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Ashok Kumar Mahapatra

Publications and source records attributed to Ashok Kumar Mahapatra.

28 records · Page 2Linked to original sources
PubMed2005

Intramedullary ectopic choroid plexus: report of a rare case.

OBJECTIVE AND IMPORTANCE: Intracranial cysts containing an ectopic choroid plexus or choroid plexus-like tissue have seldom been described in the literature. However, there has been no report of a spinal intramedullary cyst containing an ectopic choroid plexus. This is the first case report in the available literature of an ectopic choroid plexus tissue in the spinal cord. CLINICAL PRESENTATION: A 30-year-old man presented with complaints of progressive descending weakness of both upper limbs and increasing stiffness of the lower limbs along with numbness of all four limbs without a history of any bowel or bladder disturbances. Examination was suggestive of a C5-T2 intramedullary lesion. Magnetic resonance imaging revealed a C6-T2 intramedullary cystic lesion along with a small anterosuperiorly placed lesion enhancing with contrast. INTERVENTION: A C6-T2 laminotomy and exploration of the intramedullary cyst and gross total microsurgical excision of the reddish vascular frond-like structure resembling the choroid plexus were performed along with a syringostomy. A laminoplasty with miniplates and screws was performed. Histopathological and immunohistochemical studies revealed a normal choroid plexus. The patient has been followed for 1 year and has demonstrated symptomatic improvement. CONCLUSION: Although there have been rare case reports of drop metastasis of choroid plexus papillomas in the spine, this is the first case report in the available literature of normal but ectopic choroid plexus tissue in the spinal cord.

Adult↗
PubMed2005

Is medial temporal injury responsible for pediatric postconcussion syndrome? A prospective controlled study with single-photon emission computerized tomography.

OBJECT: The authors sought to correlate the finding of medial temporal hypoperfusion (MTH) demonstrated on single photon emission computerized tomography (SPECT) with pediatric persistent postconcussion syndrome (PPCS) and to ascertain its usefulness in routine clinical practice. METHODS: Thirty consecutive children with minor head injury and features of PPCS underwent SPECT scanning within 72 hours of injury. Those children having MTH on SPECT were included in the test group (14 patients), and the remaining 16 children comprised the control group. At the end of a 3-month period SPECT scanning was repeated and the incidence of PPCS was assessed clinically in both groups. Repeated SPECT scanning at 3 months revealed persisting MTH in 13 children (93%) in the test group; no child developed MTH in the control group. Twelve children were found to have PPCS in the MTH group compared with only two in the control group, and this was highly statistically significant (relative risk 6.86 [95% confidence interval 1.84-25.51], p = 0.0003). CONCLUSIONS: There exists significant MTH in pediatric patients with PPCS, which would imply that medial temporal lobe damage (involving the hippocampus and related structures) may occur after minor head injury and could be responsible for the symptoms of PPCS observed in this group of patients. Brain SPECT scans may thus help in the early identification of children prone to develop PPCS, and serial SPECT scanning may serve as a platform for testing the efficacy of various neurobehavioral and pharmacological interventions in these patients.

Adolescent↗
PubMed2005

Glioblastoma multiforme with long term survival.

Glioblastoma multiforme (GBM) Patients generally have a dismal prognosis, with median survival of 10-12 months. GBM with long-term survival (LTS) of (3) > or = 5 years is rare, and no definite markers indicating better prognosis have been identified till date. The present study was undertaken to evaluate GBMs with LTS in order to identify additional correlates associated with favourable outcome. The cases were evaluated for relevant clinicopathological data, proliferation index and expression of tumortumour suppressor gene (p53 ), cyclin-dependant kinase-inhibitors (p27 and p16 ) and epidermal growth factor receptor (EGFR) proteins. Six cases of GBM with LTS with an average survival of 9 years (range 5-15 years) were identified. All were young patients with mean age of 27 years (range 8-45 years). Histology of three cases was consistent with conventional GBM, while two showed prominent oligodendroglial component admixed with GBM areas. One was a giant cell GBM, which progressed to gliosarcoma on recurrence. The mean MIB-1LI was 12% (range 6-20%). p53 was immunopositive in 4 out of 5 cases. EGFR and p27 were immunonegative in all, whereas p16 was immunonegative in 3 out of 5 cases. Currently, in the absence of specific molecular and genetic markers, GBM in young patients should be meticulously evaluated for foci of oligodendroglial component and/or giant cell elements, in addition to proliferative index and p53 expression, since these probably have prognostic connotations, as evident in this study. The role of p16 and p27 however needs better definition with study of more number of cases.

