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Biomedical subjects

Boby Varkey Maramattom

Publications and source records attributed to Boby Varkey Maramattom.

17 recordsLinked to original sources

Leontiasis ossea and post traumatic cervical cord contusion in polyostotic fibrous dysplasia.

Leontiasis ossea (leonine facies) or cervical canal stenosis are rare complications of polyostotic fibrous dysplasia (PFD). This case report documents dramatic leontiasis ossea in PFD as well as post traumatic cervical cord contusion due to hyperextension injury in a patient with generalized PFD involving the cranio-facial bones, axial skeleton and entire spine with secondary cervical canal stenosis. Cervical cord contusion has not been reported earlier in PFD.

Accidental Falls↗

Neuromuscular disorders in medical and surgical ICUs: case studies in critical care neurology.

The differential diagnosis of generalized weakness in ICU patients is quite broad. Although neuromuscular disorders are the most common causes of generalized weakness, a thorough evaluation is necessary to delineate the underlying cause of weakness. Biochemical studies, neuroimaging, and electrophysiologic studies help to delineate most of the common disorders associated with weakness. Prompt identification of a neurologic disorder and initiation of therapy speeds up recovery and reduces morbidity and mortality in these patients.

Biopsy↗

Pulmonary complications after intracerebral hemorrhage.

OBJECTIVE: There are no data on pulmonary complications in an selected population of patients with intracerebral hemorrhages (ICH). At present, most data is extrapolated from series of patients with stroke that combine patients with both ischemic and hemorrhagic strokes. The purpose of this study was to determine the frequency, types of pulmonary complications in patients with ICH, their association with clinical variables, and contribution to hospital stay. MATERIALS AND METHODS: A total of 144 consecutive patients with ICH between January 1999 and October 2003 were analyzed for pulmonary complications such as pneumonia, pulmonary edema, pulmonary embolism, or miscellaneous complications. RESULTS: Overall, 41 patients (28%, 95% confidence interval, 22-36%) developed pulmonary complications. The most common events were pneumonia (19%) and pulmonary edema (8%). Complications were most often encountered immediately after the onset of ICH (63% detected on the day of admission). Pulmonary complications lengthened the duration of hospital stay among survivors. CONCLUSIONS: Our study provides data on pulmonary complications after acute ICH. Almost one-third of patients with ICH develop pulmonary complications. Pulmonary complications increased morbidity, mortality, and duration of hospital stay. Aggressive management of these complications can potentially reduce the morbidity, mortality, duration of hospital stay, and financial expenditure incurred in this group of patients.

Aged↗

Gadolinium encephalopathy in a patient with renal failure.

Gadolinium chelates are extensively used in MRI studies. Neurotoxicity due to gadolinium chelates is minimal and uncommon. A 57-year-old woman in renal failure developed a subacute encephalopathy after inadvertent repetitive gadolinium contrast administration. An unusual MRI appearance with CSF hyperintensity due to gadolinium diffusion into the CSF is also shown.

Amnesia, Retrograde↗

Postresuscitation encephalopathy. Current views, management, and prognostication.

BACKGROUND: Cardiac arrest has a high mortality rate. Postresuscitation encephalopathy is commonly associated with significant morbidity. REVIEW SUMMARY: Among those patients who achieve a return to spontaneous circulation, more than half die during the subsequent hospital course. Few survivors recover without significant neurologic disability. Clinical examination is often used for predicting subsequent neurologic outcome in these patients. The role of ancillary investigations and the judicious combination of these parameters with the findings on clinical examination to achieve accurate prognostication is discussed in this review. Only a few parameters have a strong predictive value in coma after cardiac arrest. These include pupillary light reflexes and motor responses at 3 days, absent somatosensory evoked potential, and possibly diffuse magnetic resonance imaging changes. CONCLUSION: The authors discuss the physiology, pathology, and consequences of cardiac arrest to the central nervous system, and the use of various parameters in prognostication. Induced hypothermia is a new therapeutic development.

Brain Diseases↗

Cerebral amyloid angiopathy presenting as a posterior leukoencephalopathy: a case report and review of the literature.

Cerebral amyloid angiopathy (CAA) is well known to present with lobar intracerebral hemorrhage, dementia or transient neurological events. White matter changes with CAA have only been recently described and can be seen with either sporadic or familial CAA. We present a 50-year-old man with rapidly progressive dementia in whom MRI brain showed symmetrical white matter changes in the parieto-occipital regions. Brain biopsy revealed changes of CAA along with features of Alzheimer's disease. Immunohistochemistry revealed amyloid beta protein. The subcortical lesions were thought to occur from hypoperfusion of the distal white matter. The role of amyloid in the pathogenesis of CAA and the mechanism of leukoencephalopathy are discussed.

Adult↗