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Z A Jamjoom

Publications and source records attributed to Z A Jamjoom.

At least 19 recordsLinked to original sources
PubMed2000

Spinal aspergillosis in nonimmunocompromised host mimicking Pott's paraplegia.

The aim of this report is to highlight the less-known aspergillus spondylitis (AS) that may completely mimic Pott's paraplegia, leading to occasional but expensive diagnostic error, as the chemotherapeutic management of the two is different. A case of a patient with the diagnosis of Pott's paraplegia who turned out to have aspergillus spondylitis is described. Issues and difficulties regarding the differentiation between these two forms of spine infection and their therapeutic implications are discussed. We conclude that differential diagnosis of spinal tuberculosis (TB) should include aspergillus spondylitis, as cure of spinal aspergillosis, especially in early stages, is possible with surgery and/or antifungal agents, and morbidity and mortality are high in neglected cases.

Adult↗
PubMed1999

Atypical forms of spinal tuberculosis: case report and review of the literature.

OBJECTIVE: The object of this report is to highlight some of the less known atypical features of spinal tuberculosis (TB) in the hope of facilitating early diagnosis. Pure neural arch and sacral TB is rare and the co-existence of these two as widely separated skip lesions in the same patient is even rarer. CLINICAL PRESENTATION: An unusual case of tuberculous process affecting the sacrum as well as the neural arches of upper cervical vertebrae is presented. Neither the clinical features nor the imaging techniques, including radiography, bone scintigraphy, computed tomography, and magnetic resonance imaging, were helpful in establishing the diagnosis. The destructive lesion of the sacrum with a rectally palpable presacral mass was thought to be a chordoma or chondrosarcoma until the patient developed upper cervical cord compression with an extradural myelographic block. Development of this second destructive lesion involving the posterior spinal elements (the neural arch) led to a diagnosis of malignant spinal metastasis. The true diagnosis was only revealed by the histology of the solid tumor-like extradural mass in the upper cervical region and demonstration of acid-fast bacilli (AFB) in the lesion. Anti-TB chemotherapy resulted in complete resolution of sacral and cervical lesions as well as the neurologic deficits. CONCLUSION: Differential diagnosis of the obscure spinal lesion should include tuberculosis, specifically the atypical forms; especially because complete cure is possible with early treatment and neurologic morbidity is high in neglected cases.

Adult↗
PubMed1998

Primary midline cranial vault lymphoma simulating a parasagittal meningioma: the role of angiography in preoperative diagnosis.

Primary non-Hodgkin's lymphoma (NHL) of the skull with extra- and intracranial extension without systemic or skeletal manifestation in a non-immunocompromised patient is extremely rare. Up to date, only nine such cases have been reported in the literature and in none was the lesion located in the midline. The authors report a unique case of a primary NHL involving the midline of the cranium. The lesion presented as a slowly growing scalp swelling mimicking a parasagittal meningioma. The angiographic findings of mild vascularity in the periphery of the tumor and downward displacement of a patent superior sagittal sinus indicated that the lesion was unlikely to be a meningioma. Neurosurgeons must maintain a broad differential diagnosis in any patient with a scalp mass eroding through the skull and associated neurological symptoms or signs. An intraoperative frozen section is recommended since the identification of a lymphoma is likely to influence the neurosurgeon's decision about the extent of the surgical excision.

Adult↗
PubMed1998

Low rate of shunt revision in tumoural obstructive hydrocephalus.

The authors calculated the shunt revision rate for 77 consecutive patients with tumoural obstructive hydrocephalus. At a mean follow up of 23.7 months, the annual revision rate was 0.06 which is significantly lower than the annual revision rate of 0.39 for other hydrocephalic patients treated during the same period. Shunted patients who had total excision of their lesions had a significantly lower revision rate than patients who had a partial excision or a biopsy. It is therefore, suggested that cases with tumoural obstructive hydrocephalus may represent a subset of hydrocephalic patients who are associated with a relatively low risk of shunt complications. The observation has to be addressed when the role of endoscopic third ventriculostomy in these patients is being considered.

Adolescent↗
PubMed1998

Factors affecting the outcome of foetal hydrocephaly.

