Biomedical subjects
Publications and source records attributed to A Sami.
We report the case of a 14 year-old patient presenting with a thoracic spinal cord compressing syndrome (T5-T6). The myelography and magnetic resonance imaging showed an intramedullary cystic mass. One year after the surgical excision of the capsule and an easy aspiration of the tumoral content, this patient had a good neurological recovery.
Three cases of abdominal catheter migration through the anus following ventriculo-peritoneal shunt are described. Two cases involved hydrocephalus secondary to tuberculous meningitis and the third myelomeningocele. Among the reasons for migration, the length of the abdominal catheter, trauma during the operation and infection must be taken into consideration. One patient was suffering from meningitis at the time of admission, while the two others were asymptomatic. Treatment involved removing the peritoneal catheter in 2 cases and the entire shunt system in the patient with meningitis. The shunt was replaced one to two weeks later. The outcome was favourable in all three cases.
Ten cases of intra-orbital hydatid cysts were operated from January 85 to December 91. The aim of this retrospective study is to show the importance of this pathology with regard to other intra-orbital expansive processes and to discuss the efficiency of neurosurgical approaches. The mean age was 25 years, with 5 women and 5 men. The symptoms consisted in progressive unilateral exophthalmia in 8 cases and acute one in 2 cases. Visual deterioration was observed in 7 cases: a reduced vision acuity in 6 cases and blindness in one case. Fundus oculi showed papillary oedema in 4 cases and optical atrophy in one case. Slight disturbance of ocular mobility was observed in 5 cases. CT Scan gave positive diagnosis and predicted the hydatid nature in 9 cases. Fronto-orbital approach, taking away the squamous portion of the frontal bone, orbital arc and roof, was made in 9 cases. It permitted to remove the cyst without rupture of the capsule in all cases. Fronto-temporal approach was used in one case. The evolution was excellent after 8 months to 6 years in 4 patients. Five patients were improved with reduction of exophthalmia, stabilisation of visual acuity and eye movements. Blindness remained unchanged in one patient.
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In this retrospective study, the authors analyse 40 cases of encephalic tuberculomas collected between 1973 and 1991. Most of the patients were young and four out of five were less than 30 years old. The intracranial hypertension syndrome was predominant (75% of the cases). Topographic diagnosis of the space-occupying process was established by arteriography in 13 cases, but a more precise approach to the nature of the lesion could only be obtained by CT (27 cases). The supratentorial localization predominated in 70% of the cases. 16% of the lesions were multiple and 7 patients had developing extracranial tuberculosis. All the patients received medical treatment associating 3 antibacillary agents. Twenty-five patients underwent surgery, 23 of these for diagnostic purpose and 2 following the failure of the isolated medical treatment. Five patients (12.5%) died after a prolonged coma. Recovery was achieved in 50% of the patients. Fifteen of these patients (37.5%) still have neuro-ophthalmologic sequelae.
Sixty-five children with 76 hand anomalies had brachial angiography performed to help plan appropriate surgical management. Three different methods of angiography were used. The study showed that the direct exposure method is safe and simple, has few complications and gives the best visualisation of the arterial supply of the hand. It also showed that each type of congenital hand deformity is frequently associated with specific vascular alterations. Angiography is an important and safe investigation in the pre-operative assessment of cases of complex congenital hand deformities.
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