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T Chakera

Publications and source records attributed to T Chakera.

8 recordsLinked to original sources
PubMed2002

Dural sinus thrombosis presenting as unilateral lobar haematomas with mass effect: an easily misdiagnosed cause of cerebral haemorrhage.

Dural sinus thrombosis has protean clinical and radiological manifestations ranging from minimal effacement of sulci with no symptoms to severe haemorrhagic infarcts associated with focal deficits, coma and even death. An uncommon form of presentation is characterized by unilateral lobar haemorrhage associated with extensive oedema and parenchymal distortion. In an acute presentation, this might resemble haemorrhage into a tumour. In delayed presentations, the haematoma, being iso- or hypodense and showing peripheral ring-like enhancement, can mimic aggressive tumours or infective processes. As this is an uncommon condition, misdiagnosis is common with the potential for mismanagement and adverse outcomes. We present five such consecutive cases that were initially misdiagnosed as other entities. Each of these cases on closer inspection show features observed on CT and MRI that should have suggested a diagnosis of dural venous sinus thrombosis. One of these cases progressed to not only extensively involve the superficial sinuses but also the deep veins, with a significant adverse outcome. The imaging features of this interesting variant of dural sinus thrombosis are reviewed. The haemodynamic basis for haemorrhage and anatomical basis for the lateralization of the lesions are discussed.

Adult↗
PubMed2001

Post-traumatic lumbar nerve root avulsion.

Lumbar nerve root avulsion is a rarely seen clinical entity that may complicate major trauma. The majority of previously reported cases have associated pelvic or lumbar vertebral fractures. Two cases of traumatic pseudomeningoceles at the lumbar level with associated avulsions of the lumbar nerve roots are presented. Both patients were involved in high velocity motor vehicle accidents. Case 1 had associated pelvic fractures but no spinal fractures and, interestingly, case 2 had no fractures of the spine or pelvis. The value of MRI in making the diagnosis is demonstrated.

Accidents, Traffic↗
PubMed2001

Lhermitte-Duclos disease associated with Cowden's syndrome: case report and literature review.

Lhermitte-Duclos disease (LDD) is a rare entity that may occur in the setting of Cowden's syndrome (CS). Accurate preoperative diagnosis can be made on the characteristic CT and MR appearances, thereby obviating the need for biopsy. It is important to be aware of the link between LDD and CS so that appropriate genetic counselling and tumour surveillance can be undertaken.

Adult↗
PubMed1990

Perth Community Stroke Study: design and preliminary results.

The first aim of the study, to see every case of stroke and TIA which has occurred in a representative population, unbiased by hospital admission and with high pathological documentation, is being achieved. To date, the incidence rates for stroke in Perth are strikingly similar to those in other major population-based studies in the Western world. Further data on risk factors are likely to contribute greatly to our understanding of the aetiology of stroke. The data on stroke outcome should be of international significance.

Cerebrovascular Disorders↗
PubMed1989

Lumbar intraspinal synovial cysts. Recognition and CT diagnosis.

The lumbar intraspinal synovial cyst is an uncommon cause of low-back pain or "sciatica." However it is important to recognize these cysts so that correct surgical management is offered to the patient. Intraspinal synovial cysts can be accurately diagnosed by computed tomography (CT). The authors report ten cases of lumbar intraspinal synovial cysts (LISC) that highlight the clinical and radiologic features.

Aged↗
PubMed1987

Cerebellar haemorrhage--diagnosis and treatment: a study of 75 consecutive cases.

A retrospective study of 75 consecutive cases of spontaneous cerebellar haemorrhage was undertaken in order to evaluate the clinical features and natural history of this condition. A wide spectrum of clinical findings contributed to the poor clinical diagnostic accuracy of 23 per cent, with common misdiagnoses including brainstem stroke and vestibular or labyrinthine disturbance. Presentation with, or the later development of stupor or coma strongly correlated with poor outcome (severe disability or death; p = 0.002). The characteristics of conscious patients who remained stable were compared with those who subsequently deteriorated. The initial conscious state (alert, drowsy or confused), severity of symptoms and ataxia, and the size of haemorrhage on CT scan were not reliable prognostic indicators. However, the presence of bilateral gaze paresis, anarthria (present in eight cases), limb weakness, a systolic blood pressure above 200 mmHg and moderate hydrocephalus significantly correlated with a poor outcome. The presence of these signs warrants consideration of urgent surgical intervention at the time of diagnosis. Since no clinical or radiological findings excluded the possibility of further deterioration, careful monitoring in an intensive care unit is necessary within the first 48 h in those conscious patients who are likely to remain stable. Guidelines for making the clinical diagnosis and for selecting those patients who will require transfer to adequately equipped centres are suggested.

Adult↗
PubMedDate not supplied

A combined flexible sigmoidoscopy and double-contrast barium enema service: initial experience.

BACKGROUND: A service has been instituted offering a combined single-stage procedure of flexible sigmoidoscopy and double-contrast barium enema (FS/DCBE). The results have been reviewed in the first 80 patients to undergo this examination (45 male: 35 female; mean age 61.4 years). METHODS: Indications for investigation were abdominal pain or suspected diverticular disease (22 patients), altered bowel habit (19), rectal bleeding (17), iron deficiency anemia (6), and miscellaneous (16). FS was followed immediately by DCBE. Radiographs were reviewed by two radiologists unaware of the FS findings. RESULTS: The extent of FS was to the proximal sigmoid or sigmoid descending colon or splenic flexure in 12.5%, and mid or distal sigmoid in 37.5%. Biopsies were performed at FS in 26 patients (33%). In 67 (84%) of DCBEs the barium coating was assessed as satisfactory or better. FS yielded pathological findings not seen at DCBE in 21 patients (26%). DCBE demonstrated additional abnormalities within the range of the FS examination in 15 patients (19%), almost entirely due to its increased sensitivity for diverticular disease. CONCLUSION: FS/DCBE is feasible as a one-stage combined procedure. The quality of DCBE following FS is satisfactory, and the extra yield of FS and its potential for biopsy make the combined FS/DCBE a useful technique in the investigation of large bowel disease.

Adult↗