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B P Brophy

Publications and source records attributed to B P Brophy.

At least 19 recordsLinked to original sources
PubMed2006

Update of radiosurgery at the Royal Adelaide Hospital.

This is an update of the Royal Adelaide Hospital radiosurgery experience between November 1993 and December 2004 comprising 165 patients with 168 intracranial lesions. Including re-treatment, there were 175 treatment episodes (163 radiosurgery and 12 stereotactic radiotherapy) at an average of 1.3 per month. The commonest lesions were acoustic neuroma (65), arteriovenous malformation (58), solitary brain metastasis (23) and meningioma (14). The clinical features, treatment details and outcome are described. Our results continue to be well within the range reported in the published work. Radiosurgery provides an elegant, non-invasive alternative to neurosurgery and conventional external beam radiotherapy for many benign and malignant brain tumours.

Adolescent↗
PubMed2003

Recurrent subarachnoid haemorrhage from a de novo basilar bifurcation aneurysm: a case report.

Well documented cases of posterior circulation de novo aneurysms are rare. We report a patient who recently presented following a third episode of aneurysmal subarachnoid haemorrhage. Subsequent cerebral angiography revealed a basilar bifurcation aneurysm. This was absent on previous angiographic studies. The current literature on de novo aneurysms is reviewed. The implications for screening are considered.

Adult↗
PubMed2003

Ataxic arm movements after thalamotomy for Parkinsonian tremor.

Voluntary finger-nose movements of the arm were analysed in six patients undergoing stereotaxic nucleus ventralis intermedius thalamotomy for relief of severe Parkinsonian tremor. In all cases thalamotomy acutely abolished tremor in the contralateral arm. In the early postoperative phase, ataxia of the arm contralateral to the operated side was also seen. Ataxia was transient, lasting between 7 and 21 days postoperatively. This observation suggests that a lesion of the Vim nucleus interrupts cerebellar input to the thalamus, and supports the concept that abnormal cerebellar activity is an important contributor to the generation of tremor in Parkinson's disease.

Aged↗
PubMed2001

Radiosurgery for vestibular schwannomas: preliminary results of the Adelaide experience.

We present the preliminary results of our experience with Linear Accelerator (LINAC) radiosurgery for unilateral vestibular schwannomas. The treatment outcomes of 42 patients with a minimum follow-up of 12 months are reported. An excellent rate of tumour control was achieved with a relatively low complication rate. The current results compare favourably with other reported studies in the literature.

Humans↗
PubMed2000

Radiosurgery at the Royal Adelaide Hospital: the first 4 1/2 years' clinical experience.

Radiosurgery refers to the treatment of small lesions localized by stereotactic technology using highly focused radiation. This review utilizes prospectively gathered data from the Royal Adelaide Hospital Radiosurgery unit to summarize experience with the first 62 patients (65 lesions) treated between November 1993 and May 1998. This experience included acoustic neuromas (23 patients), arteriovenous malformations (18), brain metastases (12), meningiomas (6), and glomus tumour, subependymoma, dural arteriovenous fistula (1 each). Although follow up is relatively short, the outcome in terms of morbidity and tumour control is thus far comparable with results reported in the literature. Radiosurgery provides a viable alternative to neurosurgery and conventional external beam radiotherapy for several benign and malignant intracranial lesions.

Adolescent↗
PubMed2000

Acoustic neuroma--surgery or radiosurgery?

This paper discusses surgery and radiosurgery from the author's personal experience with both techniques. Multi-discipline assessment will allow the patient to make an informed decision regarding preferred management.

Anastomosis, Surgical↗
PubMed1999

Extradural cavernous haemangioma simulating a disc protrusion.

Cavernous haemangiomas confined to the epidural space are rare and are therefore infrequently considered in the differential diagnosis of spinal epidural masses. In order to draw attention to this diagnosis, a case in which an epidural cavernous haemangioma simulates a lateral/foraminal disc protrusion is presented.

Adult↗
PubMed1999

Voluntary movement after pallidotomy in severe Parkinson's disease.

The mechanisms of improvement in parkinsonian bradykinesia after posteroventral pallidotomy were investigated in 17 patients undergoing unilateral pallidotomy for severe Parkinson's disease. Clinical ratings of 'off' period bradykinesia demonstrated a maximal improvement of 22% 3 months postoperatively. Kinematic assessments of rapid repetitive finger and sequential arm movements were performed after overnight withdrawal of antiparkinsonian medications. There was a bilateral reduction in the inter-onset latency of a two-stage sequential arm movement and a contralateral increase in speed of arm movement after pallidotomy. There was no significant improvement postoperatively in the rhythm, amplitude or speed of repetitive finger movements. The results confirm the clinical impression that pallidotomy improves bradykinesia. This was more evident for complex limb movements, which used attentional strategies and external (visual and auditory) cues, than for repetitive fingertapping movements, which were largely internally generated. Since ablation of the pallidum can only reduce inhibitory pallidal outflow, it is unlikely to restore the normal pallidal influence on thalamocortical motor circuits. Therefore, any improvement in bradykinesia after pallidotomy must be related to mechanisms other than restoration of pallidothalamocortical connectivity. Based on the above observations, we suggest that some of the changes in motor control may be explained by the greater efficacy of external cues in facilitating movement after withdrawal of the abnormal pallidal discharge.

Aged↗
PubMed1999

Arctic and Antarctic exploration including the contributions of physicians and effects of disease in the polar regions.

