Search PubMed⌕ Search

Biomedical subjects

H S Bhatoe

Publications and source records attributed to H S Bhatoe.

At least 19 recordsLinked to original sources
PubMed2005

Epidermoid tumour of the lateral ventricle.

Epidermoids occurring within the lateral ventricles are rare. At one time, they were regarded as anatomical curiosities. The lesions are of developmental aetiology, due to migration of epiblast inclusion at the time of formation of the cerebral vesicle. They are slow growing, and presentation is non-specific in the form of deteriorating mental functions. Generally seen in the fifth decade, but they have also been observed in the paediatric age group. MRI is suggestive of a cystic lesion, and is confirmed to be a typical epidermoid within the lateral ventricle at operation, often having a connection to the midline through the choroidal fissure. The cysts should be excised with no additional morbidity. Histopathology reveals typical stratified squamous epithelium.

Brain Neoplasms↗
PubMed2005

Transpedicular surgery for dorsolumbar junction disc prolapse: anatomic and biomechanical considerations of a minimally invasive approach.

The dorsal spine is the least affected region of the spine for intervertebral disc prolapse. The majority of cases of thoracic disc prolapse affect the lower dorsal spine, probably due to the increased mobility of that region. The dorsolumbar junction (DLJ) comprises D10 to L1 together with the intervening discs. Over a period of nine years, we have operated on thirty-two DLJ disc prolapses using a transpedicular approach in thirty patients. There were eight cases of D10/D11 disc prolapse, ten of D11/D12, and twelve of D12/L1 prolapse. Two patients had more than 1 level involvement. Back ache was the predominant symptom in patients with DLJ disc prolapse, seen in 92 % of cases. Presentation was in the form of conus/cauda equina syndrome with D11, D12 and L1 radiculopathy. All the patients were evaluated by MRI. Disc prolapse was eccentric in 10 and diffuse central in 22 levels. There was a distinct neurological improvement in all patients after surgery, pain relief being the most prominent feature. The dorsolumbar region differs from the dorsal spine in terms of mobility, anatomic and biomechanical features. It is a transition zone between the relatively fixed dorsal spine and the mobile lumbar region. These differences account for the higher incidence of disc prolapse in the region as compared to the dorsal spine cranial to D10. The transpedicular approach appears to be most suitable for discectomy for DLJ disc prolapse. The approach is minimally invasive considering the size of the incision, minimal bone removal and avoidance of vital structures. Postoperative pain is minimal and ambulation can be begun within 24 hours of surgery.

Adult↗
PubMed2003

Simultaneous occurrence of multiple meningiomas in different neuraxial compartments.

The simultaneous occurrence of multiple meningiomas in different neuraxial compartments is rare. A 35-year-old female patient had multiple meningiomas involving both the supratentorial compartments and in the upper dorsal spine. The patient underwent excision of 2 cranial and 2 spinal meningiomas, and has remained asymptomatic over a follow-up period of 18 months.

Adult↗
PubMed2003

Missile injuries of the spine.

Between 1995 and 2000, 22 cases with low velocity missile injuries of the spine and spinal cord were treated in three service hospitals. All were adult males, with a mean age of 30.7 years. The wounds were caused by splinters in 18 (82%) and bullets in 4 (18%). Twelve patients received more than one splinter. The cervical and thoracic spines were most frequently involved. In 7 cases, there were injuries to other organs. There was extensive initial deficit (quadriplegia, paraplegia) in 18 (82%) cases, while 4 (18%) had partial deficits. The patients were evaluated by spine radiographs. Myelography was done in 4, CT myelography in 11 and MRI in 4 patients. Two patients had intramedullary hematoma without any skeletal injury, and were treated conservatively. Seventeen patients were treated operatively, and associated injuries of other organs received priority management. Surgery was in the form of debridement, exploration of the spinal cord, hemostasis, decompression and dural repair. Steroids and antibiotics were given routinely. Three patients (2 with cervical and 1 with thoracic spine injury) died preoperatively, and 1 (with dorsolumbar injury) died in the postoperative period due to multi-organ injury. Patients with complete injury remained completely paralyzed, while those with an incomplete injury showed improvement in their neurological grades. The initial neurological grade is the best prognostic indicator, and these injuries are often accompanied by multi-organ injuries. There was no instance of postoperative meningitis or CSF leak. These injuries should be explored for debridement and dural repair.

Adult↗
PubMed2001

Spinal cord injury.

OBJECT: It is known that the spinal cord can sustain traumatic injury without associated injury of the spinal column in some conditions, such as a flexible spinal column or preexisting narrowed spinal canal. The purpose of this study was to characterize the clinical features and to understand the mechanisms in cases of acute cervical cord injury in which fracture or dislocation of the cervical spine has not occurred. METHODS: Eighty-nine patients who sustained an acute cervical cord injury were treated in our hospitals between 1990 and 1998. In 42 patients (47%) no bone injuries of the cervical spine were demonstrated, and this group was retrospectively analyzed. There were 35 men and seven women, aged 19 to 81 years (mean 58.9 years). The initial neurological examination indicated complete injury in five patients, whereas incomplete injury was demonstrated in 37. In the majority of the patients (90%) the authors found degenerative changes of the cervical spine such as spondylosis (22 cases) or ossification of the posterior longitudinal ligament (16 cases). The mean sagittal diameter of the cervical spinal canal, as measured on computerized tomography scans, was significantly narrower than that obtained in the control patients. Magnetic resonance (MR) imaging revealed spinal cord compression in 93% and paravertebral soft-tissue injuries in 58% of the patients. CONCLUSIONS: Degenerative changes of the cervical spine and developmental narrowing of the spinal canal are important preexisting factors. In the acute stage MR imaging is useful to understand the level and mechanisms of spinal cord injury. The fact that a significant number of the patients were found to have spinal cord compression despite the absence of bone injuries of the spinal column indicates that future investigations into surgical treatment of this type of injury are necessary.

