scholarly journals Intracranial arachnoid cyst: an institutional experience

2016 ◽  
Vol 30 (1) ◽  
pp. 136-142
Author(s):  
Mukesh Sharma ◽  
R.S. Mittal ◽  
Rajeev Bansal ◽  
Achal Sharma
Keyword(s):  
Arachnoid Cyst ◽  
Treatment Modalities ◽  
Visual Field Defects ◽  
Common Symptom ◽  
Indication For Surgery ◽  
Postoperative Results ◽  
Asymptomatic Patients ◽  
Symptomatic Headache ◽  
Institutional Experience ◽  
Intracranial Arachnoid Cyst

Abstract Aim: In this study, symptoms at presentation, indication for surgery, surgical treatment modalities, postoperative results and complications were studied. Material and methods: We retrospectively compiled the details of patients with IAC from admission and operative records admitted through our OPD during the period between January 1995 and January 2015. Only those patients were admitted whose symptoms attributes to the cyst and asymptomatic patients were followed on OPD basis. This is a single institutional study. Results: This study includes 56 patients of IAC who were operated. Posterior fossa cysts (62.5%) were found more commonly symptomatic. Headache (32%) was the most common symptom in a patient with IAC. Out of all, 24 patients presented with headache and underwent surgery subsequently; 20 showed satisfactory relief after surgery while four showed partial relief. Size of cyst was significantly reduced after surgery in 52 patients after 12 weeks but four patients, who underwent cystoperitoneal shunt, required re-operation as patients showed no decrease in size of cyst due to shunt malfunction. Head circumference was reduced following intervention in infant patients. Three patients who presented with visual field defects with IAC in sellar region showed improvement after endoscopic fenestration of cyst. One of the patient with cerebellopontine angle arachnoid was died immediately after marsupialization due to unexplained bleeding. Conclusions: IAC is not an uncommon finding on imaging but only few are symptomatic. Patients with Intracranial arachnoid cyst should be treated only if the patient’s symptoms are attributable to the cyst.

scholarly journals Study of clinical and demographic profile of patients diagnosed with secretory otitis media

2017 ◽  
Vol 3 (3) ◽  
pp. 715
Author(s):  
Ajeet Kumar Khilnani ◽  
Viral Prajapati
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Complete Recovery ◽  
Treatment Modalities ◽  
Common Symptom ◽  
Secretory Otitis Media ◽  
Long Time ◽  
Bilateral Deafness

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong>Secretory Otitis Media (SOM) is a common otological condition in children presenting most commonly with hearing loss. If untreated for long time, it can affect the language development of child. Its causes are multifactorial and treatment depends on the etiology. Various treatment modalities (medical and surgical) are available and they are administered in isolation or in combination. The objectives of the study were the present study was conducted with the objectives of knowing the most common age group affected by SOM, the common etiological factors of SOM and the outcome of various modalities of treatment of SOM.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong>This prospective study was conducted at a tertiary care teaching hospital of North Gujarat. IEC approval and consent from the patients were taken. 40 patients diagnosed with SOM were included in the study and their clinical and demographic details and treatment outcomes were studied.  </p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>Of the 40 patients, 65% were males. SOM was common in young children. Most of the cases (55%) were below 10 years of age. In 80% of cases SOM was bilateral. Deafness was the most common symptom (95%) with which patients presented with, followed by URTI and pain. All patients had impaired tympanic membrane mobility. Retraction of tympanic membrane was the next common otoscopic finding (85%). Initial management was medical and 18 patients required surgical intervention.</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>SOM is a common ear disorder in children. Initial medical treatment has a definitive role and should be tried in all cases before surgical intervention is contemplated. A variety of surgical procedures are available which can be used depending on the indication. Complete recovery is expected to occur in most of the cases by a period of 3-6 months.</p>

Clinical features and factors affecting in-hospital mortality of patients who underwent pericardiocentesis due to moderate to severe pericardial effusion

2021 ◽  
Author(s):  
Oktay Şenöz ◽  
Volkan Emren ◽  
Zeynep Yapan Emren ◽  
Ahmet Erseçgin ◽  
Ferhat Siyamend Yurdam ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Hospital Mortality ◽  
Antithrombotic Therapy ◽  
Pericardial Fluid ◽  
Common Symptom ◽  
Important Indicator ◽  
Factors Affecting ◽  
Cardiac Compression ◽  
Asymptomatic Patients ◽  
Common Causes

