المؤلفون: Robins, James M. W., Chumas, Paul D., Tyagi, Atul K.

المصدر: Child's Nervous System; Dec2023, Vol. 39 Issue 12, p3593-3593, 1p

مصطلحات موضوعية: CAVERNOUS sinus, CRANIOTOMY, INTERNAL carotid artery, CHILD patients, CRANIAL nerves, MAGNETIC resonance imaging

مستخلص: Objective: Here we demonstrate via operative video the subtemporal extradural approach to a tumour in the cavernous sinus. Methods: The extradural approach is performed here in a paediatric patient (a 15-year-old child) via a right extended pterional osteoplastic craniotomy with removal of the zygomatic arch. The operative microscope is introduced, and the dura is divided at the superior orbital fissure into endosteal and meningeal layers using a diamond knife. The middle cranial fossa floor is drilled flat to increase access, and the plane is further developed towards the cavernous sinus. The tumour is seen bulging from within the cavernous sinus, and the cavernous sinus is opened in the anteromedial triangle between cranial nerves Vi and Vii. After biopsy, the tumour is debulked with an ultrasonic aspirator. Doppler is used to identify the internal carotid artery and preserve it. The bone flap is replaced, and the wound is closed in layers in standard fashion. Results: The patient recovered well and was discharged on post-operative day 3. Persistent sixth nerve palsy (present pre-operatively) was present; however, otherwise, there was good recovery from surgery. Good resection of tumour is demonstrated on post-operative MR imaging. Conclusions: This approach is uncommon but important as it enables extradural access to the cavernous sinus, minimising the complications associated with an intradural approach such as cortical injury. In this video, we also demonstrate the fundamental anatomy using annotation and cadaveric images to enhance understanding required for the neurosurgeon to successfully complete this approach. The patient consented to the procedure in the standard fashion. [ABSTRACT FROM AUTHOR]

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المؤلفون: Sinha, Priyank, Ahmad, Maleeha, Varghese, Ann, Parekh, Tejal, Ismail, Azzam, Chakrabarty, Aruna, Tyagi, Atul, Chumas, Paul

المصدر: European Spine Journal; May2015 Supplement, Vol. 24, p472-484, 13p

مصطلحات موضوعية: CENTRAL nervous system tumors, JUVENILE diseases, CAUDA equina, MENINGEAL cancer, MAGNETIC resonance imaging

مستخلص: Atypical teratoid rhabdoid tumour (ATRT) is a rare and highly aggressive malignant neoplasm of the central nervous system (CNS), which occurs predominantly in children less than 2 years of age. There are less than 50 cases described in adult. We report a case of primary spinal ATRT in a 65-year-old male who presented to us with cauda equina syndrome. To the best of our knowledge, our patient is the (1) second oldest patient to be diagnosed with ATRT and only the third case of adult spinal ATRT report in the literature; (2) first reported case of CNS ATRT occurring in a patient with non-rhabdoid renal cancer; (3) first adult patient of ATRT to present with cauda equina syndrome. [ABSTRACT FROM AUTHOR]

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المؤلفون: Selvanathan, Senthil, Kumar, Ramesh, Goodden, John, Tyagi, Atul, Chumas, Paul

المصدر: Acta Neurochirurgica; Jan2013, Vol. 155 Issue 1, p135-138, 4p, 2 Color Photographs, 4 Black and White Photographs

مصطلحات موضوعية: ENDOSCOPIC surgery, CENTRAL nervous system tumors, BIOPSY, MAGNETIC resonance imaging

الشركة/الكيان: WORLD Health Organization

مستخلص: Background: Open surgical approaches to intraventricular tumours are complex and challenging. Neuro-endoscopy, however, has enabled us to biopsy and resect small intraventricular tumours with potentially reduced morbidity. Nevertheless, suitable methods/ instrumentation for resection have limited the use of the endoscope. The authors report the utilisation of endoscopic ultrasonic aspirator in the resection of an intraventricular tumour. This technique was compared to another case that utilised conventional endoscopic techniques for removal of an intraventricular tumour. Methods: Using an endoscope, the third ventricle was entered and visualised, with the tumours clearly seen. Tumours were then either debulked via conventional or novel technique. Results: Using the conventional technique, tumour was removed with rongeurs via the flexible scope. Irrigation was needed to improve vision due to bleeding. Postoperative magnetic resonance imaging (MRI) confirmed good excision. Histology was reported as anaplastic ependymoma World Health Organization (WHO) Grade III. Utilising the novel technique, the tumour was also debulked uneventfully. Histology confirmed Grade 1 glioneuronal tumour. Postoperative MRI revealed a small residuum. Conclusions: To date, endoscopic resection of tumours has been limited by suitable tools. The advent of an ultrasonic aspirator that can be used down an endoscope increases the possibilities for such resections. This is the first reported case of endoscopic resection of an intraventricular tumour using this technique. [ABSTRACT FROM AUTHOR]

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المؤلفون: Gayatri, Neti neti.gayatri@leedsth.nhs.uk, Tyagi, Atul¹, Mahadevan, Usha¹

المصدر: Brain & Development. Sep2009, Vol. 31 Issue 8, p618-621. 4p.

مصطلحات موضوعية: *HYDROCEPHALUS in children, *MYCOPLASMA diseases, *MAGNETIC resonance imaging of the brain, *ENCEPHALITIS, *DIAGNOSIS of brain diseases, *INTRACRANIAL pressure, *TOMOGRAPHY, *HEALTH outcome assessment

مستخلص: Abstract: Mycoplasma cerebellitis though rare, may rapidly progress to hydrocephalus needing surgical intervention. It has not been reported so far in children. We report a 6 year old girl with mycoplasma cerebellitis which progressed to acute hydrocephalus needing an emergency external ventricular drain. Magnetic Resonance Imaging is essential in making the diagnosis of cerebellar swelling as CT scan may be normal. Relapses can occur as in our case. Close monitoring for raised intracranial pressure and investigations to identify the organism including mycoplasma are indicated in all cases. Long-term outcome appears to be favorable if diagnosed and treated early. [Copyright &y& Elsevier]

المؤلفون: Kolias, Angelos G.¹ angeloskolias@gmail.com, Pal, Debasish¹, Shivane, Aditya², Ismail, Azzam², Tyagi, Atul K.¹

المصدر: Clinical Neurology & Neurosurgery. Nov2009, Vol. 111 Issue 9, p784-788. 5p.

مصطلحات موضوعية: *SPINAL cord abnormalities, *LITERATURE reviews, *PRECANCEROUS conditions, *HEMANGIOMAS, *MAGNETIC resonance imaging, *MICROSURGERY, *PEDIATRIC surgery, CENTRAL nervous system abnormality diagnosis

مستخلص: Abstract: Cavernous malformations are vascular lesions which can occur throughout the entire neuraxis. This term is synonymous to cavernous angioma, cavernous haemangioma, and cavernoma. They comprise of closely packed, capillary-like vascular channels, without intervening neural tissue. MR imaging is currently the study of choice for the diagnosis of cavernous malformations as they are considered angiographically occult lesions. Intramedullary location represents only 3–5% of all central nervous system cavernous malformations, with the majority of them being supratentorial. Only 10% of the intramedullary cavernous malformations present in the paediatric population. As the natural history of these lesions is not well known, the debate on the optimal management of them is still ongoing. Here we describe the case of a 14-year-old male with progression of symptoms over an 18 months period, which necessitated microsurgical removal of a T9 intramedullary cavernous malformation. [Copyright &y& Elsevier]