A history of Arctic and Antarctic exploration, whether to find a Northwest Passage, North Pole, or South Pole, is a story of triumph and tribulation. The hardship experienced by polar explorers in the last 1000 years permeates the tales of achievement. Physicians and surgeons have played prominent roles in all major polar explorations. No significant Arctic voyage, particularly in the last 300 years, was made without a member of the party trained in the management of medical emergencies and in basic surgery. During times of health, surgeons functioned as the voyage naturalists with expertise in biology, botany, zoology, and the writing of scientific catalogs. Spurred by our interest and fascination with the history of polar exploration, we reviewed the roles of physicians and natural scientists in Arctic and Antarctic adventures.

Antarctic Regions↗
PubMed1998

Distal anterior cerebral artery aneurysms: a clinical series.

Thirty patients with distal anterior cerebral artery (DACA) aneurysms were seen at the Royal Adelaide Hospital in the period 1970-1996. There were seven males (23%) and twenty three females (77%) with a mean age of 50 years. The average follow up was 5 years. Multiple aneurysms were present in seven cases (23%). The mean size of aneurysms was 5 mm. There were two post-traumatic aneurysms and one mycotic aneurysm. Out of the 30 cases, 19 presented with subarachnoid haemorrhage from ruptured DACA aneurysms. Eight (42%) of them were in good clinical grade (I or II). Operations were carried out in 25 (83%) patients. All five cases with unruptured aneurysms and the eight patients with good clinical grade had good recovery. In contrast, only six (55%) out of 11 patients with poor clinical grade had good outcome. The overall management mortality for the 19 cases with ruptured aneurysms was 16%. Postoperative complication occurred in two cases (8%), one patient developed deep vein thrombosis and seizures, the other patient had transient upper limb weakness. Although there is a definite trend towards better management outcome in the published series of DACA aneurysms over the years, there is still significant mortality and morbidity in the poor grade patients. Early surgery will prevent the deaths from rebleeding and may allow optimal management of vasospasm.

Adult↗
PubMed1998

Surgical palliation of dyskinesiae in Parkinson's disease.

The history of surgical management of Parkinson's disease is outlined. Current practice of thalamotomy and pallidotomy is discussed. Surgical management has re-established its role in the management of Parkinson's disease.

Globus Pallidus↗
PubMed1997

Thalamotomy for parkinsonian tremor.

Thalamotomy for parkinsonian tremor was performed in 25 patients. A good outcome was achieved in 66% of cases. Three patients sustained a significant new deficit. Stimulation through the lesioning electrode provided an adequate means of corroboration of target localisation.

Adult↗
PubMed1996

An unusual spinal intradural arachnoid cyst.

Spinal intradural arachnoid cysts are seen most frequently in the thoracic region, particularly near the midline posteriorly. A thoracic intradural arachnoid cyst in this typical location is reported, with the additional unusual finding of herniation of the spinal cord through an anterior defect in the dura matter. The MRI findings are described.

Adult↗
PubMed1995

Intracranial invasion from a primary adenocarcinoma arising in the middle and external ear.

Cerumenal adenocarcinoma is a rare neoplasm arising from the modified sweat glands of the ear. Before the diagnosis of primary tumour is made, a thorough search must be undertaken to exclude the possibility of metastatic disease, which occurs more commonly. Benign adenoma can also occur and this may be identical histologically to the malignant variety. The presence of local invasiveness may be the only differentiating feature. Aggressive local resection followed by postoperative radiotherapy form the cornerstone of management. Individuals treated with radiotherapy alone have a life expectancy of less than 12 months whereas cures have been reported with radical surgery.

Adenocarcinoma↗
PubMed1995

Lymphocytic hypophysitis: a rare cause of hyperprolactinaemia.

Lymphocytic hypophysitis is one of the rare causes of hypopituitarism and intrasellar mass observed almost exclusively in women. A temporal relationship to pregnancy has been identified in many but not all of the 34 reported cases. Intra-operative differentiation from non-secretory macroadenoma is important, as resection of the anterior lobe is unnecessary in these individuals and pituitary function may spontaneously return to normal. The authors present the case of a woman with symptomatic hyperprolactinaemia 10 years after her last pregnancy.

Adult↗
PubMed1993

Cavernous haemangiomas (angiomas) of the brain: clinically significant lesions.

A review of 2000 consecutive magnetic resonance imaging (MRI) brain studies identified 18 (0.9%) patients with lesions that satisfied MRI criteria for cavernous haemangiomas. The clinical, computed tomography (CT) and MRI findings in 23 patients with probable cavernous haemangiomas were compared. Thirty-three lesions were identified with multiple lesions in five (22%) patients. In 19 (82%) patients the neurological presentation corresponded to a cavernous haemangioma. The presenting symptoms were: seizures in 11 patients (48%); progressive neurological symptoms and signs in four (17%); and acute symptoms and signs due to haemorrhage in four (17%). T2 weighted images suggested the diagnosis in all cases, with 24 (73%) lesions showing the typical appearance of an area of mixed signal intensity with a rim of low signal intensity. In the absence of acute haemorrhage, CT demonstrated well circumscribed, round or oval hyperdense lesions without significant mass effect and with normal surrounding brain tissue in the majority of cases. Although not diagnostic, these CT features are strongly suggestive of cavernous haemangiomas.

Adolescent↗