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Biomedical subjects

V R Rao

Publications and source records attributed to V R Rao.

At least 73 records · Page 4Linked to original sources

Exploration of the pineal region: observations and results.

Experience with direct exploration of the pineal region in 22 consecutive patients is reported. Of these cases, mass lesions with obstructive hydrocephalus were found in 19; the remaining 3 had arteriovenous malformations of the pineal region. Of the 19 mass lesions, 5 (26%) were benign and curable. Although a preliminary shunt was routinely provided in all patients with obstructive hydrocephalus before exploration of the pineal region, the condition of five (26%) worsened after the shunt operation, requiring emergency decompression of the pineal tumor. A transtentorial approach through a right occipital craniotomy was uniformly employed in all cases. Overall mortality was less than 5%. These observations and results support the policy of direct exploration of all lesions in the pineal region.

Adolescent↗

Bacterial aneurysms of the intracavernous carotid artery.

Six cases of bacterial intracavernous carotid artery aneurysms of extravascular origin secondary to cavernous sinus thrombophlebitis are reported along with a review of 12 similar cases collected from the literature. Of the authors' six cases, there were three children and three adults. Meningitis was found in five patients. All patients received prolonged antibiotic therapy. Spontaneous resolution of the aneurysm occurred in one patient, thrombosis of the internal carotid artery in another, and progressive enlargement of the aneurysm was seen on sequential angiography in the other two. Evidence of associated arteritis was present in all of the patients. Carotid ligation for persistent ophthalmoplegia was carried out in two patients, of whom one had a giant aneurysm and the other progressive aneurysm enlargement. The results of treatment were good in all cases. The authors believe that carotid arteriography is obligatory in cases of cavernous sinus thrombophlebitis in which ophthalmoplegia persists despite adequate antibiotic therapy.

Adolescent↗

Symptomatic rathke's cleft cysts.

Two unusual cases of symptomatic Rathke's cleft cysts are reported. In one, the cyst was entirely suprasellar with a normal sella turcica. The gross visual failure, hypothalamic disturbances, and hypopituitarism of the patient resolved after a transfrontal aspiration and partial excision of the wall of the cyst. The second patient was a pituitary dwarf with hypothalamic dysfunction, but with normal vision. The patient had a large intrasellar cyst that exhibited marked suprasellar extension with calcification of the capsular rim. After transsphenoidal aspiration and partial excision of the wall of the cyst, the patient achieved a satisfactory recovery. The differential features between Rathke's cleft cyst and craniopharyngioma are highlighted.

Adult↗

Cesarean delivery in nulliparous women for failed oxytocin-augmented labor: route of delivery in subsequent pregnancy.

Fifty-eight patients experienced cesarean section for termination of their first term pregnancy subsequent to a failed trial of oxytocin therapy. Cephalopelvic disproportion and "failure to progress" were the sole indications for the initial cesarean section. All 58 women returned to our hospital for a subsequent trial of labor during the years 1977-1979 inclusive, and 40 of the 58 were able to have a vaginal delivery. Parameters investigated included first and subsequent pregnancy birth weights; birth weight difference; duration and maximal dose of oxytocin; status of the cervix at admission, prior to oxytocin, and before cesarean section; and the clinical and/or radiologic estimation of pelvic dimensions. Subsequent birth weight less than 3,500 gm was the only statistically significant factor associated with a high rate of vaginal delivery.

Birth Weight↗

Retrieval of a broken catheter from the aorta without operation.

The successful retrieval of a catheter fragment from the abdominal aorta by the wire snare technique, thus avoiding a major laparotomy, is reported. Whereas there are many published reports on the use of this technique in the venous circulation, similar experiences in the arterial circulation have been reported but rarely.

Adult↗

Outbreak of tuberculosis after minimal exposure to infection.

The identification of a case of respiratory tuberculosis in a swimming-baths attendant whose sputum was smear positive was followed by intensive contact tracing of children aged 8-11 years who had visited the baths. An outbreak was discovered that otherwise might not have been detected. Out of 3764 children, 108 (2.9%) had evidence of infection: there were 16 cases of tuberculosis, of which 11 were symptomless but showed lesions on chest radiography, and a further 92 with tine test grade 3 or 4 without clinical or radiological signs. The contact of these children with the index case was apparently minimal. Early detection, isolation, and treatment of infectious cases of respiratory tuberculosis and vigorous contact tracing should be given more priority in tuberculosis control.

Adult↗

Communicating cystic craniopharyngioma.

The case of a 12-year-old boy, who presented with a suprasellar cystic craniopharyngioma that freely communicated with the third ventricle, as demonstrated by ventriculography, is reported. This observation was confirmed at autopsy. The literature is reviewed briefly and the compatibility with life is discussed.

Brain Diseases↗

Hypervascular cavernous angioma at angiography.

Arteriovenous malformations usually do not present any diagnostic difficulty on the angiograms. However, small cryptic and cavernous angiomas cannot be demonstrated directly by arteriography because of either sluggish circulation or thrombosis. The present communication documents a relatively rare case of histologically proven cavernous angioma with a hypervascular pattern on the arteriogram.

Brain Neoplasms↗