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Biomedical subjects

J C Peter

Publications and source records attributed to J C Peter.

43 records · Page 3Linked to original sources
PubMed1992

The congenital bregmatic dermoid: an African cyst?

Thirty-five children with bregmatic dermoids were operated on at the Red Cross War Memorial Children's Hospital and Groote Schuur Hospital between 1969 and 1990. Most children were under 1 year of age; 20 were males and 15 females. Thirty-one were African or of African descent, two were Indian and two Caucasian, an ethnic distribution which roughly approximates the ethnic ratio of patients attending our hospital. Most were investigated with skull X-rays and CT scan, but MRI was performed where further clarity was needed. Other lesions mimicking bregmatic dermoids included four haemagiomas, two hamartomas, two lipomas and one encephalocoele through the anterior fontanelle. One bregmatic lipoma was associated with a lipoma of the corpus callosum. All bregmatic cysts were removed through a simple elliptical incision and on connection with the central nervous system or its coverings was encountered in any patient. The pathology in all specimens reviewed (75%) revealed skin appendages to be present in the cyst wall. No epidermoids were found in this series. This series is the largest to date and adds another 31 patients of African descent to the accumulated literature which suggests that although universally distributed, the bregmatic dermoid still appears to be more common in Africans or their descendants.

Adolescent↗
PubMed1991

Lipoma of the corpus callosum associated with frontal and facial anomalies.

Seven patients with a corpus callosum lipoma associated with a frontal cranial defect with or without a superficial lipoma or a fronto-nasal dysplasia, were encountered over a period of 12 years. This group of patients is reported as these associated lesions may provide a lead to the cause of lipomas of the corpus callosum as well as of the different lesions in the fronto-facial region. From our experience and that of others, the frontal lesion may be an extracranial lipoma, a frontal bone defect, with or without an external lipoma, a lipomeningocele connecting the extracranial lipoma through a frontal defect with the corpus callosum lipoma, a frontal encephalocele. Fronto-nasal dysplasia associated with a corpus callosum lipoma, seems to form an independent group although some of these patients may have other extracranial lesions as well. It is suggested by the authors that as the primitive mesenchyme gives rise to the meninx primitiva as well as to the fronto-facial skeleton a disturbance of the neural crest may give rise to these combined lesions. Further analysis of similar cases may indicate the timing of these events, and perhaps reveal a common causative factor.

Adult↗
PubMed1991

Midline dermal sinuses and cysts and their relationship to the central nervous system.

Sixty-one children (below 12 years) with midline dermal inclusions of the cranium and spine were operated on at the Red Cross War Memorial Children's Hospital between 1969-1990. The bregmatic area was the most common position for superficial cysts (33). Eight children had sinuses or cysts near the external occipital protuberance, 2 had isolated fourth ventricular cysts and 1 had a cyst in the quadrigeminal plate cistern. Fifteen children had spinal dermal inclusions, 13 of these were in the lumbosacral area, there was 1 sinus in the cervical spine and another in the midthoracic area attached to an intramedullary cyst. Two children had frontal sinuses, one of which was connected to an interhemispheric dermoid cyst and a lipoma of the corpus callosum. A midline swelling or sinus was the most common clinical presentation. Four out of 15 spinal inclusions and 1/11 occipital sinuses had a meningitic history. Five of 11 of the posterior fossa inclusions had raised intracranial pressure and signs suggestive of cerebellar tumor or abscess. Not one of the 33 bregmatic lesions had any connection to the central nervous system. MRI has proved useful in diagnosing both dermal sinuses and cysts, but CT scanning was our standard investigation. Plain x-ray revealed bony abnormalities in only 60% of our patients with spinal sinuses. We feel that all dermal sinuses or cysts in the midline should be surgically explored after CT or MRI scanning. Lesions mistaken for bregmatic cysts have included hemangiomas (4), hamartomas (2), an encephalocele through the anterior fontanelle (1) and lipomas (2).(ABSTRACT TRUNCATED AT 250 WORDS)

Central Nervous System Diseases↗
PubMed1990

Incidence of spinal deformity in children after multiple level laminectomy for selective posterior rhizotomy.

Fifty-five children with cerebral palsy had multiple-level laminectomies for selective posterior rhizotomies for the relief of spasticity. They were followed up clinically and radiologically to assess their spinal stability and the possible development of post-laminectomy deformity of the spine. The majority of the deformities found were related to cerebral palsy and did not appear to be due to the laminectomy: 16% had scoliosis, 5% kyphosis, 7% lordosis, and 9% spondylolysis/spondylolisthesis. Spondylolysis is the only abnormality that appeared to be more common in this group than in children with cerebral palsy.

Adolescent↗
PubMed1989

Intracranial tuberculomas. An assessment of a therapeutic 4-drug trial in 35 children.

35 children with suspected tuberculomas of the brain were given a therapeutic 4-drug trial of isoniazid, rifampicin, pyrazinamide and ethambutol. Their clinical and computed tomographic (CT) appearances were analysed retrospectively: 32 responded well to treatment with recognizable improvement on CT after 6 weeks. Three patients did not respond. One of these non-responders had a surgically removed temporal cystic astrocytoma. The majority presented with focal seizures and had a single hemispheral lesion. 14% had multiple lesions, 6% were in the cerebellum. Only 2 patients had raised intracranial pressure and required ventriculoperitoneal shunting.

Adolescent↗