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Biomedical subjects

T N Lui

Publications and source records attributed to T N Lui.

47 records · Page 3Linked to original sources
PubMed1989

Prophylactic anticonvulsants for prevention of immediate and early postcraniotomy seizures.

Phenytoin (15 mg/kg) was administered intravenously to 189 patients shortly before their intracranial, supratentorial surgery was completed. Intravenous phenytoin of 5-6 mg/kg/day in three divided doses was administered daily for the first 3 postoperative days. Therapeutic serum levels (10-20 micrograms/mL) were achieved in 113 (59.8%) patients. An equally constituted, randomized control group of 185 patients received a placebo under identical conditions. The group receiving phenytoin had only one immediate and two early postoperative seizures. The 185 controls had four immediate and nine early postoperative seizures. None of the follow-up computed tomography scans of the patients with seizures showed postoperative hematoma. One patient had a significant tension pneumocranium, a possible cause of postoperative seizures. To avoid a decrease in the serum anticonvulsant level due to intraoperative blood loss, it is suggested that for patients who need an urgent or emergent craniotomy, prophylatic anticonvulsant medication should be given at least 20 minutes before completion of wound closure.

Adult↗
PubMed1989

Primary intraspinal dura mesenchymal chondrosarcoma.

An 18-year-old woman presented with 6 months of local paraspinal pain and 2 months midthoracic myelopathy. She was proved to have an intraspinal tumor. After successful surgical removal, it was found histologically to be a mesenchymal chondrosarcoma. Local irradiation was administered for the prevention of local recurrence. This case is reported with a review of the literature of primary mesenchymal chondrosarcoma of the spinal dura.

Adolescent↗
PubMed1989

Late posttraumatic meningitis with concealed CSF otorrhea.

An 11-year-old girl with repeated pneumococcal meningitis after head injury is reported. High resolution CT scan with metrizamide cisternogram disclosed a fracture in petrous bone with collection of contrast medium in middle ear. Operative repair of the dura defect successfully stopped further intracranial infection. In cases of late posttraumatic infection, aggressive survey of the skull base is indicated.

Anti-Bacterial Agents↗
PubMed1988

Brain abscess after dilatation of esophageal stricture.

Two children, below 15 years of age, developed brain abscesses after esophageal dilation. They were among 40 children treated for supratentorial brain abscesses during the past 10 years. Pus culture of one of the abscesses was peptostreptococcus, which is a common oropharyngeal flora. Clinicians should be aware of this complication since the prognosis is usually satisfactory after prompt treatment.

Brain Abscess↗
PubMed1986

Psoriatic arthritis with C-1-C-2 subluxation as a neurosurgical complication.

A 39-year-old man presented with a 10-year history of psoriatic arthritis, and more recently a progressive high cervical myelopathy. The development of the myelopathy syndrome was unassociated with trauma or any other specific inciting cause. Cervical spine x-rays demonstrated a significant atlantoaxial subluxation. Other x-ray features of the spine met the criteria for diagnosis of psoriatic spondylitis. The association of a high cervical myelopathy with atlantoaxial subluxation in psoriatic spondylitis is rare. Conversely, atlantoaxial subluxation without high cervical myelopathy has been reported in 45% of cases of psoriatic spondylitis. The authors report this case with a review of the diagnosis, possible pathogenesis, and treatment of atlantoaxial subluxation in psoriatic spondylitis.

Adult↗
PubMed1985

Surgical treatment of spontaneous cerebellar hemorrhage.

