Biomedical subjects
Publications and source records attributed to A Hanieh.
We reviewed 42 cases of Crouzon's syndrome. There were 16 cases with ventricular dilation. We believe that shunt should be inserted after fronto-orbital advancement if there are persistent signs of raised intracranial pressure. However, in cases presenting with severe ventricular dilation and papilloedema, a shunt is inserted prior to fronto-orbital advancement. Medium- or high-pressure systems should be used.
A case of meningioma of the third ventricle is described. The tumor was completely removed using a transcallosal approach.
The clinical, radiological and pathological features of two cases of intraventricular meningioma in a 9-year-old boy and a 9-year-old girl are reported. Presenting features included headache, vomiting and somnolence with no localizing neurological signs on physical examination. Neither patient showed evidence of neurofibromatosis. CT scans were helpful in establishing the preoperative diagnoses with uniformly hyperdense, well-circumscribed lesions showing bright enhancement after contrast within the lateral and third ventricles respectively. Histological examination revealed mixed fibroblastic/angioblastic and fibroblastic patterns, with typical electron-microscopic and immunohistochemical features of meningioma. Successful surgical removal was achieved in both cases.
Forty one cases of arachnoid cyst are reviewed that were treated at the Adelaide Children's Hospital and the Royal Adelaide Hospital. The pathogenesis of the cysts is discussed as well as the method of treatment. Certain aspects of this condition are still unsolved.
A double-blind trial of phenytoin therapy following craniotomy was performed to test the hypothesis that phenytoin is effective in reducing postoperative epilepsy. A significant reduction in the frequency of epilepsy was observed in the group receiving the active drug up to the 10th postoperative week. Half of the seizures occurred in the first 2 weeks and two-thirds within 1 month of cranial surgery. High rates of epilepsy were observed after surgery in patients with meningioma, metastasis, aneurysm, and head injury. Routine prophylaxis with phenytoin (in a dosage of 5 to 6 mg/kg/day) would seem to be indicated, particularly in high-risk patients and, where possible, this treatment should be started 1 week preoperatively. Seizure control is best when therapeutic levels of phenytoin are maintained.
Explore the source record for details and available documents.
In a double-blind trial of phenytoin for the prevention of postoperative epilepsy in craniotomy patients, epilepsy was observed in 7.9% (8/101) of patients treated with phenytoin and in 16.7% (17/102) of those receiving placebo. Therapeutic drug levels were associated with a significant reduction in the frequency of epilepsy. Three-quarters of the fits occurred within a month of cranial surgery. High rates of epilepsy have been observed after cranial surgery in patients with meningioma, aneurysm, and head injury with or without intracranial clots, and routine prophylaxis with phenytoin would seem to be indicated in such patients.
Explore the source record for details and available documents.
This is a report of five cases in which a bullet penetrated the vertex of the skull and brain, apparently during its vertical descent after having been fired into the air.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A retrospective review of the Department of Histopathology files at the Adelaide Children's Hospital was conducted to examine all cases where sudden death (defined as death occurring within 24 h of sudden collapse and unconsciousness in a previously apparently well child) was attributable to hemorrhage from an occult central nervous system lesion. Ten cases were found with significant hemorrhage and associated cerebral edema. The diagnoses were cerebral arteriovenous malformation (1), probable cerebellar vascular malformation (4), berry aneurysm of middle cerebral artery (1), cerebellar medulloblastoma (1), optic chiasm astrocytoma (1), pineal gland teratoma (1), and fourth ventricle ependymoma (1). These cases demonstrate the wide range and variable location of intracranial lesions capable of causing sudden death in children. Careful examination of the brain in all cases of sudden pediatric death is essential so that intracranial lesions causing unexpected death will be adequately characterized.