Biomedical subjects
Publications and source records attributed to V Puri.
A 17-year-old female presented with a non-tender, firm and fixed swelling in the right frontal region. Skull x-rays revealed soft tissue shadow and mild hyperostosis of the underlying frontal bone. Histopathological examination after excision showed it to be a meningioma with an epidermoid cyst.
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A case of neurocysticercosis in an 11 year old female manifesting only as myoclonic seizures is reported. The diagnosis was based upon ELISA test, computed tomography, and biopsy of a subcutaneous nodule. The patient responded to anticysticerci drug treatment. Neurocysticercosis has not to our knowledge been previously reported to have presented with myoclonus.
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Twenty seven cases (13 male, 14 female) in the age group of 3-12 years with cerebral cysticercosis were studied and followed up to 3.9 years (mean 1.85 +/- 0.91 years). Seizures (partial 76% and generalized 23.8%) was the feature in 21 patients (77.7%) and raised intracranial tension in 15 (55.5%). Five patients (18.2%) had meningoencephalitis, while 4 (14.8%) had obstructive hydrocephalus due to intraventricular cysts in the 4th ventricle. Twenty two patients received cysticidal drugs (praziquantel or albendazole), while 8 had surgical intervention (CSF diversion, cyst removal, subtemporal decompression or extirpation of the cortical cyst). Mortality was 18.2%. Survivors had epilepsy in 18 patients (81.8%), dementia in 2 (9%), mental subnormality in 6 (27.2%) and hyperkinesia in 12 (54.5%).
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A young male aged 20 years had resection of the upper lobe of right lung for plasma cell granuloma. Five years later he developed three lesions in the brain, one of which was resected. Brain lesion showed similar histopathological picture. A unique case of plasma cell granuloma involving more than one organ is reported.
Thirty-one patients with intracranial tuberculomas were diagnosed on the basis of magnetic resonance (MR) imaging. The diagnosis was confirmed in 30; one case was a false-positive. A total of 44 tuberculomas was found in these patients of which 41 were distributed in the cerebral hemispheres, two in the brainstem and one in the cerebellum. No correlation was found between the type of lesion seen on CT and those seen on MR imaging. CT was negative in one patient with a low brainstem tuberculoma. The final diagnosis was based on the response to antituberculous drug treatment as judged by serial MR imaging in 29 patients and by biopsy in one; and one was false-positive. Thirty-nine tuberculomas, all under 2.5 cm in size, showed complete resolution after 5-8 months of treatment. The remaining five lesions were larger than 2.5 cm; four showed a 50% reduction in size after 12 months of treatment and one was completely excised. Three types of response are described to the treatment with anti-tuberculous drugs. The diagnosis of intracranial tuberculomas can be made more objectively with MR imaging.
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Epilepsia partialis continua was the chief initial complaint in a young diabetic who was found to have hyperosmolar non ketotic hyperglycaemia. Such a presentation in a juvenile diabetic is rare. Literature relevant to this interesting neurologic disturbance has been briefly reviewed.
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