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Biomedical subjects

Harjinder Singh Bhatoe

Publications and source records attributed to Harjinder Singh Bhatoe.

5 recordsLinked to original sources

Nondysraphic intramedullary spinal cord lipomas: a review.

OBJECT: Lipomas of the spinal cord are often a component of spinal dysraphic states. Nondysraphic intramedullary spinal cord lipomas are rare, and their presentation, in the form of gradually worsening myelopathy, is nonspecific. The authors report on the methods used for diagnosis and treatment in patients presenting with these lesions at their institution, and they review the relevant literature. METHODS: The authors treated 14 patients who presented with intramedullary lipomas over a period of 12 years. None of these patients had segmentation anomaly or dysraphism of the spine, or any hindbrain anomaly. Admission magnetic resonance images were diagnostic in all patients. All tumors were located dorsally in the spinal cord, the majority of them in the cervicodorsal cord. The lipomas were partially excised with the help of a carbon dioxide laser in all patients in an attempt to preserve neurological function. All patients attained improvement in their sensory and motor symptoms. CONCLUSIONS: Because these lesions do not have a clear-cut margin, it is vital to preserve neurological function at the time of surgery, even if it entails incomplete resection.

Humans↗

Missile injuries of the anterior skull base.

Missile injuries of the anterior skull base usually occur during war or war-like situations. These injuries may be isolated or associated with multiple traumatic injuries. We report 23 such cases managed during military conflicts and peacekeeping operations. All were adult males. Four of these patients sustained bullet injuries; the rest were injured from shrapnel. Eighteen patients had injury to the visual apparatus with permanent blindness. Proptosis was seen in 16, cerebrospinal fluid (CSF) leak from the wound in seven, and CSF orbitorrhea in three patients. Sixteen had irreparable injury to the eye necessitating evisceration/enucleation, and two had retrobulbar optic nerve injury. Three patients were comatose [Glasgow Coma Scale (GCS) 3/15], and 14 had altered sensorium. Six patients were fully conscious. All were investigated by computed tomography (CT), which revealed injury to the eyeball and skull base, orbital fracture, frontal hematoma, contusion, and pneumocephalus. Seventeen patients underwent emergency surgery, and six patients were initially managed conservatively. Neurosurgical management consisted of making bifrontal flaps, craniotomy/craniectomy, debridement, and repair of the base with fascia lata. Reconstruction of the orbital rim was required in three cases. All were managed postoperatively with cerebral decongestants and antibiotics in anti-meningitic dosages. There was one death in the postoperative period; outcome was good in 16 and moderate in four patients. Twelve patients had retained intracranial splinters; three of these developed recurrent suppurative meningitis. Of the six patients initially managed conservatively, three were subsequently operated for CSF rhinorrhea. Gross communition, dural loss, and injury to the frontal scalp often preclude the use of pericranial repair of the skull base. Fascia lata is extremely useful for reconstruction and repair. Anterior cranial fossa injury probably carries a better prognosis; however, there is increased risk of suppurative complications due to breach of air-filled sinuses by the missile and contamination of the intradural compartment, as compared with supratentorial vault injuries not involving the orbit or paranasal sinuses. Three patients who underwent no operative procedure and remain asymptomatic are under follow-up.

Journal Article↗

Blepharocele after head injury.

Blepharocele is a rare complication of skull base injury involving the orbital roof. We present a 23-year-old male who developed blepharocele due to an orbital rim fracture and basal dural tear. His vision remained intact. The lesion resolved completely after surgical repair of the basal dura.

Case Reports↗