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Biomedical subjects

L S Kewalramani

Publications and source records attributed to L S Kewalramani.

At least 19 recordsLinked to original sources
PubMed1982

Myelopathy following cervical spine manipulation.

Manipulation of the spine, a controversial mechanotherapeutic procedure, has been taught and practiced widely. Occlusion of vertebral, basillar, and cerebellar arteries with head and neck manipulation is well documented in the literature. However, there is a paucity of references about myelopathy associated with cervical spine manipulation. Three cases of cervical myelopathy following spinal manipulation are presented. All patients noted increase in cervical pain following manipulation, developed significant sensary/motor deficits within 24 hours and became tetraparetic. Two patients were found to have fracture of C5 and C6 vertebral bodies. On myelography, partial block was noted in all and widening of the spinal cord was noted in two. One patient underwent excision of C5 vertebral body and anterior interbody fusion C4/6. Two patients underwent cervical laminectomy. Hematomyelia was present in one, and in the other patient the spinal cord was reported to be hyperemic and oedematous. Only one patient showed neurological return and became ambulatory, while the other two remained tetraparetic.

Adult↗
PubMed1981

Atraumatic ischaemic myelopathy.

Significant and permanent neurological deficit due to ischaemic myelopathy continues to occur in 5-10 per cent of patients following surgery on the thoracic aorta for aneurysms, coarctation and lacerations, and following corrective surgery for scoliosis. Clinical features, patterns of neurological deficit, management and outcome in 29 patients with atraumatic ischaemic myelopathy following surgery on the aorta, aortocoronary bypass and cardiogenic shock, will be presented. Pertinent literature on the subject will also be reviewed.

Adult↗
PubMed1980

Acute spinal-cord lesions in a pediatric population: epidemiological and clinical features.

The occurrence of acute spinal-cord lesions in children has been reported to be rare, comprising from less than one to 3.3 per cent of all cases of spinal-cord injuries (Audic & Maury, 1969; Burke, 1971; Melzak, 1969). To our knowledge, the epidemiological features of all cases of acute spinal-cord lesions in a pediatric population have not been previously reported. The objective of this communication is, therefore, to describe the incidence and selected epidemiological and clinical features of acute spinal-cord lesions in children, aged 1 to 15 years.

Accidents, Traffic↗
PubMed1980

Autonomic dysreflexia in traumatic myelopathy.

Autonomic dysreflexia is a syndrome which occurs in patients with lesions of the spinal cord above T6, and it is characterized by exaggerated autonomic responses to stimuli which are innocuous in normal individuals. Clinical features of 68 patients with autonomic dysreflexia in traumatic myelopathy are presented and special attention is drawn to ocular manifestations of autonomic dysreflexia. The symptoms, signs, laboratory findings, differential diagnosis, pathophysiology and management have been critical analysed and pertinent literature has been extensively reviewed. A plea is made for those involved in the management of spinal cord injury patients (irrespective of specialty) to be aware that autonomic dysreflexia can be a life-threatening problem if not promptly recognized and appropriately treated.

Adolescent↗
PubMed1979

Urolithiasis in children with spinal cord injury.

In the literature there is a paucity of references on urolithiasis in children with spinal cord injury. In this paper 28 cases of urolithiasis in 97 children with spinal cord injury are analysed. An attempt is made to evaluate the role of hypercalcemia, hypercalciuria and urinary tract infection in the genesis of these calculi.

Adolescent↗
PubMed1979

Neurogenic gastroduodenal ulceration and bleeding associated with spinal cord injuries.

Twenty-four of 576 consecutive patients with spinal cord injuries developed acute gastroduodenal ulceration and hemorrhage. Twenty-two were males and two were females: 88% were 12 to 25 years old. Seventeen patients sustained injuries to the spinal cord in sports and recreation related activities. Twenty-three patients had lesions of the spinal cord above the sympathetic outflow. Twenty patients developed gastroduodenal perforation or bleeding within 4 weeks following the injury. Ten patients developed perforation of gastric or duodenal ulcer and "shoulder tip" pain was a symptom of perforation in six patients. Six patients of seven who had gastroscopy and upper GI series were found at laparotomy to have ulcers. Gastric (nine) and duodenal (seven) ulcers were evenly distributed. There were no deaths due to gastroduodenal hemorrhage in the present series. A single cause for the pathogenesis of gastroduodenal ulceration and hemorrhage cannot be pinpointed. However, ischemia of gastric mucosa produced in various ways and altered equilibrium between the parasympathetic and sympathetic neural pathways following trauma to the spinal cord seem to be important in initiating the process.

Acute Disease↗
PubMed1977

Ectopic ossification.

