Refine your search
Collections
Co-Authors
Journals
Year
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Nivargi, V.
- Paediatric Unilateral Hydrocephalus an Unusual Presentation of Endovascular Proliferative Angiopathy of Unilateral Middle Cerebral Artery
Abstract Views :176 |
PDF Views:0
Authors
R. Sangle
1,
V. Nivargi
2
Affiliations
1 Dept of Neurosurgery, B.J Medical College, Pune, IN
2 Dept of Cardiology, Ruby Hall Clinic, IN
1 Dept of Neurosurgery, B.J Medical College, Pune, IN
2 Dept of Cardiology, Ruby Hall Clinic, IN
Source
The Indian Practitioner, Vol 69, No 9 (2016), Pagination: 21-24Abstract
Adolescent female 11years of age had gradual onset progressive weakness, involving left upper limb. There was no history of headache, vomiting or diminishing of vision, trauma and fever. Full term normal delivery child received vaccinations as per schedule. Neurologically normal till 4 years of her age when she had two generalised seizures with loss of consciousness. Clinical and brain CT examinations showed no abnormality. Electro-encephalography & routine cerebrospinal fluid studies were normal. Considered epileptic and was kept on oral medication with carbamazepine. Only a few case reports of isolated MCA angiopathy in their initial stages have been reported. Clinically, diminutive-neurocognitive functions of the child at different stages must always be co-related with angiography studies and followed-up at least every two years. Therapeutic window-period and the time lost, play important role in the overall management and clinical outcome.Keywords
Isolated MCA Angiopathy, Moyamoya Disease.
References
- Nelson JS.Dr. Henry Knipe and Dr Bruno Di Muzio et al. Principles and Practice of Neuro-pathology, Oxford University Press, USA.(2003) ISBN: 0195125894.
- Takeuchi K, Shimizu 1. K. Hypoplasia of the bilateral internal carotid arteries. Brain Nerve1957; 9:37-43.
- Suzuki J, Takaku A. Cerebrovascular “moyamoya”disease: disease showing abnormal net-like vessels in base of brain. Arch Neurol 1969; 20:288-99
- Fukui M. Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (‘moyamoya’disease). ClinNeurolNeurosurg 1997; 99: Suppl 2:S238-S240.
- Baba T, Houkin K, Kuroda S. Novel: epidemiological features of moyamoya disease. J NeurolNeurosurg Psychiatry 2008; 79:900-4.
- Han DH, Kwon OK, Byun BJ, et al. A co-operative study: clinical characteristics of 334 Ko-rean patients with moyamoya disease treated at neurosurgical institutes, (1976-1994). ActaNeu-rochir (Wien) 2000;142:1263-73.
- Nagaraja D, Verma A, Taly AB, etal.Cerebro-vascular disease in children. ActaNeu-rolScand1994 ; 90:251-5.
- Wakai K, Tamakoshi A, Ikezaki K, et al. Epidemiological features of moyamoya disease in Japan: findings from a nationwide survey. ClinNeurolNeurosurg 1997; 99: Suppl 2:S1-S5.
- Berenstein A, Lasjaunias P, terBrugge KG; SurgicalNeuroangiography: Clinical and Endo-vascular aspects in paediatrics Vol. 3, 2nd edition, 2010; Heidelberg: Springer-Verlag; 2004
- Han DH, Kwon OK, Byun BJ, et al. A co-operative study: clinical characteristics of 334 Ko-rean patients with moyamoya disease treated at neurosurgical institutes,(1976-1994). ActaNeu-rochir (Wien) 2000;142: 1263-73.
- Isolated Abducens Nerve Palsy Due to Focal Patchy Inflammatory Lesion and Review of the Literature
Abstract Views :174 |
PDF Views:0
Authors
Affiliations
1 B.J.Medical College, Pune, IN
2 Ruby Hall Clinic, Pune, IN
1 B.J.Medical College, Pune, IN
2 Ruby Hall Clinic, Pune, IN
Source
The Indian Practitioner, Vol 69, No 10 (2016), Pagination: 15-20Abstract
Background: Convergent squint due to 'isolated abducens nerve palsy' (IANP) in otherwise normal patients is not often seen. Reports on natural history related to causes, time of improvement and recurrences is varied and perplexing. Objective 1) to relate IANP to the 'focal patchy inflammatory dural lesion' (FPIDL) along the lateral wall of cavernous sinus using magnetic resonance imaging (MRI), 2) to assess the use of anti-inflammatory drugs and steroids, 3) understanding incidence of recovery and recurrences. Patient&method: Retrospective review of seven patients of IANP with MRI neuroimaging and steroidal therapy. Cerebrospinal fluid (CSF) was investigated in four patients only. Results: MRI showed FPIDL affecting lateral wall of cavernous sinus all along the abducens nerve tract. Recurrent palsy similar independent lesion. Both treated with anti-inflammatory and steroidal drug therapy. Follow-up MRIs within two weeks of therapy shows significant recovery with regression of FPIL. Conclusion: Skull base MRI differentiates FPIDL from intra-nuclear and other structural causes. IANP recurrences appear independent, have similar lesions and also respond to anti-inflammatory and steroidal therapy. The authors suggest MRI-skull base neuroimaging and reviews IANP.Keywords
Isolated Abducens Nerve Palsy, Focal Patchy Inflammatory Dural Lesion, Skull Base MRI.References
- Lee JH, Lee HK, Park JK, Choi CG,Suh DC: Cavernous sinus syndrome: clinical features and differential diagnosis with MR imaging. AJR Am J Roentgenol. 2003, 181 (2): 583-590.
