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Biomedical subjects

S K Sankhla

Publications and source records attributed to S K Sankhla.

5 recordsLinked to original sources

Orbitozygomatic craniotomy. Technical note.

The orbitozygomatic approach provides wide, multidirectional access to the anterior and middle cranial fossae, as well as to the upper third of the posterior fossa and clivus. The authors describe technical details of the surgical approach as it has evolved over 3.5 years of experience in 83 consecutive cases. This modified technique eliminates the need for bone reconstruction of the orbital walls to prevent enophthalmos and minimizes the risk of injury to the frontal branch of the facial nerve. At a follow-up evaluation after a period averaging 14 months, all patients were pleased with the cosmetic results of this approach.

Brain Neoplasms↗

Adoptive immunotherapy using lymphokine-activated killer (LAK) cells and interleukin-2 for recurrent malignant primary brain tumors.

Ten patients with recurrent malignant primary brain neoplasms were treated with adoptive immunotherapy using lymphokine-activated killer (LAK) cells and interleukin-2 (IL-2). Nine patients had supratentorial glioma and they received multiple intratumoral instillations of LAK cells through reservoir-catheter system or burrhole. The other patients with disseminated subarachnoid metastases from posterior fossa medulloblastoma received immunotherapy via lumbar subarachnoid route. A partial and transient clinical response was observed in two patients. following the therapy, and a cystic transformation of the essentially solid tumour was noted on the CT scans of these two patients. No significant clinical or radiological response to the treatment was observed in the remaining 8 patients. The results of this preliminary study reveal limitations of the regional intratumoral adoptive immunotherapy using currently available techniques and provide sufficient evidence of its effectiveness to warrant further investigations.

Adolescent↗

Magnetic resonance angiography in the management of aneurysmal subarachnoid haemorrhage: a study of 51 cases.

We report preliminary experience with the use of magnetic resonance angiography (MRA) in the assessment of intracranial aneurysms. The aims of the study were to confirm that aneurysms could be detected and to assess the quality of the images with a view to early surgery if clinically indicated. We studied 51 patients with recent spontaneous subarachnoid haemorrhage with MRA, using a three-dimensional time-of-flight technique. The results of MRA were subsequently confirmed on intra-arterial digital subtraction angiography (IA-DSA) for anatomical correlation, and were considered satisfactory in 38 patients (74.5%). In 20 patients early surgical obliteration of their aneurysm was possible on the MRA results without recourse to IA-DSA. A total of 37 aneurysms were identified in 32 patients, while the remaining 6 patients did not have an aneurysm. MRA was misinterpreted in 4 patients (7.9%), and in 9 other patients (17.6%) MRA was unsatisfactory due to movement artefacts.

Adult↗

Magnetic resonance angiography for anterior midline aneurysms.

Over an 18-month period (June 1993-December 1994), all patients presenting with a subarachnoid haemorrhage (SAH) were considered for magnetic resonance angiography (MRA) as part of their investigation. Our experience to date leads us to believe that anterior midline aneurysms can be confidently and rapidly diagnosed with MRA alone without recourse to invasive intra-arterial digital subtraction angiography. This assumes, of course, that images can be obtained; some patients cannot be investigated by MR because of the presence of metallic foreign bodies; in a small proportion without anaesthesia the images will be so degraded as to be valueless and some patients will be judged unsuitable from the outset because of their clinical state. In 30 patients, a diagnosis of an anterior midline aneurysm was made on MRA and 21 of these patients underwent surgery on the MR images alone. Surgery, undertaken via a midline approach in these 21 patients, confirmed the MR findings.

Adult↗

Spinal meningeal melanocytoma: a case report and review of the literature.

We present a case of spinal meningeal melanocytoma involving the C5 nerve root with spinal cord compression which resembled a neurinoma clinically as well as radiologically. The clinical, radiological and pathological features of this and 11 other cases reported in the literature are reviewed. The significance of correct diagnosis and aggressive surgical management of this benign neoplasm is emphasized.

Adult↗