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Biomedical subjects

R Jooma

Publications and source records attributed to R Jooma.

24 records · Page 2Linked to original sources
PubMed1984

Intracranial neoplasms during the first year of life: analysis of one hundred consecutive cases.

One hundred infants with intracranial tumors symptomatic during the 1st year of life were studied. They differed from older children in having a higher percentage of supratentorial tumors and in the fact that 90% of the tumors were of neuroectodermal origin. Vomiting, alteration of psychomotor development, and macrocrania were the most common presenting features. The "diencephalic syndrome" was seen in 5 infants, and subarachnoid hemorrhage due to tumor was diagnosed in 4. Computed tomography as the primary investigation is increasing the number of neoplasms diagnosed in this age group, although review of the skull roentgenograms in the series disclosed an abnormality in 92%. Eighty of the tumors were verified, 68 by a cranial operation and the rest at autopsy. Of the verified neoplasms, 20% were medulloblastomas, 12.5% were choroid plexus papillomas, and 10% were cerebellar astrocytomas. The cumulative average survival was 27 months but, for those who underwent a tumor operation, the average survival was 37 months. The operative mortality was 30%. Thirty-nine patients were irradiated, and this subset had a 5-year survival rate of 43%. The morbidity was high irrespective of radiotherapy; 60% of those who survived 1 year were moderately or severely disabled. Those infants receiving more than 5000 rads of whole brain radiation tended to have greater deficits in the long term. When analyzed separately, patients treated after 1970 had greatly improved mortality and morbidity rates.

Age Factors↗
PubMed1983

Cerebrospinal fluid rhinorrhea and intraventricular pneumocephalus due to intermittent shunt obstruction.

Cerebrospinal fluid rhinorrhea and intraventricular pneumocephalus occurred in an adolescent with aqueduct stenosis whose ventriculoperitoneal shunt occluded repeatedly due to a faulty on-off control. The possible mechanisms are discussed, the urgency of treatment is stressed, and the risk of pneumocephalus when a shunt is used to treat cerebrospinal fluid rhinorrhea is pointed out.

Adolescent↗
PubMed1983

Third ventricle choroid plexus papillomas.

Choroid plexus papillomas are only infrequently located in the third ventricle. Two infants with such lesions are presented and the diagnosis by computed tomography described. The transcallosal approach to the third ventricle was employed in both cases and led to successful excision. This approach is recommended for lesions in the anterior third ventricle in children, and the occurrence of subdural effusions as a complication is pointed out.

Cerebral Ventricle Neoplasms↗
PubMed1983

Diagnosis and management of pineal tumors.

The management of pineal region tumors remains controversial. Advocates of a conservative approach emphasize the excellent results of radiotherapy, particularly with germinomas, while a number of recent reports have demonstrated the safety of direct surgery. In order to improve treatment planning, attempts have been made to distinguish the various tumor types by computerized tomography (CT) and by the use of markers for germ-cell tumors. This paper reports a study of 35 patients with pineal tumors including two ectopic germinomas. Pretreatment CT was performed in all 35 patients, and human chorionic gonadotropin and alpha-fetoprotein levels were assayed in 11. Histological verification was available for 33 tumors; the other two were characterized by clinical and CT features plus tumor markers. Of the 27 tumor operations, 21 were for a pineal mass and six for ectopic germinoma or metastasis. There was no operative mortality. Morbidity was minimal, and surgery did not increase the incidence of subarachnoid seeding. Each histological type of tumor has a typical appearance on CT scanning, although, in the individual case, a firm diagnosis is not always possible. However, consideration of CT scans together with the clinical features, cerebrospinal fluid cytology, tumor markers, and (if there is still doubt) response to a small dose of irradiation will generally allow a specific diagnosis with a high degree of probability. In this way, germinomas may be selected for radiotherapy and the tumors less likely to respond may be subjected to primary surgery.

Adolescent↗
PubMed1982

Intracranial tumours in the first year of life.

Twenty-five infants with histologically verified brain tumours presenting during the first year of life and diagnosed by computed tomography (CT) were studied. The clinical features are presented, the results of surgery assessed and the CT findings analysed and compared with the macroscopic appearance of the tumours. Since the introduction of CT, the number of intracranial tumours diagnosed in infancy has increased, particularly in the supratentorial location. In our study, astrocytomas were the most common, followed by choroid plexus papillomas, ependymomas and primitive glial tumours. At diagnosis, many tumours had become large, but usually had a well-defined edge, suggesting expansion rather than infiltration. The CT features generally corresponded to the macroscopic appearance of the tumours. The operative mortality in the series was 20%.

Astrocytoma↗