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Biomedical subjects

V K Kak

Publications and source records attributed to V K Kak.

At least 55 records · Page 3Linked to original sources

Bifrontal oligodendroglioma with bilateral symmetrical posterior communicating artery aneurysms.

A case of bifrontal oligodendroglioma with bilateral posterior communicating artery aneurysms, one symptomatic and the other incidental, is presented. This is the first instance of such a combination. Clipping of the aneurysm, along with partial tumour excision, was performed at the same sitting, successfully. Literature on this association is reviewed and the pathogenesis is discussed.

Brain Neoplasms↗

Air in epidural haematomas.

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.

Female↗

Intracranial olfactory neuroblastoma: evidence for olfactory epithelial origin.

AIMS: To determine the possible histogenesis of the intracranial variant of olfactory neuroblastoma. METHODS: Four specimens from three cases of intracranial olfactory neuroblastoma were studied by light microscopy and immuno-histochemistry, and electron microscopy in two cases. RESULTS: Light microscopical examination showed small cell tumour with additional features of epithelioid cells in one case and ganglion cells in another. Olfactory and Homer-Wright rosettes were present. All the specimens showed a uniform positive reaction to neurone specific enolase, S-100, and cytokeratin antibodies. Glial fibrillary acidic protein was absent. The salient electron microscopic features were the presence of cell junctions, cytoplasmic intermediate filaments, basal bodies and cytolasmic processes. Dense cored vesicles were absent. CONCLUSIONS: The results strongly support the view that intracranial olfactory neuroblastomas are of olfactory epithelial origin and differ from conventional neuroblastomas.

Adult↗

Craniospinal intradural arachnoid cyst.

A patient with an uncommonly situated congenital intradural arachnoid cyst is reported. The cyst extended from the cervical spinal canal into the posterior cranial fossa and was posterolateral to the spinal cord. The patient's initial complaint was urinary hesitancy. The location of the cyst is unique and the presenting complaint rare.

Adult↗

Non-missile penetrating injuries of the spine.

Non-missile penetrating injuries of the spine accounted for 7% of all spinal injuries admitted to this Institute during the last 10 years. Young males were most commonly affected and 73% of the injuries involved the upper dorsal und cervical spine. They presented with varying degrees of neurological deficit. Plains x-rays revealed the bony injury and/or the retained foreign body satisfactorily. Myelography (with or without CT scan) was performed in patients with progressive neurological deterioration and those not responding to conservative therapy. Surgery remained the mainstay of treatment and improved neurological function in 7 out of 9 cases. Conservative management resulted in complications such as persistent CSF fistula, uncontrolled fulminant meningitis and septicaemia, with 100% mortality. Early surgical intervention is, therefore, recommended in all penetrating injuries of the spine.

Adolescent↗

Benign osteoblastoma of the occipital bone.

An uncommon case of benign osteoblastoma of the occipital bone is presented. Poor vascularity of the tumor, as confirmed by the CT scan, operative and histopathological findings, was in contrast to its characteristic high vascularity. Radical resection produced an excellent result.

Adult↗

Pyogenic meningitis and cerebral abscesses after endoscopic injection sclerotherapy.

Infectious complications of endoscopic injection sclerotherapy (EIS) are rare. We report here a case in which pyogenic meningitis and multiple cerebral abscesses developed after a session of EIS. The patient was successfully treated with a combination of parenteral antibiotics and repeated bedside pus aspirations. Prophylactic antibiotics may be considered in such situations for subsequent sessions of EIS.

Adult↗

Stereotaxic biopsy of brain-stem tumours in children.

Stereotaxic biopsies were performed in a series of 14 patients with clinical and computed tomographic evidence of a brain-stem lesion. Seven of these cases were in the paediatric age group (under 15 years of age). Biopsies were obtained by means of the Leksell stereotaxic system, through the transcerebellar (three cases) or transfrontal route (four cases). A definite tumour diagnosis could be obtained in all cases. No patients were subjected to open biopsy, as the further management of their tumours did not warrant surgery. One patient developed transient oculomotor nerve palsy. There was no mortality related to the biopsy procedure in this series. The biopsy technique and its utility and safety are discussed.

Adolescent↗

Controversies in the management of subdural empyema. A study of 41 cases with review of literature.

Forty one cases of subdural empyema treated between 1977 and 1988 at the Postgraduate Institute of Medical Education and Research. Chandigarh, have been analysed. The patients ranged from 9 days to 80 years of age. There were 22 children, including 11 infants. Fever, altered sensorium and seizures were the most common symptoms present for 1 day to 6 months. Otogenic infection was the commonest aetiological factor followed by postoperative and posttraumatic causes. Thirty seven patients had supratentorial empyemas, including 4 with parafalcine collections, three had infratentorial empyemas, and in one there was extension of the empyema from the supratentorial to the infratentorial compartment. Therapeutic modalities used included percutaneous needle aspirations in infants and burr hole evacuation and craniotomies in adults. A wide spectrum of organisms was detected. Mortality in this series was 24%, which was mainly attributable to the deteriorated neurological status prior to treatment. A detailed review of the literature has been given, highlighting various controversies in the management of SDE. Important prognostic factors and a treatment plan are suggested.

Adolescent↗

Actinomycotic brain abscess.

A histologically confirmed actinomycotic brain abscess, in a previously healthy female, is reported. CT scan findings of a thick walled multiloculated ring enhancement with smooth inner margin and irregular nodular enhancement of outer margin, along with contiguous patchy enhancing lesion with circular low attenuation areas were suggestive of a chronic granulomatous abscess. Surgical excision and prolonged antibiotic therapy produced a good resolution.

Actinomycosis↗

Meningeal melanocytoma: report of two cases.

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.

Adult↗

Damage to the anterior visual pathway and brain parenchyma following external pituitary irradiation.

Three cases of damage to the optic nerves and chiasma following pituitary irradiation with Co60 teletherapy are described. All of them presented with progressive visual impairment months following irradiation and simulated recurrence of the tumour. CT scan was also not helpful in differentiating radionecrosis from tumour recurrence. On exploration the optic nerves and chiasma appeared discoloured and scarred. One case, who also had diffuse radionecrosis of brain parenchyma, died. No satisfactory therapy is currently available for this grave complication but proper safeguards can prevent it.

Adult↗