In this study, the authors attempt to provide an account of the factors that affect the outcome of hydrocephaly in 26 foetuses. The hydrocephalus was related to a myelomeningocele in 35% of patients. Sixty-two percent of foetuses showed intra-uterine progression of their hydrocephalus and 50% were shunted postnatally. At a mean follow up of 2 years, the outcome was considered "fair" in 54% of patients. Our findings demonstrate that in foetal hydrocephaly a more favourable outcome is expected in patients with hydrocephalus which does not progress in utero, in whom the labour is not induced before 36 weeks of gestation, who are delivered vaginally weighing more than 2.5 kg and have a head circumference below the 95th centile and a CT cortical mantle thickness of 2 cm and more and who are treated by CSF shunting. The diagnosis of the foetal hydrocephaly at or before 28 weeks of gestation and the presence of a myelomeningocele did not affect the outcome significantly. Neurosurgeons are reminded to keep an open mind for infants with foetal hydrocephaly and to offer active treatment to patients with a potentially favourable outcome.

Birth Weight↗
PubMed1998

Intraventricular and leptomeningeal dissemination of a pilocytic cerebellar astrocytoma in a child with a ventriculoperitoneal shunt: case report.

Dissemination of a pilocytic cerebellar astrocytoma is a very rare occurrence. So far only eight cases have been reported in the literature and in only one of these cases had the tumour spread into the ventricles. We report a case of a child who presented with communicating hydrocephalus and a small cerebellar lesion. The patient was initially treated by a ventriculoperitoneal (VP) shunt and the lesion was followed-up. Two years later, intraventricular and leptomeningeal dissemination of the tumour which proved to be a pilocytic astrocytoma was documented. The role of the VP shunt in diverting metastasizing tumour cells into the ventricles is discussed.

Astrocytoma↗
PubMed1997

Growing fracture of the orbital roof.

BACKGROUND: Growing fractures rarely arise in the skull base, and their pathogenesis and treatment are still debated. METHODS: The clinical and radiologic findings of a growing fracture involving the orbital roof in a 5-year-old boy are presented and the relevant literature is reviewed. RESULTS: The clinical picture of growing fracture of the orbital roof is dominated by ocular symptoms such as diplopia, eyelid swelling, and displaced eye globe. Computed tomography scan is excellent for demonstrating the bony defect in the orbital roof while magnetic resonance imaging is more sensitive in showing the intraorbital extension of the leptomeningeal cyst. Frontobasal brain injury seems to play an important role in the pathogenesis of the fracture growth. Craniotomy with direct repair of the dural and bone defects is the treatment of choice. CONCLUSION: Growing fracture of the orbital roof may complicate minor head injury and should be considered in the differentiated diagnosis in cases of persistent ocular symptoms.

Child, Preschool↗
PubMed1997

Orbito-cranial injury caused by penetrating metallic foreign bodies: report of two cases.

Two cases of orbito-cranial injury caused by foreign bodies (FBs) penetrating the lateral wall and roof of the orbit are described. In the first patient, a long rusted nail acted as a missile and was only detected by X-rays and CT scan. The nail penetrated the orbit, the eyeball, the lateral orbital wall, and the temporal lobe of the brain. Lodged partly in the orbit and partly in the brain, this nail caused leakage of cerebrospinal fluid (CSF) through eye and led to orbital cellulitis and localized meningitis. The foreign body (FB) was removed through an extradural pterional approach with rapid resolution of orbital cellulitis and meningitis. In the second patient, large metallic FB, having penetrated the orbital roof was lodged intracranially above the chiasma. This was removed via frontal craniotomy. Mechanism of such injuries and appropriate surgical approaches are described as well.

Adult↗
PubMed1997

Neural arch tuberculosis: radiological features and their correlation with surgical findings.

Radiological features of 17 cases of neural arch tuberculosis (NAT), treated surgically by the authors, are reviewed and correlated with the operative and histopathological findings. The diagnostic accuracy of different imaging modalities in the evaluation of this rare, atypical form of spinal tuberculosis was found to be very low. Thus, the initial diagnosis was in error in 15 out of 17 of our cases. Recognition of the radiological diagnostic features of NAT is important, not only because they may mimic primary or metastatic spinal neoplasms, but also because of the surgical implications. Computed tomography (CT) and magnetic resonance imaging (MRI) features correlated most closely with the surgical findings, whereas plain spinal radiographs and myelograms were found to be non-specific and non-diagnostic.