- Moster ML, Savino PJ, Sergott RC, Bosley TM, Schatz NJ. Isolated sixth nerve palsies in younger adults. Arch Ophthalmol. 1984; 102:1328–1330
- Tamhankar MA, Biousse V, Ying GS, et al. Isolated third, fourth, and sixth cranial nerve palsies from presumed microvascular versus other causes: a prospective study. Ophthalmology. 2013; 120(11):2264–2269.
- Richards BW, Jones FR, Jr, Younge BR. Causes and prognosis in 4,278 cases of paralysis of the oculomotor, trochlear, and abducens cranial nerves.Am J Ophthalmol. 1992; 113(5):489–496.
- Yousuf SJ, Khan AO; .Presenting features suggestive for later recurrence of idiopathic sixth nerve paresis in children. J AAPOS. 2007; 11(5):452–455. [PubMed]
- Anthony J King1, Emma Stacey2, Gail Stephenson3 and Roger B Trimble4 Spontaneous recovery rates for unilateral sixth nerve palsies; Eye (1995) 9, 476–478; doi: 10.1038/eye.1995.110
- Jacobson DM, McCanna TD, Layde PM. Risk factors for ischemic ocular motor nerve palsies. Arch Ophthalmol. 1994; 112:961–966
- Asbury AK, Aldredge H, Hershberg R, Fisher CM. Oculomotor palsy in diabetes mellitus: a clinico- pathological study. Brain. 1970; 93:555–566
- Meltzer CC1, Fukui MB, Kanal E, Smirniotopoulos JG; MR imaging of the meninges. Part I. Normal anatomic features and nonneoplastic disease; Radiology. 1996 Nov; 201(2):297-30
- Patel SJ, Lundy DC. Ocular manifestations of autoimmune disease. Am Fam Physician. 2002 Sep 15. 66(6):991-8. [Medline]
- Mohsen Azarmina, MD1 and Hossein Azarmina, MD2; J Ophthalmic Vis Res. 2013 Apr; 8(2): 160-171. PMCID: PMC3740468 The Six Syndromes of the Sixth Cranial Nerve.
- Kurbanyan K, Lessell S. Intracranial hypotension and abducens palsy following upper spinal manipulation. Br J Ophthalmol. 2008;92:153–155. [PubMed]
- Kuhl V, Andreas J, Müller-Forell W, Thömke F, Hopf HC. Spontaneous intracranial hypotension syndrome in cervicothorackc cerebrospinal fluid leak. Nuklearmedizin. 2000; 39:N22–24. [PubMed]
- Krishna R, Kosmorsky GS, Wright KW.Pseudotumor cerebri sine papilledema with unilateral sixth nerve palsy. J Neuroophthalmol. 1998;18:53–55. [PubMed]
- Michael S Lee, MD, Steven L Galetta, MD, and Nicholas J Volpe, MD, Grant T Liu, MD correspondence: Sixth nerve palsies in children. Pediatric Neurology; January 1999Volume 20, Issue 1, Pages 49–52 ;
- Sakalas R, Harbison JW, Vines FS, Becker DP. Chronic sixth nerve palsy. An initial sign of basisphenoid tumors. Arch Ophthalmol. 1975; 93:186–190. [PubMed]
- King AJ1, Stacey E, Stephenson G, Trimble RB. Spontaneous recovery rates for unilateral sixth nerve palsies. Eye (Lond). 1995; 9 (Pt 4):476-8.
- Schatz NJ, Farmer P. Tolosa- Hunt syndrome: the pathology of painful ophthalmoplegia. In: Smith JL, editor. Neuroophthalmology. St. Louis: C.V. Mosby; 1972.
