Browsing by Author "Joseph, S"
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Item Carotid artery stenting - An Indian experience(RIVISTA DI NEURORADIOLOGIA, 2003)Item Cerebral dural arteriovenous fistulae - An Indian experience(RIVISTA DI NEURORADIOLOGIA, 2003) Gupta, AK; Joseph, S; Kapilamoorthy, TR; Bejoy, T; Kesavadas, CItem Chordoid meningioma: A report of two cases(NEUROLOGY INDIA, 2003)Chordoid meningioma is an uncommon histopathological variant of meningioma. We report 2 cases of chordoid meningioma occurring in adult patients.Item Coil embolization for intracranial aneurysms - An Indian experience(RIVISTA DI NEURORADIOLOGIA, 2003) Gupta, AK; Joseph, S; Bhattacharya, RN; Kapilamoorhty, TR; Kesavadas, C; Thomas, BItem Direct puncture embolization of head and neck tumors(RIVISTA DI NEURORADIOLOGIA, 2003) Gupta, AK; Joseph, S; Kapilamoorthy, TR; Kesavadas, C; Thomas, BItem Endovascular treatment of carotido-cavernous fistula(RIVISTA DI NEURORADIOLOGIA, 2003) Gupta, AK; Rao, VRK; Kapilamoorthy, TR; Bhattacharya, RN; Joseph, S; Krishnamoorthy, TItem Epilepsia partialis continua - a clinical and electroencephalography study(SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, 2002)Epilepsia partialis continua (EPC) is a rare type of localization-related motor epilepsy. Clinical spectrum, electroencephalography (EEG) characteristics and various prognostic factors in EPC were studied in 20 patients. Patients who fulfilled the criteria for EPC between the years 1985 and 1999 were included in this retrospective and prospective study. The mean age was 18 years (range 5 months-70 years). Eleven patients (55%) had Type 1 EPC and in the remaining nine (45%) patients there were features of Type 2 EPC. Among children Rasmussen's encephalitis and viral encephalitis were the commonest cause for EPC. Encephalitis and vascular aetiology were frequently observed in adults. Tuberculous meningitis and tuberculomas occurred evenly in both the groups. The cause was unknown in two cases. Focal EEG abnormalities commonly consisted of discrete spikes, sharp waves (or) slow wave activity and periodic lateralized epileptiform discharges. The mean duration of follow up was 9.6 months with a range between I month and 4 years. Cognitive decline, motor deficits and pharmacoresistance to drugs were significantly seen among children with Type 2 EPC. Patients with Type I EPC had mild impairment of functional status with good response to treatment. The long-term prognosis depends upon the underlying cause. (C) 2002 Published by Elsevier Science Ltd on behalf of BEA Trading Ltd.Item Evidence of functional somatotopy in GPi from results of pallidotomy(BRAIN, 2000)The objective of this study was to explore the functional anatomy of the globus pallidus internus (GPi) by studying the effects of unilateral pallidotomy on parkinsonian 'off' signs and levodopa-induced dyskinesias (LID), We found significant positive! correlations between the preoperative levodopa responsiveness of motor signs and the levodopa responsiveness of scores in timed tests (Core Assessment Program for Intracerebral Transplantations) in the contralateral limbs and the improvement in these scores after surgery, whereas there was no correlation with the improvement in LID, We also found a highly significant correlation (P < 0,0001, p = 0.8) between the volume of the ventral lesion in the GPi and the improvement in LID in the contralateral limbs, whereas there was no correlation between the ventral volume and the improvement in parkinsonian 'off' signs. The volumes of the total Lesion cylinder and the dorsal lesion did not correlate with the outcome of either dyskinesias or parkinsonian 'off' signs. The differential predictive value of levodopa responsiveness for the outcome of parkinsonian 'off' signs and LID and the different correlations of ventral lesion volume with dyskinesias and parkinsonian 'off' signs indicate that different anatomical or pathophysiological substrates may be responsible for the generation of parkinsonian 'off' signs and dyskinesias, Whereas cells in a wider area of the GPi may be implicated in parkinsonism, the ventral GPi seems to be crucial for the manifestation of LID. We suggest that our observations are additional proof of the functional somatotopy of the systems within the GPi that mediate parkinsonism and dyskinesias, especially along the dorsoventral trajectory used in pallidotomy. The outcome of pallidotomy in which the lesion involves the ventral and dorsal GPI could be the net effect of alteration in the activity of pathways which mediate different symptoms, and hence could be variable.Item 'Face of the giant panda' sign in Wilson's disease: Revisited(NEUROLOGY INDIA, 2000)We report a patient, with Wilson's disease, who showed the characteristic radiological sign known as 'Face of the giant panda sign' on magnetic resonance imaging (MRI) of the brain.Item Focal occlusive disease of the common femoral artery: a report of 20 cases.(Cardiovascular surgery (London, England), 1994)Occlusive disease localized to the common femoral artery without contiguous involvement of the external iliac and superficial femoral arteries is distinctly uncommon in vascular surgical practice. Twenty patients with focal occlusive disease in 21 common femoral arteries are featured in this report. All except one had severe disabling symptoms: Fontaine classification was stage I in one patient, stage IIb in 13, and stage III in six patients. The probable aetiology, based on clinical features and angiographic observations, was identified as atherosclerosis (nine cases), thromboangiitis obliterans (three) and Takayasu's arteritis (two). Histological features of mucoid vasculopathy, a novel disorder, was seen in one patient while no specific aetiology was evident in five patients. Associated lesions were seen in fourteen patients: aortoiliac in one, femoropopliteal in seven (without any continuity to the common femoral lesion), internal iliac in three and tibial in three. Balloon angioplasty of the common femoral artery lesions was attempted in 14 patients with successful outcome in nine. Three patients (including two with failed balloon angioplasty), underwent thromboendarterectomy and two bypass procedures (iliofemoral, one; femoropopliteal, one). Late reocclusion occurred in one patient each in the angioplasty and surgical groups. There were no procedure-related complications in either group.Item Haemorrhage during cranial CT: Spontaneous or contrast related?