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R V Phadke

Publications and source records attributed to R V Phadke.

At least 19 recordsLinked to original sources
PubMed2006

Aneurysm of the internal carotid artery in a female patient of Behcet's disease: a rare presentation.

Behcet's disease is a systemic inflammatory disease characterized commonly by oral and genital ulcerations, with skin and eye involvement. Unlike other manifestations, involvement of the central nervous system and vascular manifestations can be late in the course and are the leading causes of death. Aneurysms are relatively common in visceral vessels but extremely rare in intracranial arteries, being limited to few case reports. Moreover, vascular involvement is significantly less common in female than in male patients. In this paper, we report a case of aneurysm of internal carotid artery in a female patient of Behcet's disease who had presented with subarachnoid hemorrhage and was treated successfully by a brief course of corticosteroids followed by endovascular treatment.

Adult↗
PubMed2006

Effect of neck flexion on F wave, somatosensory evoked potentials, and magnetic resonance imaging in Hirayama disease.

BACKGROUND: Flexion myelopathy is one of the suggested mechanism for Hirayama disease (HD) but simultaneous radiological and neurophysiological evaluation is lacking. This study therefore evaluates the effect of neck flexion in HD using somatosensory evoked potentials (SEPs), F waves, and magnetic resonance imaging (MRI). METHOD: Eight HD patients and seven matched controls were subjected to median and ulnar F wave (minimal latency, FM ratio, persistence, and chronodispersion), and SEPs evaluating N9, N13, and N20 potentials in neutral and neck flexion. Spinal MRI was carried out in neutral and neck flexion and evaluated for cord atrophy, signal changes, cord compression, posterior epidural tissue, and loss of dural attachment. RESULTS: The patients were aged 19 to 30 years. Minimal F latency, FM ratio, persistence, and chronodispersion in neutral and neck flexion did not show any change nor was there any change in N13 latency and amplitude on median and ulnar SEPs. The difference in these parameters in neutral and neck flexion were also not significant in HD compared with controls. The change in N13 was also not related to loss of dural attachment and posterior epidural tissue. CONCLUSION: Neck flexion does not produce significant changes in N13 and F wave parameters and is not related to dynamic MRI changes. The other mechanisms for HD should therefore be explored.

Action Potentials↗
PubMed2006

Subarachnoid haemorrhage as a presentation of cerebral venous sinus thrombosis.

Cerebral venous sinus thrombosis can present with a variety of clinical symptoms ranging from isolated headache to deep coma. Subarachnoid haemorrhage is a rare presentation. In the report, we describe a case of non-puerperal venous thrombosis of many dural sinuses manifesting on imaging solely as localized subarachnoid haemorrhage without underlying parenchymal involvement.

Adult↗
PubMed2005

Endovascular management of pseudoaneurysms of the splenic artery: experience with six patients.

The purpose of this paper was to describe our experience with the endovascular management of splenic artery pseudoaneurysms (SAPA). Seven patients with documented SAPA on CT and/or angiography were considered for endovascular treatment. The pseudoaneurysms were located in the main splenic artery (n = 4) or its branches (n = 3). In one patient in whom the pseudoaneurysm was located in a hilar branch, selective catheterization of splenic artery failed. Metallic coils (n = 1), gelfoam and hydrogel particles (n = 1), metallic coils and gelfoam (n = 2), metallic coil, gelfoam and acrylic glue (n = 2) were used as embolization material in the remaining six patients. These patients were followed for a mean period of 11.3 months. Transcatheter embolization was successful in five patients with no procedure-related complications. In one patient, embolization was incomplete and the patient underwent surgery, but died on the 10th postoperative day because of irreversible shock. Another patient, after successful embolization, underwent surgery for management of an associated pseudocyst. Endovascular treatment is a safe and effective method of management of SAPA.

Adult↗
PubMed2004

Neuroimaging in mental retardation.

