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Biomedical subjects

Z A Jamjoom

Publications and source records attributed to Z A Jamjoom.

At least 37 records · Page 2Linked to original sources
PubMed1996

Multiloculated hydrocephalus related to cerebrospinal fluid shunt infection.

This study is an attempt to establish that CSF shunt infection has a role in the aetiology of multiloculated hydrocephalus. The authors carried out a review of 12 cases of multiloculated hydrocephalus who were treated at King Khalid University Hospital between 1988-1994. The multiloculation appears to have developed following the shunt infection in all cases. The hydrocephalus was related to an intraventricular haemorrhage (IVH) in 9 patients and was congenital in 2 patients and post-meningitic in 1 patient. The shunt infection was caused by a gram-negative organism in 8 patients and duration of external ventricular drainage ranged from 9-24 (median 13) days. The diagnosis of multiloculated hydrocephalus was made on average 2 months after the shunt infection. In three patients endoscopic fenestration of intraventricular septations was attempted but was effective in only one case. The other patients were managed by two shunts (9 patients) and three shunts (2 patients). At a mean follow-up of 15 months, the shunt revision rate of the patients was 0.4/year. One patient died of multiple brain abscesses and 6 patients remain severely disabled. The poor outcome may also be related to the original IVH as well as the multiloculated hydrocephalus. The study also shows that patients with post-haemorrhagic hydrocephalus, who develop a shunt infection due to gram-negative organisms and in whom the CSF fails to be cleared of the infection following 12 days of external drainage appear to be at risk of developing multiloculated hydrocephalus.

Adolescent↗
PubMed1996

Growing skull fractures: surgical management of difficult and atypical cases.

The authors treated and followed-up 11 patients with growing skull fractures during the last 10 years. Two atypical forms of these fractures, characterized by difficulties in surgical repair or failure of conventional procedure, were identified. Five patients required unconventional procedures to effect a cure. Thus, three required shunt surgery (ventriculoperitoneal, n = 2 and cystoperitoneal, n = 1) and two recurrent cases had a modified surgical procedure. This unique and useful method of repairing this defect is described as well.

Acrylic Resins↗
PubMed1996

Acute spontaneous spinal epidural hematoma: the influence of magnetic resonance imaging on diagnosis and treatment.

BACKGROUND: Acute spontaneous spinal epidural hematoma (ASSEDH) is rare and its treatment standard were set prior to the era of magnetic resonance imaging (MRI). Recent data provided by this new technique necessitate a critical review of these standards. METHODS: A case of ASSEDH diagnosed by MRI and confirmed at surgery is presented. In addition, all cases of ASSEDH reported in the pertinent literature since 1987 were reviewed and compared with those cases described earlier. RESULTS: Since the introduction of MRI, the mean incidence of ASSEDH cases reported in the literature has increased from 2.2 to 6.4 new cases per year, with a remarkable rise in the percentage of those cases that did not require surgical treatment from 1.5% before the era of MRI to 29% thereafter. CONCLUSION: ASSEDH runs a benign course more often than previously estimated and, therefore, the choice of the treatment should be decided for each case individually. Urgent surgical decompression remains the treatment method of choice for patients with ASSEDH presenting with disabling neurologic deficit.

Aged↗
PubMed1996

Intestinal obstruction caused by extraperitoneal cerebrospinal fluid collection.

External compression caused by a massive extraperitoneal cerebrospinal fluid collection lead to intestinal obstruction in a 3-year-old child who had previously had a ventriculoperitoneal shunt for treatment of hydrocephalus. Radiological findings and ways of preventing this situation are discussed. A useful diagnostic radiological sign, the "coiling sign', indicating shunt misplacement at the peritoneal level, is also described.

Cerebrospinal Fluid Pressure↗
PubMed1995

Intracranial mycotic infections in neurosurgical practice.

Intracranial mycotic infections requiring neurosurgical intervention are being diagnosed more frequently. This study is a review of 17 cases of intracranial mycotic infections that were treated in a neurosurgical unit in Saudi Arabia over an 8-year period. A primary focus of infection was identified in 41% of patients while 18% of patients had a predisposing factor. Forty-seven percent of patients presented with a brain abscess (solitary 29%, multiple 18%) while 35% had a granuloma. 18% meningitis and ventriculitis and 12% hydrocephalus. The Aspergillus species and Ramichloridium machenziei were the commonest pathogens. Following the appropriate surgical and antimicrobial treatment, the mortality rate was 41% and there was evidence of residual disease at follow-up in 18%. The reason for a fatal outcome was failure to consider a fungal aetiology and to obtain a tissue diagnosis early-because of late referral (2 cases), as well as failure to respond to antimycotic therapy (4 cases) and rupture of the internal carotid artery due to Aspergillus arteritis (one case). It is concluded that an early tissue diagnosis is crucial in the management of intracranial mycotic infection so that the appropriate surgical and antimycotic treatment can be started early.

Adult↗
PubMed1995

Bilateral arachnoid cysts of the sylvian region in female siblings with glutaric aciduria type I. Report of two cases.

Two sisters, aged 6 and 2 1/2 years, presented with macrocephaly and delayed motor development and were found on computerized tomography to have bilateral arachnoid cysts of the sylvian region. Cystoperitoneal shunting of the larger cysts resulted in considerable neurological improvement in both children. Subsequent screening of the patients' urine for organic acids showed that the two sisters were suffering from glutaric aciduria type I (GA-I). To the best of the authors' knowledge, this is the first report to provide clear radiological and surgical evidence of the association between GA-I and bilateral arachnoid cysts of the sylvian region. The role of the shunting procedure used in these cases is discussed.

