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Biomedical subjects

K Till

Publications and source records attributed to K Till.

10 recordsLinked to original sources
PubMed1979

Craniopharyngiomas in childhood. A rational approach to treatment.

The authors review 60 children who presented with craniopharyngiomas. Patients were treated by either 1) cyst aspiration followed by deep x-ray therapy (DXT), 2) radical excision, 3) incomplete tumor excision, or 4) incomplete excision followed by DTX. Symptomatic clinical recurrence signified failure of treatment. Of the patients treated by cyst aspiration and DXT, 50% experienced recurrence (mean time after treatment, 4.4 years), while recurrences occurred in 23% undergoing radical excision (mean time, 2.4 years). Symptomatic recurrences occurred in 78% treated by incomplete removal only (mean time, 2.2 years). No recurrences have occurred in seven patients whose incomplete removal was followed by DTX. The authors conclude that radical excision is most likely to produce survival free of recurrence. When radical excision is not possible, DXT appears to provide an additional effect on preventing tumor regrowth. Characteristics of craniopharyngiomas favoring radical excision are also discussed.

Child↗
PubMed1978

Growing fractures of the skull.

Tne cases of growing fractures seen in the last 10 years are presented. Six of the patients sustained their injury within the first six months of life. The defects formed rapidly, several within two or three months after injury. There was enlargement of the defect in only one case after the date of discovery. Although the defects involved the parietal bone most commonly, in four out of 10 the lesion crossed either the coronal or the lambdoid suture. The edges of the defects were usually thickened; in some areas they were saucer-shaped but in two cases there was erosion of the outer table of the skull at a distance from the margin of the defect, the erosion being related to an extracranial fluid-filled cavity in continuity with a porencephalic cyst. The ipsilateral ventricle was usually dilated and in a number of cases was associated with a porencephalic cyst. In no case was a "leptomeningeal cyst" found beneath the defect at operation. A detailed review confirms many of the findings previously described but suggests that the pathology of the condition is still not fully understood. Computed tomography, undertaken in one case, appears to be the examination of choice. Further light may be thrown on the pathogenesis of this condition by the use of intracystic, intrathecal, and intraventricular water-soluble contrast media.

Arachnoid↗
PubMed1977

Impact of computerised axial tomography of the management of posterior fossa tumours in childhood.

Computerised axial tomography (CAT) has profoundly altered the management of most children with posterior fossa tumours. Fifty such children were operated on from October 1973 to December 1975, 20 of whom were explored after investigation by CAT only. Most recent experience suggests that CAT need by the only investigation in the majority of children suspected of having an expanding lesion in the posterior fossa.

Adolescent↗
PubMed1977

Intracranial ependymomas in children: a review of 43 cases.

43 cases of intracranial ependymomas in children 0-13 years of age have been reviewed with attention given to various clinical aspects, including location, age, duration of history, signs and symptoms, and plain skull film abnormalities. 39 of the patients were treated by intracranial surgical procedures and 30 of these also had radiation therapy. Three patients had needle biopsy only and one died without treatment. The survival rate was below that anticipated and in part felt to be related to the frequent occurrence of malignant tumors in this series.

Age Factors↗
PubMed1976

Spinal dysraphism: genetic relation to neural tube malformations.

The families of 207 index patients treated for spinal dysraphism at The Hospital for Sick Children were studied to discover whether the condition was aetiologically related to the classical neural tube malformation--spina bifida cystica and anencephaly. The index patients had all had a tethered conus medullaris and one or more of a variety of anomalies of the spinal cord, vertebrae, or skin overlying the vertebral column. Of 364 sibs of index patients, 9 had an encephaly and 6 spina bifida cystica, a pro-proportion of 4.12%. This approximates to the proportion of sibs affected by neural tube malformations in the London region when the index patients themselves have spina bifida or anencephaly. It is, therefore, appropriate that the mothers of children with spinal dysraphism should be offered prenatal screening for neural tube malformations.

Adult↗
PubMed1975

Incomplete, false, and true diastematomyelia: radiological evaluation by air myelography and tomography.

Six cases of possible diastematomyelia studied by air myelography with tomography were thought to involve fibrous or bony septa, but in each case no septum was found. Surgical findings included prominent midline posterior fissures in the cord associated with fibrous bands, an unusual tentlike extension of the arachnoid over the spinal cord, and hemicords with no intervening septum. Recognition of an osseous septum on the plain film does not necessarily mean that the cord is completely divided by bone, as other structures derived from the mesoderm, such as fat or cartilage, may contribute to the septum. The importance of defining tethering of the cord posteriorly at the septum or conus level is stressed. Air myelography with appropriate projections appears to show posterior fixation of the cord to best advantage.

Child↗