Adolescent↗
PubMed1997

Pharyngo-cutaneous fistula following anterior cervical fusion.

A 26-year-old man who underwent anterior cervical fusion for a compressed fracture of the C5 vertebra developed postoperatively partial extrusion of the bone graft, followed by progressive dysphagia and retropharyngeal emphysema. Although no definite perforation of the oesophagus or pharynx was detected at reoperation, an extensive pharyngocutaneous fistula formed subsequently through the operative wound. Open drainage in association with broad spectrum antibiotics, continuous nasopharyngeal suctioning, stopping of oral intake and gastrostomy feeding resulted in closure of the fistula. However, the fistula recurred twice soon after resumption of the oral feeding. The diagnostic difficulties in determining when the healing of a pharyngo-cutaneous fistula is complete are underlined. In addition, the importance of continued treatment for 4-6 weeks after first radiological evidence of closure of the fistula is emphasized.

Adult↗
PubMed1996

Trigeminal neuralgia related to cerebellopontine angle tumors.

A review of 30 cases with cerebellopontine angle tumors was carried out to identify patients with trigeminal neuralgia (TN) at presentation and to compare them with patients without TN. The study shows that dermoid tumors and the presence of tumor at the apex of petrous bone on CT are associated with a significantly higher incidence of TN, while the incidence did not appear to be influenced by age, sex, or size of tumor. In all patients but one (with medulloblastoma) that had surgery, there the TN disappeared following total or subtotal excision of the tumor, providing the trigeminal nerve was well decompressed. Patients with TN should be investigated carefully by CT or MRI irrespective of their age or the absence of neurological signs.

Adult↗
PubMed1996

Cerebro-vasculopathy and malignancy: catastrophic complications of radiotherapy for optic nerve glioma in a von Recklinghausen neurofibromatosis patient.

The authors report a unique case of a patient with intraorbital optic nerve glioma and von Recklinghausen neurofibromatosis who developed cerebro-vasculopathy and malignant transformation in the orbit 18 months after radiotherapy treatment. The case is an important reminder of the possibly increased susceptibility of von Recklinghausen neurofibromatosis patients to the complications of radiotherapy.

Brain↗
PubMed1996

Modified coronal computerized tomographic cuts for transsphenoidal surgery. Technical note.

Computerized tomographic (CT) cuts passing through the anterior nasal spine and the most prominent part of the sellar floor (spino-sellar or SS cuts) were found to be useful in minimizing the chances of anatomical disorientation during the transsphenoidal microsurgical approach as well as in preoperative planning and selection of the length and choice of the instruments to be used. Routine preoperative SS cuts of CT scan are advised.

Adenoma↗
PubMed1996

Cranial and intracranial aspergillosis of sino-nasal origin. Report of nine cases.

This paper is an attempt at defining the most efficacious surgical and antifungal therapy for invasive cranial and intracranial aspergillosis, and is based on experience with nine non-immunocompromised patients treated and followed-up by the authors between 1983 and 1994; as well as on the summary of previously reported cases and advances in therapy of this condition. Depending on the degree of aspergillar involvement of the cranial base and intracranial structures, a classification, with implications for treatment and prognosis, is also proposed. Two patients had extracranial skull base erosion; whereas relentlessly progressive granulomas, mimicking malignancy, invaded the skull base and intracranial contents in seven cases. Of these seven patients with cranial and intracranial invasion, two died of acute intracranial haemorrhage due to fungal invasion of cerebral blood vessels. In two patients, complete surgical eradication of the disease proved impossible due to cavernous sinus involvement, while residual aspergillomas are still present in orbit and paranasal sinuses (PNS) in a further two patients in spite of multiple surgical procedures and prolonged antifungal chemotherapy (AFC). What appears to be a cure has been effected in one patient only. Multiple therapeutic strategies were used. Biopsy plus systemic AFC was ineffective, surgical drainage and debridement plus systemic AFC resulted in long-term survivals but no cure. Radical surgery in conjunction with systemic and local (intracavitary) AFC should be considered to improve an otherwise poor prognosis.

Adult↗