PubMed Health⌕ Search

Biomedical subjects

R R Sharma

Publications and source records attributed to R R Sharma.

At least 55 records · Page 3Linked to original sources
PubMed1999

Symptomatic calcified subdural hematomas.

Two unique cases of chronic calcified subdural hematomas are reported in children as a long-term complication of a ventriculoperitoneal shunt. Both the patients had undergone shunt procedures in infancy for congenital hydrocephalus. In one patient, the cause of the hydrocephalus was aqueduct stenosis, while in the second patient, a lumbar meningomyelocele was associated with hydrocephalus. In both these patients, a ventriculoperitoneal shunt was done in infancy. In one of them, following the shunt surgery, a bilateral subdural collection was noticed which required burr hole evacuation. Both the patients remained asymptomatic for 9 years, when they presented to our center with acute raised intracranial pressure and contralateral hemiparesis. Both the patients had a relatively short history and had altered sensorium at admission. Surprisingly, in both the patients, the CT scan showed significant mass effect producing calcified subdural hematomas. The shunt systems were found to be working well at surgery. Craniotomy and excision of the calcified subdural hematomas was undertaken. Postoperatively, the patients showed satisfactory recovery, and at discharge the patients were doing well. At the follow-up at the outpatient clinic, the patients were asymptomatic.

Calcinosis↗
PubMed1996

Comparison of prevalence and resection rates in patients with esophageal squamous cell carcinoma and adenocarcinoma.

Since 1987 we have observed a predominance of adenocarcinoma in patients undergoing esophagectomy because of carcinoma at our institution. To discover whether this observation represented an actual change in the prevalence of adenocarcinoma, the Johns Hopkins Hospital pathology records were reviewed for the years 1959 to 1994. Overall, esophageal squamous cell carcinoma was the most common histologic type with 817 cases identified versus 284 cases of adenocarcinoma. The number of patients with squamous cell carcinoma rose slowly from 1959 to 1992 but since 1992 has decreased. Whereas adenocarcinoma was uncommon before 1978, its frequency has since increased markedly, exceeding that of squamous cell carcinoma in 1994. The number of patients with adenocarcinoma who underwent surgical resection has equaled or exceeded the number of those treated nonoperatively for all recorded years. Therefore the predominance of adenocarcinoma in patients undergoing esophageal resection for carcinoma appears to result from two factors: an overall increase in the prevalence of adenocarcinoma since 1978 and an increased likelihood of resection for patients with these tumors.

Adenocarcinoma↗
PubMed1995

Primary cerebral gliosarcoma: report of 17 cases.

A retrospective study of 17 cases of primary cerebral gliosarcoma is presented. These uncommon highly aggressive intracranial neoplasms were seen at the Royal Preston Hospital, between 1973 and 1992. The patients' ages ranged from 21 to 73 years (mean 52), nine were males and eight were females. They presented with signs and symptoms of a rapidly expanding brain tumour. The diagnosis was suspected on radiological findings and confirmed by histological examination. Treatment involved surgical excision in 15 cases and biopsy in two followed by radiotherapy. Chemotherapy was given in three cases. Despite active management, median survival was only 9 months. The clinical, radiological and pathological features of these lesions are highlighted with emphasis on combined histochemistry and immunohistochemistry. The features of gliosarcoma and glioblastoma are compared and contrasted.

Adult↗
PubMed1995

Supratentorial haemangioblastoma not associated with Von Hippel Lindau complex or polycythaemia: case report and literature review.

Solitary or multiple supratentorial haemangioblastomas are rare and may be associated with Von Hippel Lindau complex (VHLC), polycythaemia or a family history of VHLC. An extensive review of the literature (1902-1992) has revealed 112 cases. They account for 2-8% of all haemangioblastomas and are commonly intraparenchymatous (86.8%) and infrequently intraventricular (6.6%). However, a meningeal location 5.6%) is extremely rare. Only one case of a solitary leptomeningeal haemangioblastoma has previously been reported and this was associated with a family and personal history of VHLC, cerebellar haemangioblastoma and renal carcinoma. We report a solitary solid left parietal leptomeningeal haemangioblastoma mimicking a meningioma or a secondary deposit on computed tomography in a 72-year-old male. There were no manifestations of or a family history of VHLC or polycythaemia.

Aged↗
PubMed1995

Intracerebral haemorrhage due to amphetamine abuse: report of two cases with underlying arteriovenous malformations.

Amphetamine abuse may be complicated by intracerebral, subdural or subarachnoid haemorrhage. The causative mechanism is probably a combination of vasculitis and induced hypertension. Most cases of intracerebral haemorrhage are subcortical. Only one case of amphetamine-induced intracerebral haematoma where there was also an underlying arteriovenous malformation has been previously reported. We report two cases of intracerebral haematoma due to amphetamine abuse whether an underlying AVM was found at the time of surgery. This possibility should be considered in cases of amphetamine-induced intracerebral haemorrhage.

Adult↗
PubMed1994

Spinal extradural arteriovenous malformation presenting with recurrent hemorrhage and intermittent paraplegia: case report and review of the literature.

Symptomatic spinal extradural arteriovenous malformations (AVMs) are uncommon. They usually present with slowly progressive myelopathy and/or radiculopathy and only rarely with spinal extradural hemorrhage (SEH). Histopathologic features of a true spinal extradural AVM causing an overt SEH have only previously been described in four cases. A further case of a histologically confirmed spinal extradural AVM causing SEH in a 50-year-old otherwise medically normal Caucasian woman is presented. Recurrent hemorrhage resulted in intermittent paraplegia and acute chest/shoulder pain--diagnosed initially as hysteria. Interesting sequential myelographic, computed tomographic, and magnetic resonance imaging studies are presented, and the literature on spinal extradural AVMs presenting with SEH is reviewed.

