Death following ventricular cerebrospinal fluid shunting in supratentorial malignant tumor associated with hydrocephalus.
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Biomedical subjects
Publications and source records attributed to M G Bhatjiwale.
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An 18-year-old male presented with uncontrolled left focal seizures with secondary generalisation for the past 10 years. Investigations revealed a large lobulated mass in the right frontal brain. Surgical excision of a giant cavernous haemangioma was performed. The patient is seizure-free following the surgery. The case and relevant literature on the rare entity of giant intracranial cavernous haemangiomas is discussed.
A 7-year-old boy was playfully revolving a partly insulated electric wire which accidentally struck a bamboo pole in its path. He soon found that his left nostril was hit and blood trickled from the site. Unsuspected on investigation, a small fragment of the wire was found within the brain. The sequence of events is reported.
OBJECTIVE AND IMPORTANCE: This is a report of four cases of huge trigeminal neuromas that presented with the principle symptom of pathological laughter (PL). CLINICAL PRESENTATION: All four patients were male and were in either the third or fourth decade of life. In addition to PL, there were neurological deficits related to trigeminal nerve, brainstem, and cerebellar dysfunctions. INTERVENTION: All tumors were radically excised via a lateral basal temporal approach. The PL was cured immediately after surgery. CONCLUSION: PL sometimes precedes other neurological manifestations and may be a useful localizing sign. The clinical and radiological features in our cases suggest that PL is a result of extra-axial compression of the pons and adjoining neural structures.
Rasmussen's encephalitis usually presents in childhood. The clinical picture in Rasmussen's disease is protean, and the findings from direct brain imaging help to explain the variations seen in this syndrome. The role and involvement of the basal ganglia in this condition is clarified by comparing the changes seen on computerised tomography and magnetic resonance imaging with the clinical details of 21 patients described in this retrospective study.
A 26-year-old male presented with a trigeminal neurinoma manifesting as pathological laughter. After resection of the large tumor, the symptom disappeared completely. Pathological laughter sometimes precedes other manifestations of tumors around the brainstem and may be a useful localizing sign.
Twenty-three patients with intractable trigeminal neuralgia were treated by a modified technique of middle fossa extradural decompression of the trigeminal sensory root at the petrous ridge. After exposing the ganglion and the root at the petrous ridge, by an extradural Frazier's approach a thin layer of autogenous fat was interposed between the dura propria and the middle fossa dura anteriorly, and between the petrous ridge and the root posteriorly. The fat layers were used to prevent dural adhesions and to maintain a space between the petrous ridge and the root. The dura propria was preserved intact. All patients obtained immediate relief of pain following surgery. Twenty patients continue to remain pain free. Two patients have mild occasional pains and one has a persistent pain of moderate intensity. One patient developed a dense sensory loss and two had delayed facial weakness which recovered completely within a month. The mechanism of trigeminal neuralgia is discussed on the basis of anatomical, histopathological and electrophysiological findings and the rationale of middle fossa decompression of the root is stressed. This method is short, simple and safe and may serve as an alternative to the more recent methods of treating trigeminal neuralgia.
Stereotactic procedures have been prevalent in neurosurgical practice for a prolonged time period. With the advent of new custom-made frames designed for morphologic and functional neurosurgical procedures, its extended use in the pediatric population is becoming increasingly popular. However, there is still a need for sophistication in design and instrumentation. We describe a novel method of a plaster of Paris mould for stereotactic frame fixation, which can be a useful adjunct during frame fixation. It primarily accounts for a remarkable variation in skull shapes and sizes seen in the pediatric population undergoing stereotaxy besides many other advantages.
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A rare case of a diffuse calvarial meningioma in a sixty-three year-old female is reported. The patient presented with headache, painful proptosis and chemosis of the left eye. Imaging showed that the frontoparietal calvarium on both sides and the left orbital roof were thickened. The thickened bone showed patchy rarefaction. In relationship to the thickened bone, there was an enhancing en-plaque meningioma. The tumour extended on to the superolateral aspect of the left orbit and resulted in proptosis. Excision of the left frontoparietal calvarium and the orbital tumour was performed. The management of diffuse calvarial meningioma is discussed and the relevant literature is briefly reviewed.
A rare case of a cavernous haemangioma in the interpeduncular cistern is reported. The patient, forty-five year old male presented with excruciating left sided trigeminal neuralgia and diplopia for the past one year. Examination revealed left third and fifth nerve paresis. Magnetic resonance imaging showed a well-defined, lobulated tumour in the interpeduncular cistern. The tumour was totally excised through a subtemporal route. Histology of the tumour revealed a cavernous haemangioma. Extracerebral location for a cavernous haemangioma is rare. An interpeduncular cavernous haemangioma has never been reported earlier in literature. The clinical and radiological features are discussed and relevant literature is briefly reviewed.
An unusual astrocytoma occurring in different anatomical compartments of the brain is reported. The child was operated upon for a cerebellar astrocytoma when he was eight-and-half years old. Seven years later, he was operated for a cerebral astrocytoma. The growth of the similar tumours at these two sites is analysed and literature on the subject is reviewed. The concept of multicentricity is emphasized.