- Campbell RJ, Okazaki H. Painful ophthalmoplegia (TolosaHunt variant): autopsy findings in a patient with necrotizing intracavernous carotid vasculitis and inflammatory disease of the orbit. Mayo Clin Proc.1987; 62:520–526. [PubMed]
- Steven R. Hamilton, M.D., Simmons Lessell, M.D. Recurrent Idiopathic Lateral Rectus Muscle Palsy in Adults: American Journal of Ophthalmology, Volume 112, Issue 5, November 1991, Pages 540-542
- Ebright JR, Pace MT, Niazi AF.Septic thrombosis of the cavernous sinuses. Arch Intern Med. 2001; 161:2671–6. [PubMed]
- Endovascular De-Vascularization of the Jugulo-Tympanic 'Aggressive-Paraganglioma'
Abstract Views :160 |
PDF Views:0
Authors
Affiliations
1 Dept of Neurosurgery, B.J. Govt Medical College, Pune, IN
2 Ruby Hall Clinic, IN
3 Ruby Hall Clinic, Pune, IN
4 Poona Hospital, Pune, IN
1 Dept of Neurosurgery, B.J. Govt Medical College, Pune, IN
2 Ruby Hall Clinic, IN
3 Ruby Hall Clinic, Pune, IN
4 Poona Hospital, Pune, IN
Source
The Indian Practitioner, Vol 69, No 12 (2016), Pagination: 11-20Abstract
Background: Jugulotympanic 'aggressive-paraganglioma' (JTa-P) grows rapidly, within months intrudes in to jugular bulb, labyrinth and compresses the lower cranial nerves (LCN). Scanty cellularity and intense-vascularity complicates tumor surgery. Post-surgically, it yields large volumes of residues and results in LCN-palsy. With increased recurrence rate it causes more morbidity and mortality.
Objective: 1. Radio-imaging early the aggressive-phenotypes. 2. De-vascularization and super-selective endovascular arterial embolization(EAE) of the tumor feeding arteries for better surgical outcome.
Material & Method: Computerized tomography (CT), magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) characteristically defines the aggressive phenotypes. Seven patients of intractable vertigo and lower cranial nerve palsy diagnosed and devascularized between 2008 and 2012 years. JTa-P categorized as Type 1, Type 2, Type 3 and Type 4. Pre-surgically adequate de-vascularization of vascular blush-map (90%) along with EAE performed, followed by surgery between 3rd and 5th day of the de-vascularization. It gives maximum avascularity.
Results: Subtotal radical excision was possible. LCN-functions could be preserved in 42.85%. Morbidity reduced to 50%. Vertigo tinnitus improved. Four year follow up showed no tumor recurrence.
Conclusion: 1. Radio imaging gives early diagnosis. 2. Endovascular de-vascularizationis an useful adjunct in reducing morbidity and mortality.
Keywords
1) Jugular Foramen Syndrome, 2) Aggressive-Jugulo-Tympanic Paraganglioma, 3. Radio-Imaging, Digital Subtraction Angiography (DSA), 4. De-Vascularization and EAE.References
- Fliedner SM, Lehnert H, Pacak K; Metastatic paraganglioma. SeminOncol. 2010 Dec; 37(6):627-37. doi: 10.1053/j.seminoncol.2010.10.017
- WL Olsen, WP Dillon, WM Kelly, D Norman, M Brant-Zawadzki and TH Newton American Journal of Roentgenology. 1987;148: 201-204. 10.2214/ ajr.148.1.201
- Schwaber M K, Glasscock M E, Nissen A J, Jackson C G, Smith P G. Diagnosis and management of catecholamine secreting glomus tumors. Laryngoscope. 1984;94:1008–1015.
- Havekes B, van der Klaauw AA, Hoftijzer HC, Jansen JC, and van der Mey AG, Vriends AH. Reduced quality of life in patients with head and neck paragangliomas. Eur J Endocrinol. 2008 Feb. 158(2):247-53.
- Rao AB, Koeller KK, Adair CF. From the archives of the AFIP. Paragangliomas of the head and neck: radiologic-pathologic correlation. Armed Forces Institute of Pathology. Radiographics. 19 (6): 1605-32.
- Jansen JC, van den Berg R, Kuiper A, et al. Estimation of growth rate in patients with head and neck paraganglioma influences the treatment proposal. Cancer 2000; 88:2811–2816
- McNeil AR, Blok BH, Koelmeyer TD et al: Phaeochromocytomas discovered during coronial autopsies in Sydney, Melbourne and Auckland. Aust NZJ Med 2000; 30 (6): 648)
- CJM LipsEmail author, EGWM Lentjes, JWM Höppener, RB van der Luijt and FL Moll; Familial paragangliomas; Hereditary Cancer in Clinical Practice20064:169
- Spector GJ, Druck NS, Gapo M. Neurologic manifestations of glomus tumors in the head and neck. Arch Neurol 1976; 33:270-274
- Al-Mefty O, Teixeira A. Complex tumors of the glomus jugulare: criteria, treatment, and outcome. J Neurosurg 2002;97:1356–1366.
- Eisenhofer G, Bornstein SR, Brouwers FM, et al. Malignant pheochromocytoma: current status and initiatives for future progress. Endocrine-related cancer. 2004 Sep; 11(3):423–436. [PubMed]
- Young AL, Baysal BE, Deb A, Young WF., Jr. Familial malignant catecholamine-secreting paraganglioma with prolonged survival associated with mutation in the succinate dehydrogenase B gene.The Journal of clinical endocrinology and metabolism. 2002 Sep; 87(9):4101–4105.
- Hawthorne MR, Makek MS, Harris JP, FischU.The histopathological and clinical features of irradiated and non-irradiated temporal paragangliomas. Laryngoscope 1988; 98(3):325–331.
- Kukherji SK, Kasper ME, Rart RP, Mancuso