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  1. Article ; Online: Primary paraganglioma of the spine

    Toshi Mishra / Naina A Goel / Atul H Goel

    Journal of Craniovertebral Junction and Spine, Vol 5, Iss 1, Pp 20-

    A clinicopathological study of eight cases

    2014  Volume 24

    Abstract: Context: Spinal paragangliomas are rare neuroendocrine tumors of the extra-adrenal paraganglionic system. Aims: This study describes the clinicopathological features of eight cases of spinal paraganglioma and highlights the significance of important ... ...

    Abstract Context: Spinal paragangliomas are rare neuroendocrine tumors of the extra-adrenal paraganglionic system. Aims: This study describes the clinicopathological features of eight cases of spinal paraganglioma and highlights the significance of important morphological features and immunohistochemistry in the diagnosis of paraganglioma at this unusual site. Material and Methods: All the cases of primary spinal paragangliomas diagnosed during the last six years (2008-2013) in the Department of Pathology at our hospital were reviewed. Results: There were six males and two females. The mean age at diagnosis was 50.4 years. All patients presented with low back pain. All tumors were located in the cauda equina or conus medullaris region. Magnetic Resonance Imaging and intraoperative appearance were that of a vascular, well-circumscribed intradural, extramedullary tumor suggestive of either schwannoma or ependymoma. All the patients underwent gross total resection of the tumor. Histopathology in five of the cases showed ′ependymoma-like histology′ while only three cases had a predominant classic ′zellballen′ pattern. Two cases had prominent ′gangliocytic differentiation′. In the five cases with ′ependymoma-like histology′, the diagnosis was confirmed on Immunohistochemistry (IHC). Conclusions: Even though relatively rare, paraganglioma should be considered in the differential diagnosis of spinal tumors and due to their clinical, radiological and histopathological similarity to schwannoma and ependymoma, the diagnosis should be based on close examination of the clinical, radiological and pathological findings.
    Keywords Cauda equina ; ependymoma-like histology ; paraganglioma ; spinal ; Orthopedic surgery ; RD701-811 ; Surgery ; RD1-811 ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2014-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Congenital meningocoele presenting in an adult

    Raghvendra V Ramdasi / Trimurti D Nadkarni / Atul H Goel

    Journal of Craniovertebral Junction and Spine, Vol 5, Iss 3, Pp 134-

    2014  Volume 136

    Abstract: A 53-year-old male patient presented with low back pain radiating to both lower limbs for 2 years and urinary incontinence for 2 months. He had swelled over his lower back since birth. The neurological examination revealed a decreased perianal sensation. ...

    Abstract A 53-year-old male patient presented with low back pain radiating to both lower limbs for 2 years and urinary incontinence for 2 months. He had swelled over his lower back since birth. The neurological examination revealed a decreased perianal sensation. Local examination of the lumbar swelling showed a brilliantly transilluminant, cystic midline swelling in the lumbar area with underlying spina bifida. Magnetic resonance imaging revealed a low-lying conus at L3 level associated with spina bifida at L5 and a meningocoele sac. The patient underwent excision of the meningocoele and detethering of cord by extirpation of hypertrophied filum terminale. The patient had an immediate relief of his symptoms. At 3 month follow-up the lumbar wound had healed well, and there was a significant improvement in the perianal hypoesthesia. The adult presentation of a congenital meningocoele and spinal dysraphism is rare, especially in the fifth decade. The possible causes of this delayed presentation are analyzed, and the relevant literature on the subject is presented.
    Keywords Adult meningocoele ; spinal dysraphism ; tethered cord ; Orthopedic surgery ; RD701-811 ; Surgery ; RD1-811 ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2014-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Traumatic cervical epidural hematoma in an infant

    Vithal Rangarajan / Sandip B Mavani / Trimurti D Nadkarni / Atul H Goel

    Journal of Craniovertebral Junction and Spine, Vol 4, Iss 1, Pp 37-

    2013  Volume 39

    Abstract: An 8-month-old male infant had presented with a history of a fall from the crib a fortnight ago. He had developed progressive weakness of both lower limbs. On examination, the infant had spastic paraplegia. Magnetic resonance (MR) imaging of the cervical ...

    Abstract An 8-month-old male infant had presented with a history of a fall from the crib a fortnight ago. He had developed progressive weakness of both lower limbs. On examination, the infant had spastic paraplegia. Magnetic resonance (MR) imaging of the cervical spine showed an epidural hematoma extending from the fourth cervical (C4) to the first dorsal (D1) vertebral level with cord compression. The patient had no bleeding disorder on investigation. He underwent cervical laminoplasty at C6 and C7 levels. The epidural hematoma was evacuated. The cervical cord started pulsating immediately. Postoperatively, the patient′s paraplegia improved dramatically in 48 hours. According to the author′s literature search, only seven cases of post-traumatic epidural hematoma have been reported in pediatric patients, and our patient is the youngest. The present case report discusses the etiopathology, presentation, and management of this rare case.
    Keywords Cervical epidural hematoma ; cervical trauma ; traumatic spinal hematoma ; Orthopedic surgery ; RD701-811 ; Surgery ; RD1-811 ; Medicine ; R
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Intracranial nonvestibular neurinomas

    Forhad Hossain Chowdhury / Mohammod R. Haque / Khandkar A. Kawsar / Mainul H. Sarker / Mahmudul Hasan / Atul H. Goel

    Journal of Neurosciences in Rural Practice, Vol 5, Iss 3, Pp 231-

    Young neurosurgeons′ experience

    2014  Volume 243

    Abstract: Background and Objectives: Neurinoma arising from other than nonvestibular cranial nerves is less prevalent. Here we present our experiences regarding the clinical profile, investigations, microneurosurgical management, and the outcome of nonvestibular ... ...

    Abstract Background and Objectives: Neurinoma arising from other than nonvestibular cranial nerves is less prevalent. Here we present our experiences regarding the clinical profile, investigations, microneurosurgical management, and the outcome of nonvestibular cranial nerve neurinomas. Materials and Methods: From January 2005 to December 2011, the recorded documents of operated nonvestibular intracranial neurinomas were retrospectively studied for clinical profile, investigations, microneurosurgical management, complications, follow-up, and outcomes. Results: The average follow-up was 24.5 months. Total number of cases was 30, with age ranging from 9 to 60 years. Sixteen cases were males and 14 were females. Nonvestibular cranial nerve schwannomas most commonly originated from trigeminal nerve followed by glossopharyngeal+/vagus nerve. There were three abducent nerve schwannomas that are very rare. There was no trochlear nerve schwannoma. Two glossopharyngeal+/vagus nerve schwannomas extended into the neck through jugular foramen and one extended into the upper cervical spinal canal. Involved nerve dysfunction was a common clinical feature except in trigeminal neurinomas where facial pain was a common feature. Aiming for no new neurodeficit, total resection of the tumor was done in 24 cases, and near-total resection or gross total resection or subtotal resection was done in 6 cases. Preoperative symptoms improved or disappeared in 25 cases. New persistent deficit occurred in 3 cases. Two patients died postoperatively. There was no recurrence of tumor till the last follow-up. Conclusion: Nonvestibular schwannomas are far less common, but curable benign lesions. Surgical approach to the skull base and craniovertebral junction is a often complex and lengthy procedure associated with chances of significant morbidity. But early diagnosis, proper investigations, and evaluation, along with appropriate decision making and surgical planning with microsurgical techniques are the essential factors that can result in optimum outcome.
    Keywords Intracranial ; microneurosurgical management ; neurilemmomas ; neurinomas ; nonvestibular ; schwannomas ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2014-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

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