Biomedical subjects
Publications and source records attributed to R C Thakur.
An 11-year-old boy presented with pain in the back, urinary retention, paraplegia and loss of sensations below L1. Investigations revealed an intramedullary lesion. An intramedullary spinal cord abscess was found at surgery. The pus was evacuated and abscess was excised. Minimal recovery was seen following surgery. Early intervention and a high index of suspicion is required in such cases.
Air in epidural haematoma is an uncommon finding. It is usually seen if epidural haematoma is associated with fracture involving one of the air sinuses, but can be seen at times in the absence of any demonstrable fracture on the CT scan. Seven such cases are described in the present communication and the significance of this finding discussed.
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A patient with an uncommonly situated congenital intradural arachnoid cyst is reported. The cyst extended from the cervical spinal canal into the posterior cranial fossa and was posterolateral to the spinal cord. The patient's initial complaint was urinary hesitancy. The location of the cyst is unique and the presenting complaint rare.
Non-missile penetrating injuries of the spine accounted for 7% of all spinal injuries admitted to this Institute during the last 10 years. Young males were most commonly affected and 73% of the injuries involved the upper dorsal und cervical spine. They presented with varying degrees of neurological deficit. Plains x-rays revealed the bony injury and/or the retained foreign body satisfactorily. Myelography (with or without CT scan) was performed in patients with progressive neurological deterioration and those not responding to conservative therapy. Surgery remained the mainstay of treatment and improved neurological function in 7 out of 9 cases. Conservative management resulted in complications such as persistent CSF fistula, uncontrolled fulminant meningitis and septicaemia, with 100% mortality. Early surgical intervention is, therefore, recommended in all penetrating injuries of the spine.
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An unusual case of an anterior stab injury, involving the cauda equina, with a progressive neurological deterioration is presented. Myelography showed a filling defect and surgery revealed a subarachnoid clot. Good recovery followed removal of the clot.
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