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Biomedical subjects

Z Ram

Publications and source records attributed to Z Ram.

At least 73 records · Page 4Linked to original sources
PubMed1990

Another complication of thoracostomy--perforation of the right atrium.

Tube thoracostomy is an invasive procedure that is frequently life-saving but carries a risk of complications. We describe herein a complication not documented before-laceration of the right atrium. This occurred in a severely kyphoscoliotic patient with a markedly narrowed chest and led to his demise. This case attests to the extreme caution warranted when using trocar-type thoracostomy in patients with thoracic deformities.

Aged↗
PubMed1989

MR demonstration of spontaneous acute epidural hematoma of the thoracic spine.

Two patients with spontaneous epidural hematoma of the thoracic spine are presented. The magnetic resonance (MR) examination performed within the first hours following the onset of symptoms demonstrated an epidural elongated lesion impinging on the spinal cord, compatible with hematoma. In one of the patients this finding was surgically confirmed. The second patient improved under steroid treatment. The MR findings were highly suggestive of the pathological nature of the lesion. The MR examination should replace other diagnostic procedures, such as computerised tomography (CT) and myelography.

Acute Disease↗
PubMed1989

Intratumoural cyst formation in pituitary macroadenomas.

Twenty-one patients with various types of pituitary macroadenomas underwent hypophysectomy at the Chaim Sheba Medical Centre between 1985 to 1987. Intraoperative fine needle aspiration of the tumoural content was attempted prior to tumour excision. Although none of the patients had a history compatible with pituitary apoplexy, intratumoural fluid suggestive of a cyst within the tumour was found in 57% of the patients. Analysis of the hormones in the aspirated fluid revealed variable elevations in hormone levels, some reaching 3,000 times the equivalent plasma levels. Concomitant elevated levels of other pituitary hormones found in the cyst fluid support the concept of mixed secretory potential of pituitary adenomas, including the apparently non-functioning tumours. Six out of seven patients (86%) who received preoperative treatment with bromocriptine had an intratumoural cyst while only seven out of fourteen patients (50%) who were not treated with this drug prior to surgery had a cyst within the tumour. The implications of these observations on current theories concerning the pathophysiology of pituitary adenomas are discussed.

Adenoma↗
PubMed1989

Upward transtentorial herniation: a complication of postoperative edema at the cervicomedullary junction.

Local edema at the operative bed developed a few hours after uneventful subtotal removal of a lesion occupying the lower medulla and upper cervical cord. The patient experienced apnea, quadriplegia, and circulatory collapse followed by acute respiratory insufficiency. Hydrocephalus secondary to aqueductal occlusion occurred on the 3rd postoperative day. A computerized tomographic scan was compatible with upward transtentorial herniation. The association of this phenomenon with an intra-axial lesion at the cervicomedullary junction has not been previously documented. The pathophysiological mechanisms implicated in this complication are discussed.

Adult↗
PubMed1989

Delayed postoperative neurological deterioration from prolonged sodium nitroprusside administration. Case report.

Sodium nitroprusside is commonly used for the induction of hypotension during neurosurgical procedures. Its toxicity stems from hemodynamic compromise as well as from its metabolites, especially the formation of cyanide. A patient is described who underwent craniotomy for hypertensive intracerebral hemorrhage. He gradually recovered following the operation, but needed continued administration of sodium nitroprusside for control of hypertension. On the 7th postoperative day, he deteriorated into coma with evidence of severe edema and herniation on the computerized tomography scan. Cessation of sodium nitroprusside and treatment for cyanide poisoning resulted in resolution of his symptoms within hours. The potential toxicity of sodium nitroprusside, measures to prevent toxicity, and therapeutic steps are discussed.

Brain Edema↗
PubMed1989

Delayed nonhemorrhagic encephalopathy following mild head trauma. Case report.

Delayed nonhemorrhagic encephalopathy following mild head trauma is a rare condition with an unknown etiology. The few cases reported in the literature are in young adults, all of them in the era before computerized tomography (CT) became available, and all had a devastating clinical course with multifocal ischemia or necrotic lesions found at autopsy. A case is presented of a young man with this syndrome who survived the acute encephalopathic phase with severe residual neurological deficits. Repeat CT scans during and following the acute phase as well as magnetic resonance imaging showed diffuse multifocal lesions compatible with ischemic changes and demyelination in the "watershed" areas of the brain.

Adult↗
PubMed1988

Spinal cord involvement as the presenting symptom of acute monocytic leukemia.

Spinal cord involvement in leukemia is rare and has been described only once in association with acute monocytic leukemia. A patient whose presenting symptom of acute monocytic leukemia was the syndrome of cauda equina compression due to an epidural and retroperitoneal leukemic mass is reported. Peripheral blood smears were normal throughout the evolution of the disease. The radiological, surgical, and pathological findings are presented, and the therapeutic, along with the prognostic implications of spinal cord involvement by leukemia are discussed.

Adult↗
PubMed1987

Intermittent priapism in spinal canal stenosis.

A case of spontaneous intermittent priapism in a patient with spinal canal stenosis is presented. Erection, as well as intermittent neurogenic claudication and urinary incontinence were provoked by physical exertion, mainly walking. The symptoms completely resolved after decompressive lumbar laminectomy.

Aged↗
PubMed1987

Visual hallucinations associated with pituitary adenoma.

Visual hallucinations were the presenting symptom in three patients with pituitary adenoma. One patient reported only simple unformed hallucinations, which are a well-documented phenomenon occurring in lesions compressing the optic nerves and chiasm. The other two patients, however, experienced complex formed visual hallucinations believed to be of the release type. No evidence of seizure activity responsible for the hallucinations was found; the mechanism producing them is discussed with correlation to operative findings and electrophysiological studies.

Adenoma↗
PubMed1986

Brain metastasis: a rare manifestation of adenoid cystic carcinoma of the breast.

Adenoid cystic carcinoma of the breast is a rare neoplasm that usually has a benign biological behavior. A patient who was operated upon for removal of this tumor developed metastases to the lungs and brain 12 years after mastectomy. This is probably the first report in the literature of brain metastasis from adenoid cystic carcinoma of the breast. Radiological and histological evidence of both primary breast tumor and the metastasis to the brain are presented.

Brain Neoplasms↗
PubMed1985

[Mycotoxins].

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Chemical Phenomena↗