PubMed Health⌕ Search

Biomedical subjects

R D Nagpal

Publications and source records attributed to R D Nagpal.

At least 19 recordsLinked to original sources
PubMed1996

Cerebellar haemangioblastoma with extensive dissemination.

Haemangioblastomas are benign tumours of uncertain origin. They are composed of capillaries and/or cavernous spaces interspersed with interstitial cells. Malignant spread, distant metastases and subarachnoid seeding are very rare, and only two such cases have been reported in the English literature. We report a third such case in a 4-year-old girl. The recurrence and extensive spread were excellently demonstrated by MRI.

Cerebellar Neoplasms↗
PubMed1996

Unattached intracranial extra-axial schwannoma.

We describe an intracranial extra-axial petroclival schwannoma which did not arise from any cranial nerve, nor was it attached to brain parenchyma or dura. The possible pathogenesis is discussed.

Adult↗
PubMed1994

Massive benign osteoblastoma of the clivus and atlas.

A case of massive benign osteoblastoma involving the clivus and atlas is reported. Usually, these tumours involve the posterior elements of a vertebra and are detected when small as a result of the usual presenting symptom of pain. The unusual site, massive size and presentation with neurological deficits are rare for benign osteoblastomas. The problems encountered in the surgical management of the patient are discussed.

Cervical Atlas↗
PubMed1994

An unusual trigeminal neurinoma.

We report a large trigeminal neurinoma in an 18-month-old child involving the Gasserian ganglion and all three divisions in a plexiform pattern. The tumour in the ophthalmic division extended all the way to the supraorbital nerve. The child presented with proptosis which had been observed since she was 4 months of age. There was a family history of neurofibromatosis.

Cranial Nerve Neoplasms↗
PubMed1991

Trans-sphenoidal excision of craniopharyngiomas.

Craniopharyngiomas have been by and large excised by the transcranial route. Since 1982, 11 patients have been operated by the traus-sphensidal route in the department. The clinical features with which they were presented, diagnostic investigations, details of surgical procedures and follow-up analysis is being presented here. A retrospective study of radiological investigation was done to determine the features that help decide the choice of surgical approach to these lesions. Only lesions that were primarily intrasellar, cystic and those that expanded the sella could be treated by the trans-sphenoidal route. Associated suprasellar extensions could also be removed. Predominantly calcified or firm, fleshy tumours lent themselves poorly to removal by the trans-sphenoidal route.

Adolescent↗
PubMed1990

Intracranial ectopic pituitary tumour.

Pituitary tumours originating primarily from sites other than the sella turcica are rare. A case of an ectopic pituitary tumour in the region of the lesser wing of the sphenoid is reported. The patient presented with signs and symptoms of a progressive increase in intracranial pressure. CT scan appearances resembled those of a sphenoid wing meningioma. The vascular lesion was partially excised. Histology showed it to be a pituitary tumour.

Adenoma, Chromophobe↗
PubMed1983

Dural sinus and cerebral venous thrombosis.

Eighty patients with 'primary' dural sinus and cerebral venous thrombosis were seen over a period of 16 years. There was an equal distribution amongst the sexes and the largest number of patients presented in the third decade. The commonest predisposing factors were puerperium, pregnancy, synthetic steroid contraceptives and anaemia. Seventy patients presented in an acute fashion with headache, focal or generalized seizures and focal neurological deficits. Ten patients presented in a subacute to chronic manner, with features to suggest an intracerebral space-occupying lesion. The investigation of choice was angiography. Thirty-five patients were treated conservatively with anticonvulsants, low molecular weight dextran and anti-oedema measures. Anti-coagulants were not used for fear of haemorrhage in the associated red infarcts. Antibiotics were not needed as infection played no part in the pathogenesis. Thirty-four patients needed an operation which took the form of a decompressive craniotomy and dural closure with the aid of a pericranial graft. The conservatively treated group appeared to fare better only because it included patients with a milder ictus. Forty patients improved, three remained unchanged and 37 expired. Autopsy in the 35 of the 37 patients showed cortical vein and sinus thrombosis and oedema with a haemorrhagic infarct. Long term follow-up showed good recovery of neurological function, but epilepsy was a troublesome sequel and needs regular anti-epileptic drug treatment.

Adolescent↗
PubMed1978

Death following external carotid artery embolization for a functioning glomus jugulare chemodectoma. Case report.

A 24-year-old man with left sixth through twelfth cranial nerve palsies and severe, fluctuating, systemic arterial hypertension was found to have a large, vascular, catecholamine-forming glomus jugulare chemodectoma. After his electrolyte imbalance was corrected, left external carotid embolization (using Gelfoam) was carried out. The systemic blood pressure stabilized at around 160/100 mm Hg over the next 12 hours. Ten hours later the hitherto conscious patient developed acute arterial hypotension, lapsed into coma, and died. Autopsy showed tumor infarction, swelling, cerebellar tonsillar herniation, and medullary compression. An unusual complication of glomus tumor embolization is highlighted. The roles of preliminary decompressive surgery and urgent resuscitation by vasopressors are discussed.

Adult↗
PubMedDate not supplied

Craniopharyngioma: treatment by conservative surgery and radiation therapy.

Benign neoplasms are curable only when excised. This applies even to craniopharyngiomas. The proximity of craniopharyngiomas to the hypothalamus and neurovascular structures makes total excision difficult to achieve. Over the last 3-4 decades, it has become increasingly obvious that craniopharyngiomas respond to radiation therapy. Early, unhappy results with major excisions have prompted us to adopt a policy of conservative surgery and radiation therapy to the residual tumour. Preliminary results suggest a good outcome in 35 of the 63 patients so treated from 1981. Details of the study are presented.

Adolescent↗