Biomedical subjects

Lakshminarayan Raghuram

Publications and source records attributed to Lakshminarayan Raghuram.

4 recordsLinked to original sources

PubMed2004

Accelerated spondylotic changes adjacent to the fused segment following central cervical corpectomy: magnetic resonance imaging study evidence.

OBJECT: The authors studied whether cervical spine motion segments adjacent to a fused segment exhibit accelerated degenerative changes on short-term follow-up magnetic resonance (MR) imaging. METHODS: Preoperative and short-term follow-up (mean duration 17.5 months, range 10-48 months) cervical MR images obtained in 44 patients who had undergone one- or two-level corpectomy for cervical spondylotic myelopathy were evaluated qualitatively and quantitatively. The motion segment adjacent to the fused segment and a segment remote from the fused segment were evaluated for indentation of the thecal sac, disc height, and sagittal functional diameter of the spinal canal on midsagittal T2-weighted MR images. Thecal sac indentations were classified as mild, moderate, and severe. New indentations of the thecal sac of varying severity (mild in 17 patients [38.6%], moderate in 10 [22.7%], and severe in six [13.6%]) had developed at the adjacent segments in 33 (75%) of 44 patients. The degenerative changes were seen at the superior level in 11 patients, inferior level in 10 patients, and at both levels in 12 patients and resulted from both anterior and posterior element degeneration in the majority (23 [69.6%]) of patients. The remote segments showed mild thecal sac indentations in seven patients and moderate indentations in two patients (nine [20.5%] of 44). Compared with the changes at the remote segment, the canal size was significantly decreased at the superior adjacent segment by 0.9 mm (p = 0.007). No patient sustained a new neurological deficit due to adjacent-segment changes. CONCLUSIONS: On short-term follow-up MR imaging, levels adjacent to the fused segment exhibited more pronounced degenerative changes (compared with remote levels) in 75% of patients who had undergone one- or two-level central corpectomy.

Adult↗

PubMed2003

Benign metastasizing leiomyoma causing spinal cord compression.

BACKGROUND: Leiomyoma as a cause of cord compression is extremely rare. To our knowledge this is the first report of a dural-based leiomyoma and second report of a leiomyoma causing cord compression. CASE DESCRIPTION: A 38-year-old female renal transplant recipient presented with features of cervical cord compression. On imaging and at surgery, the tumor was mistaken for a neurofibroma. A cervical laminectomy and near total excision of the tumor was done. She did well in the postoperative period but presented 5 months later with thoracic empyema leading to septicemia and her demise. Ultrasound examination and autopsy showed leiomyomas in many other sites including the uterus. CONCLUSIONS: The presence of extrauterine and uterine leiomyomas is a curious condition termed as "benign metastasizing leiomyoma." As our patient was on immunosuppressant therapy following a renal transplant, it might have predisposed her to this rare condition with multifocal tumors.

Adult↗

PubMed2003

MR ventriculography for the study of CSF flow.

BACKGROUND AND PURPOSE: Various MR techniques have been used to assess CSF flow and to image the subarachnoid spaces and ventricles. Anecdotal reports describe the use of intrathecal and intraventricular gadolinium-based contrast agents in humans and animals. We sought to determine the clinical usefulness of gadolinium-enhanced MR ventriculography for assessing CSF flow in patients with various neurologic conditions. METHODS: Five patients (three female and two male patients aged 6 months to 65 years) were included in the study. After performing sagittal, coronal, and axial T1-weighted MR imaging of the brain, 0.02-0.04 mmol of gadodiamide was injected into the lateral ventricle. Sagittal, coronal, and axial T1-weighted imaging was repeated soon after the injection. We were specifically looking for the site of obstruction to CSF flow in those patients with hydrocephalus, communication between cysts and ventricles, elucidation of suspicious intraventricular lesions, and patency of third ventriculostomies. RESULTS: MR ventriculography showed good delineation of the ventricular system in all patients. In one patient with carcinomatosis and hydrocephalus, a block to contrast material flow was detected at the right foramen of Luschka. In another patient with hydrocephalus, partial block to the flow of contrast material was demonstrated at the right foramen of Monro. In a patient with hydrocephalus and a posterior fossa cyst, flow of contrast material was blocked between the third ventricle and the cyst, with a thin streak of contrast material in the aqueduct. As an assessment of the patency of a third ventriculostomy, MR ventriculography showed flow of contrast material into the suprasellar cisterns from the third ventricle in one patient and absence of flow in another. CONCLUSION: MR ventriculography is a safe technique for assessing CSF flow, with application in determining the site of obstruction in hydrocephalus, in assessing communication between cysts and the ventricle, and in determining the functioning status of endoscopic third ventriculostomies.

Adolescent↗

PubMedDate not supplied

Transcatheter hepatic artery embolization for spontaneous rupture of amyloid liver.

Spontaneous rupture of amyloid liver is a fatal complication. A 48-year-old man with systemic amyloidosis secondary to multiple myeloma presented with acute hemoperitoneum. Emergency angiogram showed extravasation of contrast from the liver into the sub-hepatic space, which was successfully stopped by embolization of the right hepatic artery.

Amyloidosis↗