OBJECTIVE: To determine the diagnostic yield of neuroimaging in a cohort of children with mental retardation of unknown origin. METHODS: Neuroimaging was performed in a total of 47 patients with developmental delay/mental retardation, where no etiologic diagnosis could be made following clinical examination and preliminary investigations. RESULTS: Thirty (63.82%) children had abnormal neuroimaging findings of which 19 (42.42%) were specific abnormalities useful in arriving at etiological diagnosis. Positive outcome of neuroimaging increased with the severity of mental retardation and in presence of microcephaly and neurologic deficits other than mental retardation. CONCLUSION: Neuroimaging should be the standard clinical practice for a child with global developmental delay where no cause is apparent after examination and relevant investigations.

Adolescent↗
PubMed2004

Postoperative residual tumour imaged by contrast-enhanced computed tomography and 201Tl single photon emission tomography: can they predict progression-free survival in high-grade gliomas?

AIMS: To evaluate if postoperative residual tumour imaged by either computed tomography or 201Tl single photon emission tomography (SPECT) carried out postoperatively could predict progression-free survival (PFS) in high-grade malignant gliomas. MATERIALS AND METHODS: Thirty-three patients with high-grade malignant gliomas underwent both contrast-enhanced CT scan and 201Tl-SPECT postoperatively before receiving radiotherapy. The PFS was evaluated against the individual reports of the above two imaging studies by univariate analysis. RESULTS: CT and 201Tl-SPECT were carried out within a median interval of 17 days after surgery. Of the 33 patients, CT and 201Tl-SPECT were reported as positive for residual tumours in 23 (69.7%) and 30 (91%) patients, respectively. Sensitivity, specificity and overall accuracy were 71.4%, 40% and 66.6% for CT, and 96.4%, 40% and 87.8% for 201Tl-SPECT, respectively, and were based on their last follow-up status (P = 0.627 for CT; P = 0.053 for 201Tl-SPECT). The median PFS for patients reported to be positive or negative on CT scan was 4 and 5 months, respectively (P = 0.202). With 201Tl-SPECT, although the median PFS for patients with a positive 201Tl uptake was also 4 months, it had not even reached for those reported having a negative 201Tl uptake (cumulative survival 66.7% at last follow-up) (P = 0.198). However, Karnofsky performance status (KPS) was the only significant predictor on univariate analysis (KPS: < 80 vs. > or = 80; P < 0.001) for PFS. CONCLUSIONS: Although both the imaging modalities have a poor specificity, postoperative 201Tl-SPECT had a significantly better accuracy to predict the status at last follow-up than contrast-enhanced CT. Nevertheless, KPS remained the most significant outcome predictor for PFS in high-grade malignant gliomas.

Adult↗
PubMed2004

MRI findings in Kallmann syndrome.

Kallmann syndrome (KS) is a neuronal migration disorder characterised by hypogonadotrophic hypogonadism and anosmia or hyposmia. Five patients with clinical findings suggestive of KS were evaluated with MRI. All patients had abnormalities of olfactory system. Olfactory bulbs were absent in all patients. Olfactory sulci were absent in 3 patients and hypoplastic in 2 patients. Anterior pituitary was hypoplastic in two patients. The MRI findings in KS are characteristic and MRI is a useful adjunct to the diagnosis of KS.

Adult↗
PubMed2003

MR appearance of interpeduncular lipoma.

Interpeduncular lipoma (IPL) is a very rare benign intracranial lesion. Non-invasive diagnosis of this condition is important, as these lesions are usually asymptomatic and are found incidentally. We describe a rare case of IPL in a 35-year-old woman presenting with headache of long duration and a recent increase in severity and frequency of headache. There was no neurological abnormality on clinical examination. MR imaging demonstrated a homogeneous lobulated T1-hyperintense and T2-hypointense lesion in interpeduncular fossa. A T1-weighted fat suppression sequence with chemical shift method confirmed the fatty nature of the lesion. The patient was managed conservatively.

Adult↗
PubMed2002

Use of the direct puncture technique in management of capillaro-venous malformations: case report.

