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Biomedical subjects

D Nagaraja

Publications and source records attributed to D Nagaraja.

At least 19 recordsLinked to original sources
PubMed1992

Epidemic of acute inflammatory myopathy in Karnataka, south India: 30 cases.

Thirty patients of acute inflammatory myopathy were seen over a short period of 11 months (February to December 1986) at NIMHANS, Bangalore, South India. The characteristic features were: short febrile illness followed a few days later by myalgia, edema of extremities, severe motor weakness and involvement of multiple other systems. Their mean age was 32.3 years and M:F ratio was 4:1. CK levels were increased in all. EMG done in 23 patients showed spontaneous activity in 13 and myopathic pattern in all. Nerve conduction studies revealed abnormalities in 12 cases. Muscle biopsy done in 21 patients showed varying degree of myophagocytosis and inflammatory infiltrates. All patients received steroids for only 6-8 weeks. Twenty-two patients recovered, one developed residual disability and 7 patients died during the acute phase. None of the survivors has developed relapse so far. Such cases with monophasic illness in clusters have not been reported earlier.

Adolescent↗
PubMed1991

Angiographic profile of ischaemic stroke in the young--study of 143 cases.

The incidence of stroke in the young is higher in the Indian subcontinent than in the West, but the precise cause is not known. Previous angiographic studies in cases of "young stroke" have yielded variable results. The present angiographic study of 143 cases of young stroke (under 40 years of age) showed a high incidence of abnormality (71%). The lesions included atherosclerotic disease of the internal carotid artery (68%), stenosis/occlusion of the major intracranial vessels (37%) and small-vessel disease. Tandem lesions were common (26%). Primary atherosclerosis is thought to be the cause of young stroke in the Indian population.

Adult↗
PubMed1991

Acute ataxic neuropathy: a clinical, electrophysiological and morphological study.

Sensory ataxia as the chief manifestation of acute neuropathy is rather rare. Of the 224 cases of acute polyneuropathy seen over 6 years (1984-1990) only 10 patients (M:F 3:7) had disabling ataxia as the presenting feature. Their ages ranged from 14-61 years. Antecedent febrile illness was present in 6 patients and the peak deficit evolved over 2-25 days. Severe ataxia, paresthesia, distal areflexia and predominant joint sense loss were common to all, motor weakness was either absent or insignificant. CSF was acellular and revealed elevated protein in 3 subjects. All patients had electrophysiological evidence of severe sensory neuropathy with mild or no motor neuropathy. Sural nerve biopsy in one patient showed loss of large, as well as small, diameter myelinated fibres, secondary demyelination, but no evidence of inflammation. At follow up marginal to moderate improvement in ataxia was noted in only 5 patients. Absence of ophthalmoplegia and motor weakness, poor prognosis and characteristic electrophysiological and histopathological observations suggest that acute ataxic neuropathy may be a distinct entity.

Adolescent↗
PubMed1990

Vertebro-basilar insufficiency due to carotid stenosis.

Two patients with internal carotid disease and normal/hypoplastic vertebro-basilar system presenting with symptoms of vertebrobasilar insufficiency are presented. The role of associated anomalies of the circle of Willis or major vessels in the pathogenesis of symptoms is highlighted.

Carotid Artery Diseases↗
PubMed1990

Hypothermia: an unusual manifestation of Reye's syndrome.

A four year old girl manifested with seizures, raised intracranial tension and altered consciousness. Laboratory investigations suggested Reye's syndrome. Later she developed fatal hypothermia. Rarity of such a case is highlighted. Probable pathogenesis of hypothermia in Reye's syndrome is discussed.

Biopsy↗
PubMed1990

Simultaneous cerebral arterial and venous thrombosis.

Simultaneous thrombotic occlusion of cerebral arterial and venous systems in the same individual is rare. Three patients of stroke in whom autopsy revealed co-existing arterial and venous infarctions, major arterial occlusion (vertebral 1, internal carotid 1) and dural sinus and cortical vein thrombosis are reported. Role of infarcted brain, haemorrheological factors and alcohol in the pathogenesis of this rare event is highlighted.

Adult↗
PubMed1989

Crossed aphasia in a dextral.

A case of crossed aphasia in a monolingual dextral with detailed clinical, neuropsychological and language assessment is described. The presence of Gerstmann-syndrome suggested cross-over of even dominant parietal lobe functions. Lateralization and localization of various language functions in relation to crossed aphasia are discussed.

