Biomedical subjects
Publications and source records attributed to N Trost.
With the development of MRI, the natural history of cavernous haemangiomas has been appreciated. This article describes a series of patients with deep cavernous haemangiomas who have presented with acute hydrocephalus. The diagnosis and treatment options are discussed with a review of the literature.
Synovial cysts have been well reported as a cause of sciatica, with a sudden acute exacerbation being attributed to haemorrhage and subsequent enlargement of the cyst. Cyst formation is attributed to facet joint degeneration associated with a defect or rupture of the joint capsule. The mechanisms of haemorrhage have not been well described previously. Two cases of haemorrhagic synovial cysts causing acute exacerbation of sciatica are described. Both cases were directly attributable to manipulation of degenerate spines. The MRI and histopathological findings are discussed and we propose a mechanism whereby excessive stress on a degenerate revascularized synovium leads to haemorrhage within synovial cysts.
Paroxysmal visual manifestations may represent epileptic seizures arising from the occipital lobe. In coeliac disease (CD) bilateral occipital calcifications and seizure semiology consistent with an occipital origin have been described, primarily in Mediterranean countries. By reporting three adult patients from an Australian outpatient clinic with visual disturbances, occipital cerebral calcifications, and CD, this study seeks to emphasise that CD should be considered even when patients of non-Mediterranean origin present with these symptoms. Seizure types included simple partial, complex-partial, and secondarily generalised seizures. The seizure semiology consisted of visual disturbances such as: blurred vision, loss of focus, seeing coloured dots, and brief stereotyped complex visual hallucinations like seeing unfamiliar faces or scenes. Symptoms of malabsorption were not always present. Neurological examination was unremarkable in two patients, impaired dexterity and mild hemiatrophy on the left was noted in one. Routine electroencephalography was unremarkable. In all cases, computed tomography demonstrated bilateral cortical calcification of the occipital-parietal regions. Magnetic resonance imaging showed no additional lesion. All patients had biopsy confirmed CD. Seizure control improved after treatment with gluten free diet and anticonvulsants. This report illustrates the association between seizures of occipital origin, cerebral calcifications, and CD even in patients not of Mediterranean origin.