Arachnoid Cysts↗
PubMed1995

Isolated posterior fossa hypertension and brainstem compression caused by entrapped Dandy-Walker cyst: a case report.

Lateral ventricular shunting alone is often considered to be adequate treatment for hydrocephalus caused by Dandy-Walker syndrome. A patient is presented in whom progressive spastic tetraparesis and signs of severe brainstem compression developed due to an entrapped posterior fossa cysts, in spite of an adequately functioning lateral ventricular shunt. Addition of a cystoperitoneal shunt resulted in rapid resolution of symptoms and deficits. This case illustrates that potentially fatal brainstem compression and dangerous posterior fossa hypertension may develop if the posterior fossa cyst does not communicate with the lateral ventricles, where the shunt is placed.

Brain Diseases↗
PubMed1994

Clinical characteristics of traumatic extradural hematoma: a comparison between children and adults.

In this study of 43 children who had surgery for traumatic extradural hematoma (EDH) at Frenchay Hospital, England, between 1975 and 1987, the authors attempt to outline the various clinical characteristics of EDH which are different in children (age range 1-15 years) and adults (age range 16-84 years). The results confirm that children with traumatic EDH are less likely to have injury be caused by an RTA, are less likely to remain unconscious from the time of injury to the time of the operation, and are less likely to require immediate surgery (less than 6 hours after injury). In addition, the CT scan is less likely to show in associated intradural injury, and the outcome is significantly better.

Adolescent↗
PubMed1994

Subtentorial diverticulum of the third ventricle associated with a mural cavernous angioma in a child.

The authors describe a case of a large subtentorial supracollicular diverticulum of the third ventricle associated with a cavernous angioma in its wall in a 6-year-old girl who presented with developmental delay and obstructive hydrocephalus. This is the first case in which such association has been diagnosed and successfully treated. The literature is reviewed, and the possible relationship between these two rare lesions is discussed.

Brain Diseases↗
PubMed1994

Cervical lymph nodes metastases from a pituitary carcinoma.

The authors report a case of a pituitary carcinoma which was locally invasive and which metastasized to cervical lymph nodes more than 9 years after the initial presentation. Cells from the tumour and metastasis immunostained with antibodies to prolactin and growth hormone, even though there was no clinical or biochemical evidence that the tumour was secreting prolactin or growth hormone. In addition, ultrastructural studies showed a monomorphic tumour with secretory granules much smaller than those normally associated with prolactin and growth hormone secretion. The clinical and pathological features suggest that the tumour is probably an acidophil stem cell adenoma, which although known to be aggressive in its clinical behaviour has not been previously reported to metastasize.

Adenoma, Chromophobe↗
PubMed1994

Experience with brain abscess in the central province of Saudi Arabia.

The characteristics of brain abscess in the Central Province of Saudi Arabia are outlined in this report which is a review of 22 consecutive cases that were treated at King Khalid University Hospital between 1985-1991. The incidence of brain abscess in Saudi Arabia is calculated to be 3.6 cases/500,000 population/year which is twice as high as the incidence reported from the West. There were 17 males and 5 females with an age range of 8 months-80 years (mean 29.9 years). The parietal lobe was involved in 27%, while the abscess was in the posterior fossa in 14% and multiple in another 14% of cases. The primary source of sepsis was unknown in 50%, post-traumatic in 18% and from a dental and mastoid origin in 14% of cases only. Duration of symptoms ranged between 4-30 days (mean 12 days). Fever was present in 55% of cases and epilepsy in 23%. Sixteen (73%) cases had burr hole aspiration, while 3 (14%) had craniotomy and excision, and 3 (14%) cases were managed with antimicrobial treatment only. Staphylococci were the pathogens in 27%, while streptococci were cultured in 23% cases and the culture was negative in 23%. Three (14%) cases all of which died had fungal abscesses caused by Fonsecaea pedrosoi. The mortality was 18%, good recovery in 68% and fair recovery in 14%. Follow-up was from 3 months to 5.5 years (mean 1.8 years).

Adolescent↗
PubMed1993

Cerebellopontine angle epithelial cyst. A case report.

A case of epithelial cyst in the cerebellopontine angle is reported. The cyst wall showed glandular epithelium with areas of non-keratinized stratified epithelium and flattened cuboidal cells. The glandular areas stained positively with antibodies to cytokeratin. In addition, the cyst wall contained areas of arachnoid tissue. This, and the unusual position of the cyst, suggest that the epithelial elements in the cyst wall may be metaplastic in origin. Similar previously described cysts were considered to be endodermal in origin.

Adult↗
PubMed1993

Systemic metastasis of medulloblastoma through ventriculoperitoneal shunt: report of a case and critical analysis of the literature.

An unusual case of medulloblastoma metastasizing through a ventriculoperitoneal shunt to the scrotum in a child with a hydrocele is presented. A review of the literature disclosed 160 cases of medulloblastoma with systemic metastases, 30 (18.7%) of them having undergone systemic shunts. Analysis of the distribution patterns of the metastases in relation to the shunt type revealed that shunts had probably provided the route of systemic spread in no more than 11 cases (6.9%). Only one of these cases had no intracranial tumor at autopsy, suggesting that the outcome was probably worsened by the systemic metastases through the shunt. In contrast, five patients had intraaxial tumor recurrence that largely determined the outcome. In the remaining five cases, information concerning the tumor within the central nervous system was not available, and it remains speculative whether these patients could have survived longer without the shunts. It is concluded that the chance of medulloblastoma metastasizing through cerebrospinal fluid shunt is quite small and has an even smaller chance of adversely affecting the final outcome of the medulloblastoma patient. Consequently, in our opinion there should be no contraindication to precraniotomy shunting if required in such patients.

Cerebellar Neoplasms↗