(NEUROLOGY INDIA, 1998) Joseph, S; Saluja, S; Gupta, AK; Kesavadas, C; Ramakrishnan, KGTwo cases of haemorrhage during cranial computed tomography (CT) occurring during the enhancement phase of CT examination immediately after the administration of intravenous contrast medium are reported. In both cases, the preceding unenhanced scans showed evidence of haemorrhage. The risk of aneurysmal rupture as a result of retching and vomiting induced by intravenous contrast is stressed. Judicious use of contrast enhanced CT is suggested in patients with suspected aneurysmal subarachnoid haemorrhage.Item Intra-arterial thrombolysis in stroke and procedure-related complications(RIVISTA DI NEURORADIOLOGIA, 2003) Gupta, AK; Kapilamoorthy, TR; Joseph, S; Bejoy, TItem Neurocysticercosis: a clinical and radiological appraisal from Kerala State, South India.(Singapore medical journal, 2001)OBJECTIVES: Little has been published on Neurocysticercosis (NCC) in the State of Kerala, South India. This study was conducted to describe the clinical and radiological features of NCC in Kerala and also to study the frequency of NCC as seen in a tertiary referral setting.MATERIALS AND METHODS: We evaluated retrospectively 11 patients who were admitted with a diagnosis of NCC from 1986 to 1998. A pre-abstracted proforma containing detailed demographic data, dietary habits, clinical features and history of travel outside Kerala and neuroimaging findings were obtained from patient records and the data was tabulated and analysed. Follow up assessment was made three months after treatment.RESULTS: There were a total of 11 patients, including nine males and two females in the age range of 24 to 62 years and a mean age of 35.2 years. All were nonvegans, only 36% were pork eaters while 18% claimed consumption of salads and uncooked vegetables. 55% of patients were migrants. Migrants were defined as those who lived outside the state of Kerala for more than six months. Seizure was the most common presenting complaint and occurred in all patients (100%). Multiple ring enhancing lesions were seen on computerised tomography (CT) and magnetic resonance imaging (MRI) scans in 60%. Calcified lesions were noted in two patients. An isolated instance of miliary or disseminated cysticercosis with subcutaneous nodules and multiple brain lesions in MRI scan was observed. All patients received anticysticercal therapy besides anticonvulsants.CONCLUSIONS: It appears that NCC is rather uncommon in Kerala. Better socioeconomic status, high literacy rate, improved sanitation and health care in the state of Kerala could be reasons for this observation. A prospective case-control study of NCC in Kerala is needed to study these factors.Item Occlusion of an aberrant right subclavian artery arising from a Kommerel diverticulum.(Journal of vascular and interventional radiology : JVIR, 1993)Item Osteoid osteoma - CT-guided percutaneous laser ablation in spine and long bones(RIVISTA DI NEURORADIOLOGIA, 2003) Gupta, AK; Thomas, B; Joseph, S; Kapilamoorthy, TR; Kesavadas, C; Purkayastha, SItem Percutaneous laser disc decompression(RIVISTA DI NEURORADIOLOGIA, 2003) Gupta, AK; Kapilamoorthy, TR; Joseph, S; Thomas, B; Kesavadas, C; Bodhey, NKItem Percutaneous vertebroplasty - Initial experience(RIVISTA DI NEURORADIOLOGIA, 2003) Kapilamoorthy, TR; Gupta, AK; Joseph, S; Bejoy, T; Kesavadas, C; Purkayastha, SItem Preoperative embolization of craniofacial vascular malformations(RIVISTA DI NEURORADIOLOGIA, 2003) Gupta, AK; Rao, VRK; Kapilamoorthy, TR; Joseph, S; Kesavadas, C; Bejoy, TItem Role of angiographic catheters in surgery of popliteal arteriovenous fistulas.(Cardiovascular surgery (London, England), 1993)A 50-year-old woman with a chronic, traumatic popliteal arteriovenous fistula was treated surgically by closure of the fistula. Placement of an angiographic catheter across the fistula into the venous sac immediately before surgery helped to locate the fistula accurately and quickly at operation. This simple manoeuvre will facilitate surgical treatment, particularly in cases of long-standing, chronic arteriovenous fistulas.Item Selective intra arterial thrombolysis in acute carotid territory stroke(NEUROLOGY INDIA, 2001)The safety and efficacy of selective intraarterial administration of urokinase in five male patients, (age range 30 to 65 years, mean 41.2 years), with occlusive stroke involving the carotid territory and a normal cranial computed tomography scan was evaluated. The time elapsed before treatment ranged from one to 10 hours. Digital substraction angiography disclosed distal internal carotid artery occlusion in one patient and occlusion of the middle cerebral artery or its branches in the others. The urokinase dose ranged from 120,000 to 500,000 units. In two patients who received thrombolytic treatment within three hours of the onset of symptoms, there was a 100% recanalisation associated with excellent neurological recovery. In the remaining three patients, recanalisation rate varied from 0 to 50% with partial recovery in two and no recovery in one patient. None had a haemorrhagic transformation of the infarct, Although no firm conclusions can be drawn because of the small number of patients studied, selective intraarterial urokinase therapy appears to be safe and useful in patients with carotid territory stroke if undertaken early. Only through a multicenter, randomized, controlled trial, enough number of patients can be recruited to verify these observations.