UNLABELLED: Spontaneous cerebellar hemorrhage accounts for 5%-10% of intracerebral hemorrhage in most series. From June 1979 to June 1983 we had 26 surgical cases of spontaneous cerebellar hemorrhage. There were 15 men and 11 women. The typical history was sudden onset of severe headache, vomiting, dizziness, and inability to walk. Disturbance of consciousness was usually a late feature. Common signs were truncal ataxia, nystagmus, conjugate eyeball deviation, small miotic pupils with or without light reflex and abducens palsy. Surgical indications are (a) disturbance of consciousness, (b) signs of brainstem compression and (c) hematoma with transverse diameter greater than 3 cm. The overall surgical mortality was 34.6%. Twenty-two patients underwent suboccipital craniectomy to evacuate hematomas with or without ventriculostomy; mortality rate was 27%. Four patients underwent ventriculostomy only; mortality was 75%. Causes of death were (a) brainstem failure, six patients; (b) airway obstruction, one patient; (c) chest infection, one patient; (d) chronic renal failure, one patient. CONCLUSION: (a) suboccipital craniectomy to evacuate the hematoma is the most effective procedure where treatment is indicated; (b) the clinical recovery of the survivors show that 31% return to work, 38% are moderately disabled but take care of themselves, and 31% remain dependent on others; (c) deeply comatose patients may still benefit from early operation.

Adult↗
PubMedDate not supplied

Motor control assessment for rhizotomy in cerebral palsy.

OBJECTIVE: To apply motor control assessment for selection of appropriate spastic cerebral palsy children to receive selective posterior rhizotomy (SPR). DESIGN: Forty children with spastic cerebral palsy (3-16 yr) were divided into three groups: "independent ambulator," "dependent ambulator," and "nonambulator." Another 18 healthy children were selected as the control group. Both motor control (tested by using polyelectromyography (PEMG)) and clinical ambulatory capability were assessed within 1 mo before SPR and 12 mo after. PEMG patterns were classified into seven patterns according to electromyographic activities during hip/knee flexion and extension. Gait patterns, which were analyzed by computer DynoGraphy, were classified into four patterns for children with ambulatory capability. RESULTS: PEMG and gait patterns were correlated with ambulatory ability. PEMG patterns 2-3 could predict independent ambulatory ability, whereas patterns 6-7 will interfere with ambulatory ability. PEMG patterns showed significant improvement after SPR in the ambulatory groups (P < 0.05), whereas they did not improve in the nonambulator group. Children with cerebral palsy with co-contraction of proximal/distal muscles had better results after SPR, whereas those with diffuse co-contraction or reduced electromyography activities had poor results. CONCLUSIONS: PEMG patterns may allow the physician to select the appropriate children with spastic cerebral palsy to receive SPR with good results.

Activities of Daily Living↗
PubMedDate not supplied

Neurocutaneous melanosis associated with inferior vermian hypoplasia: MR findings.

OBJECTIVE: We describe the MR findings of two cases of neurocutaneous melanosis (NCM) associated with inferior vermian hypoplasia (IVH). MATERIALS AND METHODS: Two cases of NCM associated with IVH are presented. Both patients had congenital giant hairy nevi and multiple satellite lesions. RESULTS: Magnetic resonance imaging revealed IVH as well as hyperintensities in the pons and the cerebellar leptomeninges on T1-weighted images. The hyperintensities may be ascribed to the T1-shortening effect of melanin. A right parietal tumor in one patient and unilateral ventriculomegaly in another patient were also depicted. CONCLUSIONS: Magnetic resonance demonstration of the T1-shortening leptomeningeal infiltrations adds weight to the diagnosis of NCM. The implication of the concurrence of NCM and IVH is discussed.

Brain Neoplasms↗
PubMedDate not supplied

Coexistence of schizencephaly and intracranial arteriovenous malformation in an infant.

A 9-month-old infant had unilateral closed-lip schizencephaly in the right parietal lobe, which coexisted with an arteriovenous malformation in the nearby temporal area. Cranial MR showed a right parietal cleft lined with gray matter between the right lateral ventricle and the subarachnoid space, and cluster hypointensities throughout the right temporal lobe. Cerebral angiography revealed a right temporal arteriovenous malformation with feeding arteries arising from the right middle and posterior cerebral arteries and draining into the right sigmoid sinus via the engorged vein of Labbé.

Brain↗