Objectives: The aim of this study was to determine the primary etiology of pericardial effusion in patients undergoing percutaneous pericardiocentesis. Possible in-hospital mortality related predictors were also investigated. Patients and Methods: A retrospective analysis was made of the clinical and laboratory features of 268 patients who underwent pericardiocentesis due to moderate to severe pericardial effusion between January 2009 and March 2020. Results: The patients comprised 57.5% males and 42.5% females with a mean age of 62.3±15.4 years. Cardiac compression was detected in 220 (82.1%) patients, of which 208 (77.6%) were clinically tamponade and 12 (4.5%) were asymptomatic cardiac compression. The most common symptom was dyspnea (58.6%) and 10.8% of patients were asymptomatic. Pericardial fluid was exudate in 235 (87.7%) patients. The most common causes were malignancy (37.3%) followed by idiopathic (22.1%) and iatrogenic (12.7%) causes. The patients with asymptomatic cardiac compression were more likely to have malignant effusion than those with other etiologies (p=0.001). In-hospital mortality developed in 37 (13.8%) patients. The independent predictors of in-hospital mortality were determined as follows; etiology other than infectious or idiopathic (OR = 3.447; 95% CI = 1.266, 9.386; p = 0.015), and receiving antithrombotic therapy (OR = 2.306; 95% CI = 1.078, 4.932; p=0.031). Conclusion: Malignancy is the most common cause of moderate to severe pericardial effusions. The detection of cardiac compression in asymptomatic patients may be an important indicator of malignancy. Receiving antithrombotic therapy and having a non-idiopathic and non-infectious etiology may be predictors of in-hospital mortality.

Ventricular size determination and management of ventriculomegaly and hydrocephalus in patients with diffuse intrinsic pontine glioma: an institutional experience

2021 ◽  
pp. 1-7
Author(s):  
Adriana Fonseca ◽  
Palma Solano ◽  
Vijay Ramaswamy ◽  
Uri Tabori ◽  
Annie Huang ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Univariate Analysis ◽  
Diffuse Intrinsic Pontine Glioma ◽  
Survival Advantage ◽  
Ventricular Size ◽  
Pontine Glioma ◽  
Asymptomatic Patients ◽  
Institutional Experience ◽  
Csf Diversion ◽  
The Impact

OBJECTIVE There is no consensus on the optimal clinical management of ventriculomegaly and hydrocephalus in patients with diffuse intrinsic pontine glioma (DIPG). To date, the impact on survival in patients with ventriculomegaly and CSF diversion for hydrocephalus in this population remains to be elucidated. Herein, the authors describe their institutional experience. METHODS Patients diagnosed with DIPG and treated with up-front radiation therapy (RT) at The Hospital for Sick Children between 2000 and 2019 were identified. Images at diagnosis and progression were used to determine the frontal/occipital horn ratio (FOR) as a method to measure ventricular size. Patients with ventriculomegaly (FOR ≥ 0.36) were stratified according to the presence of symptoms and categorized as follows: 1) asymptomatic ventriculomegaly and 2) symptomatic hydrocephalus. For patients with ventriculomegaly who did not require CSF diversion, post-RT imaging was also evaluated to assess changes in the FOR after RT. Proportional hazards analyses were used to identify clinical and treatment factors correlated with survival. The Kaplan-Meier method was used to perform survival estimates, and the log-rank method was used to identify survival differences between groups. RESULTS Eighty-two patients met the inclusion criteria. At diagnosis, 28% (n = 23) of patients presented with ventriculomegaly, including 8 patients who had symptomatic hydrocephalus and underwent CSF diversion. A ventriculoperitoneal shunt was placed in the majority of patients (6/8). Fifteen asymptomatic patients were managed without CSF diversion. Six patients had resolution of ventriculomegaly after RT. Of 66 patients with imaging at the time of progression, 36 (55%) had ventriculomegaly, and 9 of them required CSF diversion. The presence of ventriculomegaly at diagnosis did not correlate with survival on univariate analysis. However, patients with symptomatic hydrocephalus at the time of progression who underwent CSF diversion had a survival advantage (p = 0.0340) when compared to patients with ventriculomegaly managed with conservative approaches. CONCLUSIONS Although ventriculomegaly can be present in up to 55% of patients with DIPG, the majority of patients present with asymptomatic ventriculomegaly and do not require surgical interventions. In some cases ventriculomegaly improved after medical management with steroids and RT. CSF diversion for hydrocephalus at the time of diagnosis does not impact survival. In contrast, our results suggest a survival advantage in patients who undergo CSF diversion for hydrocephalus at the time of progression, albeit that advantage is likely to be confounded by biological and individual patient factors. Further research in this area is needed to understand the best timing and type of interventions in this population.

scholarly journals P.014 The natural history of third ventricle colloid cysts includes asymptomatic regression: a report of two cases and review of the literature

2017 ◽  
Vol 44 (S2) ◽  
pp. S17-S17
Author(s):  
R Bokhari ◽  
J Chankowsky ◽  
J Marcoux
Keyword(s):  
Natural History ◽  
Third Ventricle ◽  
Symptomatic Patient ◽  
Review Of The Literature ◽  
Indication For Surgery ◽  
Asymptomatic Patients ◽  
Signal Characteristics ◽  
History Of ◽  
Colloid Cysts