Ectopic ossification is a biologic process in which new bone is formed in tissues which normally do not ossify. Three cases of this disease are described. The literature on this subject has been extensively analysed and organized. Classification, etiology, clinical and radiological features and laboratory tests are discussed. The paper also discusses the histopathology, differential diagnosis and management of this disease.

Adult↗
PubMed1977

Acute spinal-cord lesions from diving--epidemiological and clinical features.

The aquatic activity that produces the greatest number of spinal-cord lesions is diving. Persons in the general population at greatest risk are males aged 15 to 19 years. Of the cases identified, 45 percent resulted from diving into a river or stream, 27 percent into swimming pools and 28 percent into lakes, reservoirs or the ocean. Distribution by age differed for the major groups of bodies of water. The incidence of spinal-cord injuries was related to season (spring-summer) and day of the week (weekends). The incidence of injuries was highest in those county areas with the least opportunity for exposure to swimming pools or rivers. Of the injured persons, 60 percent were tetraplegic at hospital admission. The most frequent radiologic finding was wedge fracture. This finding, in the absence of objective evidence that most divers struck the bottom of the water reservoir or a hard object, suggests that hyperventroflexion was the mechanism responsible for injury in most of the cases. Physicians and others should be aware of strategy options for preventing or reducing such injuries.

Acute Disease↗
PubMed1976

Multiple non-contiguous injuries to the spine.

Over a period of 4 years, 120 patients with an identified neurologic defect secondary to spinal cord injury were admitted to the UCD-Sacramento Medical Center. Of these cases five (4.2 per cent) were found to have multiple non-contiguous injuries to the spine which would have been capable of producing complete neurologic loss at either level. Proper treatment is dependent on diagnosis, and correct diagnosis is dependent on the awareness that multiple non-contiguous injuries to the vertebral column can occur in victims of severe motor vehicle accidents.

Adolescent↗
PubMed1976

Scheuermann's kyphoscoliosis associated with Charcot-Marie-Tooth syndrome.

Much confusion and disagreement exists regarding the classification and characteristics of inherited disorders manifesting neurogenic muscular atrophy. Many authors consider Charcot-Marie-Tooth syndrome (CMTS) and Roussy Levy syndrome (RLS) forme fruste or variants of Friedreich's ataxia (FA). Familial kyphoscoliosis has often been described in FA and RLS but not with CMTS. The purpose of this paper is to present detailed clinical and laboratory findings in a family with three cases of Scheuermann's kyphoscoliosis and CMTS in three generations. In all cases Scheuermann's kyphoscoliosis was associated with pes cavus, markedly diminished vibratory and position sensation in the lower extremities, absent deep tendon reflexes and muscular atrophy, predominantly of the distal muscles. Fine rhythmic tremor of outstretched hands and positive Romberg sign were present in one case only. Serum creating phosphokinase was elevated in two cases. Motor nerve conduction studies revealed impaired function in the median, ulnar, tibial and peroneal nerves. Sensory nerve conduction wal also impaired in median and ulnar nerves. There was evidence of left ventricular hypertrophy in one case only. The nosology and relationship between CMTS, RLS and FA are discussed.

Adolescent↗
PubMed1975

Cervical spine injury in patients with ankylosing spondylitis.

Fractures of the cervical spine associated with ankylosing spondylitis are rare. Relatively minor injury can cause a fracture of the vertebral body or through the ossified intervertebral space, because of the loss of normal flexibility, mobility, and elasticity in the rigid spine. Sixty-six per cent of the fracture subluxations of the ankylosed spine are associated with injury to the spinal cord, and the mortality rate is 40%. Because of the complete nature of fracture and instability, there is a high risk of neurologic deterioration. Immobilization of the cervical spine in a Halo cast appears to be the treatment of choice. If skull traction is applied the cervical spine should be immobilized in the neutral position, and overzealous traction exceeding 10 pounds should be avoided. Callus formation and fracture healing following immobilization is rapid. Four new cases are described and 44 previously reported cases in the literature have been reviewed.

Cervical Vertebrae↗
PubMed1975

Brachial plexus root avulsion: role of myelography--review of diagnostic procedures.

Myelographic evidence of traumatic meningocele in brachial plexus injuries has been considered to be pathognomonic of root avulsion. Two such cases with myelographic evidence of root avulsion with excellent recovery at those levels are presented. Various diagnostic procedures in brachial plexus injuries are critically reviewed. The sequence in which these tests are of diagnostic value are: 1) clinical evaluation, motor and sensory, from the time of admission; 2) electroneuromyography at 2-3 weeks following injury; 3) axon reflex response at 2-3 weeks; 4) myelography; 5) very rarely, surgical exploration.

Adult↗