Adult↗
PubMed2001

Retained intracranial splinters : a follow up study in survivors of low intensity military conflicts.

With improvements in the ballistic physics, patient evacuation, imaging, neurosurgical management and intensive care facilities, there has been overall improvement in the survival of patients with missile injuries of the brain. Patients with retained intracranial fragments have been followed up and the sequelae of such fragments were analysed. We present our observations in 43 such patients who had survived low velocity missile injuries of the brain during military conflicts and had retained intracranial fragments. Over a follow up period of 2 to 7 years, suppurative sequelae (brain abscess, recurrent meningitis) were seen in 6 patients, two of these progressing to formation of brain abscess. Three patients developed hydrocephalus and one seizures. Patients with orbitocranial or faciocranial wound of entry had a higher incidence of suppurative complications (3 out of 4), while those with skull vault entry had a lower incidence of such sequelae (7 out of 30). Nine patients were lost to follow up. Other determinants of suppurative complications were postoperative CSF leak and intraventricular lodgement of the fragment.

Brain Abscess↗
PubMed2000

Trichinoechinococcosis T-5. Case report.

Echinococcosis affecting the spine is rare. The authors present the case of a 23-year-old man in whom features of thoracic spinal cord compression were demonstrated. Magnetic resonance imaging of the thoracic spine revealed an extradural cystic lesion involving the spine and paraspinal musculature. At surgery echinococcosis was confirmed, and subsequent histopathological examination also revealed Trichinella infestation of the paraspinal musculature. After undergoing decompressive surgery and albendazole therapy, the patient made a remarkable improvement. Although primary echinococcosis can affect the spine, concomitant infestation with Trichinella has not been reported. Surgery has to be followed by albendazole therapy.

Adult↗
PubMed2000

Cervical spinal cord injury without radiological abnormality in adults.

Spinal cord injury occurring without concomitant radiologically demonstrable trauma to the skeletal elements of the spinal canal rim, or compromise of the spinal canal rim without fracture, is a rare event. Though documented in children, the injury is not very well reported in adults. We present seventeen adult patients with spinal cord injury without accompanying fracture of the spinal canal rim, or vertebral dislocation, seen over seven years. None had preexisting spinal canal stenosis or cervical spondylosis. Following trauma, these patients had weakness of all four limbs. They were evaluated by MRI (CT scan in one patient), which showed hypo / isointense lesion in the cord on T1 weighted images, and hyperintensity on T2 weighted images, suggesting cord contusion or oedema. MRI was normal in two patients. With conservative management, fifteen patients showed neurological improvement, one remained quadriplegic and one died. With increasing use of MRI in the evaluation of traumatic myelopathy, such injuries will be diagnosed more often. The mechanism of injury is probably acute stretching of the cord as in flexion and torsional strain. Management is essentially conservative and prognosis is better than that seen in patients with fracture or dislocation of cervical spine.

Adolescent↗
PubMed1999

Primary brainstem injury: benign course and improved survival.

Primary brainstem injury following head injury is a rare event. The victims often have features of supratentorial injury, and a primary isolated injury to the brainstem occurring due to shearing stresses or to injury from the tentorial edge is extremely rare. In the presence of supratentorial injury, these patients may have altered sensorium. Isolated brainstem injury may manifest itself as internuclear ophthalmoplegia, anisocoria, rigidity and cerebellar tremor. Such injuries are now being diagnosed more often due to improved imaging techniques. We treated nine such cases who had sustained primary brainstem injury in road traffic accidents, all but one of whom were subsequently independent. Primary brainstem injuries need not be associated with poor prognosis and mortality and may run a benign course with good quality of survival.

Adult↗
PubMed1999

Movement disorders caused by brain tumours.

Movement disorders are uncommon presenting features of brain tumours. Early recognition of such lesions is important to arrest further deficit. We treated seven patients with movement disorders secondary to brain tumours over a period of seven years. Only two of these were intrinsic thalamic tumours (astrocytomas) while the rest were extrinsic tumours. The intrinsic tumours were accompanied by hemichorea. Among the extrinsic tumours, there was one pituitary macroadenoma with hemiballismus and four meningiomas with parkinsonism. Symptoms were unilateral in all patients except one with anterior third falcine meningioma who had bilateral rest tremors. There was relief in movement disorders observed after surgery. Imaging by computed tomography or magnetic resonance imaging is mandatory in the evaluation of movement disorders, especially if the presentation is atypical, unilateral and/or accompanied by long tract signs.

Adenoma↗
PubMed1998

Primary cranial Ewing's sarcoma.

Primary Ewing's sarcoma of the cranium is extremely rare, with only 17 cases reported so far. We describe a further case with involvement of the frontotemporal region and the orbit. The patient, an adult male, was admitted with headache and papilloedema, and later developed localised swelling and proptosis. He was treated with surgery, radiotherapy and chemotherapy, and was free from metastases during a follow-up of 14 months. The prognosis of Ewing's sarcoma is improving with radiotherapy and chemotherapy. Further cases are needed to study the biological behaviour of primary cranial Ewing's sarcoma.

Adult↗