Biomedical subjects
Publications and source records attributed to M K Tewari.
An 11-year-old boy presented with pain in the back, urinary retention, paraplegia and loss of sensations below L1. Investigations revealed an intramedullary lesion. An intramedullary spinal cord abscess was found at surgery. The pus was evacuated and abscess was excised. Minimal recovery was seen following surgery. Early intervention and a high index of suspicion is required in such cases.
Three young children who presented with acute backache and rapidly progressive neurological deterioration were investigated and found to have spontaneous spinal extradural hematoma (SSEDH). They were operated on soon after the diagnosis had been confirmed. The present report highlights the fact that in children progressive weakness of nontraumatic origin should be investigated thoroughly and as early as possible. Patients with SSEDH should be operated on immediately, as this is a curable condition. The pertinent literature has been reviewed.
Air in epidural haematoma is an uncommon finding. It is usually seen if epidural haematoma is associated with fracture involving one of the air sinuses, but can be seen at times in the absence of any demonstrable fracture on the CT scan. Seven such cases are described in the present communication and the significance of this finding discussed.
Two cases meningeal melanocytoma, one each at cranial and spinal location, are described. Neurological deficits in both cases improved following surgery. Pathological features of this rare tumour are discussed.
Five cases of a rare complication of tension pneumocephalus following evacuation of chronic subdural haematoma are described. This occurred in 8% of all cases of chronic subdural haematoma treated following installation of a CT scanner. The chronically compressed brain contributes to the ingress of this intracranial air. The increase in the brain bulk and gradual re-expansion of the brain, in the early postoperative period, competes with the trapped subdural air resulting in a rise in intracranial pressure leading to neurological deterioration. Twist drill craniostomy and aspiration, using a brain cannula with a three-way connector, has produced excellent results.
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