Browsing by Author "Bahuleyan, Biji"

Now showing 1 - 5 of 5
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    Acute subdural hematoma after transsphenoidal surgery
    (JOURNAL OF CLINICAL NEUROSCIENCE, 2009)
    We report the case of a 48-year-old male who developed an acute subdural hematoma after transsphenoidal decompression of a pituitary adenoma followed by lumbar drain to conservatively manage postoperative cerebrospinal fluid rhinorrhoea. An attempt is made to discuss the risk factors. The need for constant monitoring, early imaging and prompt treatment is stressed. (C) 2008 Elsevier Ltd. All rights reserved.
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    Non-surgical management of cystic prolactinomas
    (JOURNAL OF CLINICAL NEUROSCIENCE, 2009)
    Cystic prolactinomas are considered not amenable to dopamine agonist therapy. We present the results of dopamine agonist therapy in six patients with cystic prolactinomas. The inclusion criteria of patients were: (i) cystic macroadenomas with the cyst occupying more than 50% of the turnout volume: (ii) a serum prolactin value more than 150 ng/mL. All patients were males with a mean age of 35 years. The clinical presentations were erectile dysfunction in 66.6%, Visual deficits in 50% and headache in 50% of patients. All patients were treated with bromocriptine only except one who was treated with both bromocriptine and cabergoline. The mean duration of follow up was 57.1 months. At the final follow-up 50% of patients had hormonal Cure, 50% had radiological cure and 50% had reduction in the size of the turnout. Hence, it is appropriate to consider dopamine agonist therapy in patients with cystic prolactinomas before considering surgery. (C) 2009 Elsevier Ltd. All rights reserved.
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    Role of three-dimensional fluid-attenuated inversion recovery (3D FLAIR) and proton density magnetic resonance imaging for the detection and evaluation of lesion extent of focal cortical dysplasia in patients with refractory epilepsy
    (ACTA RADIOLOGICA, 2010)
    Background: Focal cortical dysplasia (FCD) is often associated with epilepsy. Identification of FCD can be difficult due to subtle magnetic resonance imaging (MRI) changes. Though fluid-attenuated inversion recovery (FLAIR) sequence detects the majority of these lesions, smaller lesions may go unnoticed while larger lesions may be poorly delineated.Purpose: To determine the ability of a specialized epilepsy protocol in visualizing and delineating the extent of FCD.Material and Methods: We compared the imaging findings in nine patients with cortical malformation who underwent routine epilepsy MR imaging as well as a specialized epilepsy protocol. All imaging was done on a 1.5T MR unit. The specialized epilepsy protocol included 3D FLAIR in the sagittal plane as well as proton density (PD) and high-resolution T2-weighted (T2W) images in the transverse plane.Results: In all nine patients, the specialized protocol identified lesion anatomy better. In three patients in whom routine MRI was normal, the specialized epilepsy protocol including 3D FLAIR helped in identifying the lesions. One of these patients underwent surgery, and histo-pathology revealed a cortical dysplasia. In one patient, lesion characterization was improved, while in the remaining patients the extent of the FCD was more clearly demonstrated in the 3D FLAIR and PD images. Statistical analysis of images for cortical thickness, cortical signal intensity, adjacent white matter abnormalities, and gray-white matter junction showed significant statistical difference in the ability of 3D FLAIR to assess these aspects over conventional images. PD images were also found superior to the routine epilepsy protocol in assessment of cortical signal, adjacent white matter, and gray-white matter junction.Conclusion: Specialized MRI sequences and techniques should be performed whenever there is a high suspicion of cortical dysplasia, especially when they remain occult on conventional MR protocols. These techniques can also be used to define lesion extent more precisely.
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    Symptomatic posterior fossa and supratentorial subdural hygromas as a rare complication following foramen magnum decompression for Chiari malformation Type I
    (JOURNAL OF NEUROSURGERY, 2011)
    Symptomatic subdural hygroma due to foramen magnum decompression for Chiari malformation Type I is extremely rare. The authors present their experience with 2 patients harboring such lesions and discuss treatment issues. They conclude that the possibility of subdural hygromas should be considered in all patients presenting with increased intracranial tension following foramen magnum decompression for Chiari malformation Type I. Immediate neuroimaging and appropriate surgical intervention provides a good outcome. (DOI: 10.3171/2010.8.JNS10413)