Biomedical subjects
Publications and source records attributed to V S Madan.
Proximal migration of ventriculoperitoneal (VP) shunt is extremely rare. A medium pressure VP shunt was inserted in a 10-month-old infant suffering from severe hydrocephalus. One month later, complete migration of the shunt into the lateral ventricle was encountered. Possible causative mechanisms and the literature on this subject are briefly discussed.
A 14 year old girl presented with a 6 months' history of headache with vomiting, ataxia and cerebellar signs. CT and MRI revealed obstructive hydrocephalus secondary to a large fourth ventricular mass which enhanced markedly on contrast administration. Histopathology of the resected mass revealed papillary structures lined by cuboidal cells confirming choroid plexus papilloma.
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Extradural ependymomas arising from filum terminale externa in the sacrococcygeal region are very rare. Since 1937, out of 58 cases reported in English literature, only 13 cases of tumor located presacrally in the retrorectal space, have been reported. The authors report a 38 yrs old male with a primary ependymoma of the sacrococcygeal region causing extensive sacral destruction.
Syringomyelia following meningitis is a rare condition. This report summarizes the history of a 43 year old Indian male who developed arachnoiditis as a sequalae of tubercular meningitis. This later progressed to syringomyelia. The patient was treated with a syringo-subarachnoid shunt.
The authors report a rare case of cryptogenic osteomyelitis of the skull with an intracerebral and a subgaleal abscess. Total excision of the abscess extending from the cortical surface to the lateral ventricle led to ventriculitis and subgaleal cerebrospinal fluid collection. These complications could have been avoided by aspirating the abscess after removing the infected portion of the skull and the epidural granulation tissue. Neurosurgeons preferring to excise such an abscess should leave a small area of capsule at the base in order to avoid having to open the ventricle.
Three cases of solitary osteochondroma of the spine are reported. Two presented with cervical myelopathy and one with radiculopathy. Plain radiography or tomography is adequate for the diagnosis in the majority of cases; nevertheless, a CT scan or MRI is of immense help in planning surgical treatment. The radiological features of spinal exostoses are reviewed.
Calcification in cases of medulloblastoma has been described with varying frequency (10%-15.4%) on computed tomographic (CT) scan. Usually these calcifications are small in size and speckled. The authors report a case of medulloblastoma with extensive calcification in the lateral hemisphere of the cerebellum in an 18-year-old boy.
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A case of lymphocytic hypophysitis (LYHY) in a menopausal woman is presented. A review of the literature suggests that conservative treatment may be tried in suspected cases of LYHY, if the vision of the patient is not threatened. A transphenoidal stereotactic biopsy of the mass may be performed if the patient fails to improve or deteriorates, thus avoiding open exploration of the sella in selected cases.
Two cases of gross post-operative cerebrospinal fluid (CSF) leakage along an indwelling ventricular catheter are reported. The CSF appeared to leak through the perforations of the ventricular catheter, as well as at the site of penetration of the ventricular wall. A small or slit ventricle with high intraventricular pressure may thus be a predisposing factor for this localized CSF collection.
We report a 35 year old lady who developed lumbosacral plexopathy immediately following regional paracervical block anaesthesia for medical termination of pregnancy. There was only partial recovery at one year. The neurological deficit and its mechanisms are discussed.
A study of eleven patients presenting with neurological complications following acute viral conjunctivitis, mostly haemorrhagic, is reported and the literature reviewed. A Guillain-Barre syndrome-like profile was seen in six patients while the remaining had features of radiculomyelitis. Besides asymmetrical neurological deficits, protein cell reaction and residual muscle wasting, the occurrence of dysautonomias was the striking feature noted in the patients with a Guillain-Barre syndrome-like profile. The dysautonomic features included fatal paroxysmal hypertensive and hypotensive crises in one patient and self limiting tachycardias, episodic profuse sweating, abnormal expiration-inspiration ratio and valsalva ratio in four patients. High antibody titers to EV-70 virus were seen in five patients. A follow up of one and a half year revealed poor neurologic recovery in patients with radiculomyelitis as compared to good functional recovery in others. The importance of early recognition and appropriate treatment of dysautonomias is emphasised. The probable aetiopathogenesis of the neurological complications including dysautonomias is discussed.
A group of patients presenting with seizures (focal or generalised) and abnormal CT scans who, on follow up, showed complete resolution of the CT scan changes, without any treatment other than anticonvulsants, are described.
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Explore the source record for details and available documents.