BACKGROUND: Preoperative devascularization of the capillaro-venous malformations located in the aero-digestive tract is important for surgeons, to minimize blood loss during surgical excision of malformations. CASE PRESENTATION: Here we present two cases of capillaro-venous malformation in which we could successfully achieve preoperative devascularization, by directly injecting n-butyl cyano acrylate into the capillaro-venous bed. This technique is relatively easy, safe and cheap, and can be carried out immediately before surgery.

Journal Article↗
PubMed2002

Migraine-like visual hallucinations in occipital lesions of cysticercosis.

Four Indian patients with occipital lesions of cysticercosis presented with visual hallucinations. Neuro-ophthalmic and systemic examinations were normal in all cases except for one patient who had a partial homonymous hemianopia. Electroencephalography was normal in all cases. Neuroimaging revealed ring-enhancing lesions in the occipital lobe typical of neurocysticercosis. In endemic regions like India, neurocysticercosis should be suspected in patients presenting with visual hallucinations, even when there are no other clinical findings.

Adolescent↗
PubMed2002

A population-based study of brain arteriovenous malformation: long-term treatment outcomes.

BACKGROUND AND PURPOSE: By undertaking long-term follow-up of a functionally isolated population study group, we sought to achieve a true picture of intrinsic brain arteriovenous malformation (BAVM). We sought to assess the validity of earlier population-based series and to determine the effects of newer treatment methods on the overall morbidity and mortality of BAVM. METHODS: We excluded other intracranial vascular pathologies by defining criteria. By retrospective and prospective study, 240 patients with BAVM were followed for a mean of 10.11 years from first diagnosis. RESULTS: Death rates were as follows: all causes, 12.9%; all BAVM related, 8.75%; BAVM related during conservative management, 24.6%; and BAVM related during active management, 3.9% (P=0.031). Mean diagnosis-to-death interval was 10.6 years. Oxford neurological disability scale grades of 209 survivors (July 2001) were as follows: grades 0 to 2, 74.1%; grade 3, 17.2%; and grades 4 to 5, 9.5%. Death rates were higher for patients who had bled or suffered nonhemorrhagic neurological deficit at original presentation. Incidence of first-ever hemorrhage in untreated patients was as follows: 0 to 9 years, 4.6% (P=0.0035); 30 to 39 years, 21% (P=0.02); and 60 to 69 years, 40.0% (P=0.045). The first bleed was fatal in 4.6%. CONCLUSIONS: We find no evidence of a substantial undiagnosed reservoir of nonsymptomatic BAVM. All BAVM are potentially hazardous. The great majority of BAVM patients become symptomatic during the patient's lifetime, and the majority will bleed. The risk of first hemorrhage is lifelong and rises with age. Compared with earlier population-based series, our low overall patient mortality is predominantly due to higher proportions of active treatment in the 1980s and 1990s.

Adult↗
PubMed2001

Intra-arterial embolization of lumbar artery pseudoaneurysm following percutaneous nephrolithotomy.

The management of a patient with haematuria following percutaneous nephrolithotomy is described. The patient underwent renal angiography to assess the cause of bleeding. A pseudoaneurysm arising from first left lumbar artery was incidentally discovered, which was then successfully embolized using an indigenously fabricated metallic coil and gel foam particles in the same sitting.

Aneurysm, False↗
PubMed2000

Tuberculosis of the skull. A case report and review of the literature.

A case of tuberculosis of frontal, ethmoid, and sphenoid bones with intracranial extension is presented. The patient had presented with a history of painless left frontal swelling for the previous 7 months. A diagnosis of tubercular etiology was established with the histopathology of the biopsy specimen. The patient was kept on antitubercular treatment for 18 months. She responded well, with a marked resolution of symptoms and radiologic findings. At the end of treatment, there was no clinical or radiological evidence of disease. At 6-month and 1-year follow-ups, there was no evidence of recurrence or reactivation of the disease.

Adolescent↗