Adult↗
PubMed1989

Multi-infarct dementia: a computed tomographic study.

CT Scan of 30 patients with multi-infarct dementia (MID) were compared with age- and sex-matched controls. Infarcts were seen in 93% of MID cases and 10% of controls. A marked difference in the occurrence of white matter low attenuation was seen between the groups. All the parameters of cerebral atrophy studied showed a statistically significant correlation with the presence of dementia.

Brain↗
PubMed1989

Prognosis in solitary intraventricular haemorrhage. Clinical and computed tomographic observations.

Isolated intraventricular haemorrhage (IVH) in the absence of parenchymal haematoma is unusual. Fifteen patients with solitary IVH among 170 with intracranial haemorrhage were studied. Clinical details and computed tomographic features were analysed to evaluate the prognostic significance of various clinical and CT parameters. Outcome is affected by hypertension, level of consciousness, clinical progression, pupillary changes and restriction of eye movements. Factors found on CT to have prognostic significance included degree of ventricular bleed, presence of cisternal bleed, hydrocephalus and cerebral atrophy.

Adolescent↗
PubMed1989

Risk factors in extracranial carotid disease.

One hundred patients with ischaemic cerebro vascular disease (TIA/RIND--67% and completed stroke--33%) were evaluated for various clinical and biochemical risk factors. Evidence of extra-cranial carotid vascular disease (ECCVD) was looked for by using Doppler scan and carotid angiography. Of the 28 patients with abnormal Dop scan, 27 were confirmed to have ECCVD by angiography. Though the history of hypertension was elicited in 40%, only 28% had BP of 160/95 mm Hg or more during hospital stay. Hypertension was twice more common in ECCVD group compared to the group with normal carotid vessels. Obesity was seen in 15%, diabetes mellitus in 10% and 1% had hyperuricaemia. Total cholesterol was elevated in 29% and HDL cholesterol fraction was decreased (less than 35 mg%) in 43%. The reduction of HDL cholesterol was more frequent in ECCVD group (63%) and in hypertensive (73%) patients. Lipoproteins, triglycerides, free fatty acids and phospholipids were not significantly affected.

Adolescent↗
PubMed1989

Trunkal tremor: orthostatic or essential?

A sixty two year old man who presented with tremors of trunk and lower limbs, appearing only on standing, is reported. The tremor frequency was 14-16 Hz and there was co-contraction of antagonistic muscles. No therapeutic benefit was noted with propranolol, primidone and diazepam. The possible pathogenesis of this rare orthostatic trunkal tremor and its relationship with essential tremor are discussed.

Aged↗
PubMed1989

Surgery in spontaneous intra-cerebral haematoma.

Twenty-six patients of intracerebral haemorrhage (ICH) were treated by surgical evacuation of clot. Six patients were operated within 24 hour, four on the second day, seven between the third and fifth day and nine after five days. Their therapeutic out-come was compared with an equal number of age, location and severity matched group of patients of ICH who did not undergo surgery. Mortality in surgically treated group (16/26) was comparable to control group (20/26), however, follow up of survivors showed slightly reduced morbidity in operated group. Patients in grade III (level of consciousness) were the only ones who were benefited from surgery. The timing of the surgery did not affect the immediate mortality.

Adolescent↗
PubMed1987

Permanent neurological sequelae due to lithium toxicity.

Lithium intoxication is well known to produce acute and chronic symptoms but development of permanent neurological deficit is a rarity. Six cases of manic depressive psychosis who developed neurological sequelae following treatment with lithium carbonate are described. There were multiple lesions in the central nervous system. However, the main brunt was borne by cerebellum. The serum lithium levels of five patients were within therapeutic range. The value of identifying the precipitating factors, early diagnosis and prompt intervention in the prevention of persistent neurological dysfunction is emphasized.

Adult↗
PubMed1987

Sturge-Weber-Dimitri disease without facial nevus.

A patient with Sturge-Weber-Dimitri disease presented with intractable seizures and progressive intellectual deterioration. There was no facial nevus or focal neurologic abnormality. CT disclosed bilateral calcification in a parieto-occipital gyral pattern. Histopathology of the brain revealed extensive calcification of vessel wall in parieto-occipital cortices.

Angiomatosis↗