgically are reviewed. Six out of the seven presented with signs of uncal herniation, three of them for at least for four hours or more. They all died in spite of urgent decompression and drainage. Three others suffered from uncal herniation for less than four hours and they all did well. The seventh patient had a small subdural haematoma with no signs of compression of the underlying neural structures. This last patient also had a good outcome. The authors point out that the aneurysm causing the haematoma might be overlooked should one utilize CT (computerized tomography) scan alone without contrast. However, in most instances the history gives the aneurysm diagnosis despite the CT scan of haematoma only. Intravenous contrast CT scan may occasionally demonstrate the aneurysm, provided modern CT equipment is adequately utilised. Severe neurological deficit and uncal herniation might still be reversible provided decompression can be carried out in less than four hours. If accessible the aneurysm should also be clipped at the same time.

Adult↗
PubMed1986

A cavernous sinus cavernous hemangioma. Case report.

The case of a Turner's syndrome patient with an intracavernous hemangioma is presented. The rarity of this lesion is stressed, as is surgical removal without postoperative deficit, the role of estrogens in the pathogenesis, and the clinical and radiological findings.

Adolescent↗
PubMed1985

Anterolateral decompression for metastatic epidural spinal cord tumors. Results of a modified costotransversectomy approach.

Since 1981, 12 patients with epidural spinal cord compression from metastatic carcinoma have been treated surgically by a modified costotransversectomy approach for anterolateral decompression. Before surgery, all patients had received dexamethasone, and had deteriorated neurologically despite radiation therapy, chemotherapy, or steroid therapy. Postoperatively, nine patients (75%) improved neurologically and were ambulatory, two (17%) had no change in neurological status, and one patient was unchanged initially but deteriorated and died 8 weeks later. Anterolateral decompression by a modified costotransversectomy approach should be considered for management of ventrally located tumors or when posterior stabilization is considered a possible requirement following a proposed anterior decompression.

Adenocarcinoma↗
PubMed1985

Multiple intracranial aneurysms in sickle cell anemia. Report of two cases.

Neurological complications of sickle cell anemia occur in 18% to 29% of patients with homozygous hemoglobin S disease. A review of the literature yielded reports of two cases, both treated conservatively, of multiple intracranial aneurysms occurring in patients with sickle cell anemia. The authors report two cases of subarachnoid hemorrhage secondary to multiple intracranial aneurysms in patients with sickle cell anemia. One of the two patients underwent three craniotomies for ablation of six intracranial aneurysms. The techniques used in the treatment of these patients are presented.

Adult↗