Adolescent↗
PubMed2004

p53 protein alterations in adult astrocytic tumors and oligodendrogliomas.

BACKGROUND: p53 is a tumor suppressor gene implicated in the genesis of a variety of malignancies including brain tumors. Overexpression of the p53 protein is often used as a surrogate indicator of alterations in the p53 gene. AIMS: In this study, data is presented on p53 protein expression in adult cases (>15 years of age) of astrocytic (n=152) and oligodendroglial (n=28) tumors of all grades. Of the astrocytic tumors, 86% were supratentorial in location while remaining 14% were located infratentorially - 8 in the the cerebellum and 13 in the brainstem. All the oligodendrogliomas were supratentorial. MATERIALS AND METHODS: p53 protein expression was evaluated on formalin-fixed paraffin-embedded sections using streptavidin biotin immunoperoxidase technique after high temperature antigen retrieval. RESULTS: Overall 52% of supratentorial astrocytic tumors showed p53 immunopositivity with no correlation to the histological grade. Thus, 58.8% of diffuse astrocytomas (WHO Grade II), 53.8% of anaplastic astrocytomas (WHO Grade III) and 50% of glioblastomas (WHO Grade IV) were p53 protein positive. In contrast, all the infratentorial tumors were p53 negative except for one brainstem glioblastoma. Similarly, pilocytic astrocytomas were uniformly p53 negative irrespective of the location. Among oligodendroglial tumors, the overall frequency of p53 immunopositivity was lower (only 28%), though a trend of positive correlation with the tumor grade was noted - 25% in Grade II and 31.5% in grade III (anaplastic oligodendroglioma). Interestingly, p53 labeling index (p53 LI) did not correlate with the histopathological grade in both astrocytic and oligodendroglial tumors. CONCLUSIONS: Thus, this study gives an insight into the genetic and hence biological heterogeneity of gliomas, not only between astrocytic tumors vs. oligodendrogliomas but also within astrocytic tumors with regard to their grade and location. With p53 gene therapy trials in progress, this will possibly have future therapeutic implications.

Adolescent↗
PubMed2003

Primary excision of pediatric posterior fossa abscesses--towards zero mortality? A series of nine cases and review.

Nine children with infratentorial brain abscesses were treated at our institution over a 3-year period. Seven of them were boys and two were girls. In five cases, the abscesses were otogenic, and in two cases, the cause was tubercular (including one case of tubercular otitis). There were three cases of abscess formation in dermoids. All cases were managed with primary excision of the abscess. The average hospital stay was 12 days, and there was no mortality. The most common complication was hydrocephalus, noticed in three patients, of whom one eventually required shunt placement. Our policy of primary excision of these abscesses has yielded gratifying results. This approach also resulted in minimal morbidity and a substantially shortened hospital stay. Moreover, primary excision yields definitive histopathology of the lesion, especially in cases of tubercular and dermoid etiologies.

Adolescent↗
PubMed2002

Congenital intra-extracranial dumbbell schwannoma of temporal fossa unassociated with any major cranial nerve.

Intracranial schwannomas commonly arise from the vestibular nerve and less commonly from other cranial nerves. On rare occasions, they may be intraparenchymatous, intraventricularor intrasellar. However, the occurrence of a congenital solitary intracranial extradural schwannoma unrelated to any cranial nerve in the absence of von Recklinghausan's syndrome is exceptional. The authors report a unique, heretofore unreported case of a congenital temporal extradural schwannoma, unassociated with any known cranial nerve and with a transcranial extension presenting as a temporal fossa mass since birth in a 16-year-old female patient. Total resection of this tumour was uncomplicated. A brief review of the relevant literature is presented.

Adolescent↗
PubMedDate not supplied

Spontaneous posterior fossa extradural hematoma--a rare complication following cardiac surgery.

Posterior fossa extradural hematoma (PFEDH) is an infrequent condition. Though numerous neuropathological sequelae of cardiopulmonary bypass have been described, to the best of the authors' knowledge, PFEDH after cardiac surgery has not been reported in the English literature. We report a 4-year-old boy with tricuspid atresia, who underwent cardiac surgery under cardiopulmonary bypass. On the 2nd postoperative day, his neurological condition deteriorated, and a CT scan of the head revealed a large PFEDH with mass effect and hydrocephalus. He underwent a midline suboccipital craniectomy and evacuation of PFEDH. There was diffuse bleeding from the dura; however, no specific site of bleeding was identified. The child started following commands on the 1st postoperative day, had an uneventful recovery and was discharged on the 10th postoperative day. On follow-up, 1 year after the surgery, he was doing well.

Cardiopulmonary Bypass↗