Arteriovenous Malformations↗
PubMed1994

Extradural application of bismuth iodoform paraffin paste causing relapsing bismuth encephalopathy: a case report with CT and MRI studies.

Bismuth iodoform paraffin paste (BIPP) is used in dressings in ear, nose, and throat, dental, and neurosurgical practice. Neurotoxicity due to absorption of bismuth from the BIPP pack is rare. It is preventable and reversible but likely to be fatal if unrecognised. A case of relapsing but reversible toxic encephalopathy due to a large extradural BIPP pack is reported in a 57 year old Caucasian woman, operated on for a huge basal cell carcinoma of the vertex invading the skull and extradural space. Clinical, neuroradiological (CT and MRI), and biochemical studies are presented and discussed in the light of the available literature.

Bandages↗
PubMed1994

Idiopathic spinal extradural lipomatosis in a non-obese otherwise healthy man.

Spinal extradural lipomatosis is rare and is usually associated with long-term steroid administration or obesity. It is most commonly thoracic in situation. We present a unique case of spinal extradural lipomatosis in a 20-year-old non-obese, clinically normal man. The role of MRI in investigation and the management options are discussed.

Adult↗
PubMed1993

Primary malignant non-Hodgkin's lymphoma of cranial vault: a case report.

Primary cranial vault non-Hodgkin's lymphomas are rare and only four such cases are described in the literature. A 65-year-old woman presented with focal neurological deficits and a subcutaneous scalp lump. Computed tomography (CT) scan showed a left parietal cranial vault lesion with soft tissue scalp swelling and underlying intracranial extra axial mass mimicking a meningioma. Histology showed features of a typical B-cell non-Hodgkin's lymphoma, there was no systemic involvement. The characteristic CT findings of this lesion are described and relevant literature is reviewed. We are reporting this case because of its rare occurrence. A diagnosis of primary lymphoma of the skull vault should always be considered in the differential diagnosis when such a lesion is encountered.

Aged↗
PubMed1993

Multifocal giant cell glioblastoma: case report.

Glioblastoma multiforme (GM) of the cerebellum is a rare tumour. A variant of GM, a multifocal giant cell glioblastoma, initially presenting in the cerebellum, has not previously been reported. A giant cell glioblastoma occurring in a 46-year-old man who presented initially with a cerebellar tumour is described. One month after excision of the tumour, the patient had a grand mal seizure. Computed tomography (CT) showed a low-density lesion in the left temporal lobe. Four months later he developed dysphasia and right-sided hemiparesis. Repeat CT scan revealed a large temporal lobe tumour which was excised, and histologically found to be a giant-cell glioblastoma with histopathological similarities to the original cerebellar tumour. The clinical course, computed tomographic and pathological features of this tumour are described and discussed.

Brain Neoplasms↗
PubMed1993

The anterior interhemispheric trephine approach to anterior midline aneurysms: results of treatment in 72 consecutive patients.

We report the results of a prospective study of an anterior interhemispheric trephine approach in 72 consecutive patients with aneurysms of the anterior communicating artery (64 cases) and anterior cerebral arteries (eight cases). The salient features of the operative technique include a limited forehead crease incision, low anterior frontal midline trephine (4 cm), unilateral dural opening (2.5 cm), opening up of the anterior interhemispheric fissure and exposure of aneurysm and anterior cerebral vessels by a phased dissection. The best anatomical orientation is retained without compromising the superior sagittal sinus, falx cerebri, left frontal cortical veins, or eloquent areas of the brain. The results (excellent to good recovery or mild to moderate disability in 87.5% of cases) confirm that the technique is safe and well tolerated even in the elderly or fragile patients.

Adult↗
PubMed1993

Intraparenchymatous schwannoma of the cerebellum.

Intraparenchymatous schwannomas of the central nervous system are rare. In decreasing order of frequency they are found in the spinal cord, cerebral hemispheres, brainstem and cerebellum. So far, only six such tumours have been reported in the cerebellum. A male predominance and early onset of symptoms are salient features. A case of a 73-year-old Caucasian female with an intraparenchymatous schwannoma of the right cerebellar hemisphere which extended into the brainstem is reported. A complete cure followed surgical removal of the tumour. The preoperative clinical and radiological diagnosis was that of a cerebellar astrocytoma.

Aged↗
PubMed1993

Osteoradionecrosis of the petrous bone and recurrent cerebrospinal fluid otorrhoea.

A case is reported of delayed necrosis of the petrous bone following a course of radiotherapy for a well-differentiated squamous cell carcinoma in a 60-year-old female who presented with recurrent intractable cerebrospinal fluid otorrhoea, meningitis and pneumocephalus. Multiple attempts at surgical repair of the necrosed dural deficit and tegmental fistula failed and eventually petrousectomy was necessary leading to a successful outcome.

Carcinoma, Squamous Cell↗
PubMed1993

Compression of the C-2 root by a rare anomalous ectatic vertebral artery. Case report.

The authors report a symptomatic congenitally anomalous ectatic vertebral artery not passing through the transverse foramen of the atlas (C-1), but instead piercing the dura mater below the posterior arch of the C-1 in the atlantoaxial (C1-2) interlaminar space. This occurrence is exceptionally rare, but in this case it was uniquely associated with occipital neuralgia due to vascular compression of the C-2 root. Microvascular decompression was curative. Neuroradiological and surgical findings are presented and their implications discussed.

Aged↗