Intrinsic third ventricular craniopharyngioma: two case reports with review of the literature.
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Biomedical subjects
Publications and source records attributed to B Bose.
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In the past experimental methods used for producing focal cerebral ischemia have had considerable difficulty with regard to reproducibility of the size of the infarcted region. In this study we have developed an experimental model which enables us to consistently produce focal regions of cerebral ischemia (resulting in infarction) which vary little in size in a number of animals. Thirty-seven cats (3-4 kg b. wt.) anesthetized with chloralose and urethane were used. Physiologic monitoring and adjustments maintained arterial blood values as follows: pCO2 27-35 Torr, pO2 100-150 Torr, pH +/- 7.4, glucose 200 mg%, hematocrit greater than 25. The left middle cerebral artery was exposed via a transorbital approach and occluded for 1-2 h with and without left and/or both carotid artery occlusion. Sixteen hours following the ischemic episode, the animals were sacrificed and sections of fresh brain tissue were processed for vital staining using 1% tetrazolium solution. With this method normal brain areas appear dark red, ischemic regions (without infarction) appear gray and irreversibly infarcted areas appear pinkish-white. The volumetric dimensions of the lesioned area were measured using a planimeter. The same tissue was also evaluated histologically by means of standard histopathologic techniques on paraffin-embedded material. Infarcted areas as delineated macroscopically by the tetrazolium correlated well with the light microscopic findings. Ten animals subjected to a 2-h occlusion of the left middle cerebral artery (LMCA) and both carotid arteries resulted in a reproducible infarct which was 3.2 +/- 0.7 ml in volume. This represents 13.3 +/- 2.9% of the total volume of both cerebral hemispheres (above the level of the inferior colliculus.(ABSTRACT TRUNCATED AT 250 WORDS)
Two cases of epidermal cyst of the breast are presented. Mammography and ultrasonography merely confirmed that the masses were solid. As is usual with these extremely rare lesions, the initial diagnoses (fibroadenoma and carcinoma) were incorrect.
Early investigators indicated that conservative management was superior to operative intervention in the treatment of central cord injuries. Their clinical data suggested that operative treatment, in fact, worsened the condition. Recent experience with this clinical entity, however, indicates that in selected patients operative intervention may be of value in improving the rate and degree of motor recovery. A retrospective study of all individuals admitted to our hospital (Delaware Valley Spinal Cord Injury Center) with central cervical spinal cord injury was done (28 patients). One-half had been treated with medical therapy alone (Group I); the others were treated both medically and surgically (Group II). Medical therapy consisted of intravenous mannitol, dexamethasone, and sodium bicarbonate given during the acute phase of the injury. Both groups were immobilized using either a halo or a Philadelphia collar. Criteria for entry into the surgical group were one or both of the following: (a) failure to improve progressively after an initial period of improvement, with persistent compression of neural tissue visualized on myelography and (b) unacceptable instability of the spinal bony elements. The patients were given neurological scores based on the motor power of the major muscle groups. The stability of the spine was scored using the Panjabi-White scale. The two groups were compared using Student's t-test and the two-factor analysis of variance. There was no significant difference in initial neurological scores between the groups. The surgical groups had a higher incidence of instability of the bony elements of the cervical spine, as judged by the Panjabi-White scale.(ABSTRACT TRUNCATED AT 250 WORDS)
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Neurological evaluation supplemented by myelography has been highly successful in diagnosing spinal cord tumors. Our experience shows that a widening of the cord on myelography is not always diagnostic of spinal cord tumors. Two patients who presented clinically with evidence of spinal cord tumor and had a widening of the cord on myelography were found to have severe cervical arachnoiditis without any evidence of intrinsic cord abnormality. Hence, cervical arachnoiditis should be considered in the differential diagnosis of spinal cord tumor on myelography.
Giant aneurysm of the basilar artery presenting as a 3rd ventricular tumor is an unusual phenomenon. We are reporting a case in which a patient with a giant aneurysm of the basilar artery presented with symptoms of headaches and gait disturbance secondary to obstructive hydrocephalus. Although giant aneurysms presenting as mass lesions have been reported, the computed axial tomographic findings in our case were unique. Giant aneurysms of the basilar artery may be considered in the differential diagnosis of 3rd ventricular tumors.
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Hot tar burns, although rare, usually occur in workers in the paving and roofing industries. When tar is heated to high temperatures it can cause deep burns, and its removal often causes further damage. However, the use of one of the polysorbates (surface-active agents) makes removal easy and painless.
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A case of a spontaneous cure of intracerebral hematoma by drainage into the middle ear is reported. A 38-year-old man was brought to the emergency room in a semicomatose state. He was found to have skull fractures and an intracerebral hematoma. His clinical condition improved, and a repeat computed tomographic scan showed disappearance of the hematoma and its replacement by air.
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The use of amniotic membrane as a biological dressing for thermal injury is simple and cheap and has been found to be superior to allograft and xenograft. The membrane prevents heat and water loss from the wound surface and acts as a barrier against bacterial contamination, thus aiding the healing process and reducing morbidity. Another clinically significant and important property of the membrane is its ability to offer marked relief from pain. Over a period of 30 months amniotic membrane was used to treat 15 cases of burn in a small hospital, with uniformly satisfactory results. The practical aspects of this method of treatment can easily be adopted by any hospital regardless of its available facilities.