Background: Colloid cysts of the third ventricle are a rare entity with an unclear natural history. Although intervening in the setting of a symptomatic patient is fairly straightforward, decision-making for asymptomatic patients is not. Few studies address this question and proposed risk factors for cyst progression vary.A cyst diameter exceeding 1 cm is a common indication for surgery. This is rooted in the belief that the natural history is continued growth. A few cases have recently surfaced that suggests some cysts may spontaneously regress without complication. We describe our experience with two such cases and contrast it with those of others. Methods: We collected all cases of “colloid cysts” identified as incidental findings on Brain CT scans in a large urban center with available follow-up. We then conducted a comprehensive review of the literature. Results: Among all incidental cases from our database, none required surgery and two were found to decrease in size on neuroimaging surveillance with interesting evolution in MRI signal characteristics. These cysts remain asymptomatic at last follow up. Conclusions: The natural history of colloid cysts includes spontaneous regression. This should be mentioned in counseling asymptomatic patients.

scholarly journals Spontaneous intracystic hemorrhage complicating an intracranial arachnoid cyst

2015 ◽  
Vol 06 (04) ◽  
pp. 629-630 ◽  
Author(s):  
V. V. Ramesh Chandra ◽  
B. Chandramowliswara Prasad ◽  
C. Siva Subramanium ◽  
Ravi Kumar
Keyword(s):  
Arachnoid Cyst ◽  
Intracystic Hemorrhage ◽  
Intracranial Arachnoid Cyst

scholarly journals Multimodal treatment of myophasal chronic pelvic pain in women: institutional experience

2019 ◽  
Vol 8 (5) ◽  
pp. 1708
Author(s):  
Guadalupe Guerrero Reyes ◽  
Cristobal Barragan Ochoa ◽  
Claudia M. Moysen Marin ◽  
Vianey B. Ayala Quispe ◽  
Laura Escobar Del barco ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Multimodal Treatment ◽  
Chronic Pelvic Pain ◽  
Trigger Point ◽  
Pain Scale ◽  
Treatment Modalities ◽  
Average Score ◽  
Significant Difference ◽  
Institutional Experience ◽  
Multimodal Management

Background: Chronic pelvic pain of myofascial origin is an underdiagnosed condition and with partial responses to the different treatment modalities. The objective of this study was to report the results of the multimodal management of Myofascial Chronic Pelvic Pain.Methods: Retrospective cohort of 33 patients with myofascial chronic pelvic pain, during the period 01 January 2016 to August 31, 2018, who were treated based on trigger point infiltration and analgesic vaginal electrostimulation. The analogous visual pain scale (VAS) was used at the beginning, sixth, twelfth and six months after the last electrostimulation session, in order to measure the effect of the treatment.Results: During the study period, 32 patients with chronic myofascial pelvic pain were found who received the multimodal scheme that is offered in our clinic. The average score of the EVA before starting the treatment was 8.5 points, at the sixth session of the treatment the average EVA was 3.6 points, at the twelfth session of 1.3 points and the average score of the EVA at six months after the last session of the multimodal treatment was 2.9 points. A significant difference was demonstrated in the average EVA score in the first with respect to the sixth, twelfth and six months (p = <0.000). There were no complications or adverse effects secondary to the multimodal treatment.Conclusions: Multimodal treatment was associated with progressive improvement in 80% of patients with miofascial chronic pelvic pain.

scholarly journals A Surgical Case of Intracranial Arachnoid Cyst in a Dog.

2002 ◽  
Vol 33 (2) ◽  
pp. 19-23
Author(s):  
Motoji MOROZUMI ◽  
Hitoshi MAKINO ◽  
Yumiko UNO ◽  
Tsuyoshi NAKAJIMA ◽  
Kaoru KATO ◽  
...  
Keyword(s):  
Arachnoid Cyst ◽  
Surgical Case ◽  
Intracranial Arachnoid Cyst

Advances in Our Understanding of Pituitary Adenoma

2008 ◽  
Vol 04 (01) ◽  
pp. 88
Author(s):  
Sandra Pekic ◽  
Vera Popovic-Brkic
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Pituitary Tumors ◽  
Pituitary Hormones ◽  
Current Treatment ◽  
Thyroid Stimulating Hormone ◽  
Treatment Modalities ◽  
High Resolution Computed Tomography ◽  
New Therapeutic Approaches ◽  
Asymptomatic Patients

Pituitary adenomas are common benign monoclonal neoplasms— accounting for 15% of intracranial neoplasms—that may be clinically silent or secrete anterior pituitary hormones such as prolactin, growth hormone (GH), adrenocorticotrophic hormone (ACTH), or, rarely, thyroid-stimulating hormone (TSH) or gonadotrophins. Radiological studies for other reasons using high-resolution computed tomography (CT) or magnetic resonance imaging (MRI) detect incidental pituitary adenomas in approximately 20% of asymptomatic patients.1The incidence of the various types of adenoma varies;2prolactinomas are the most common pituitary adenomas. Clinically non-functioning pituitary adenomas (NFPAs), which do not secrete hormones, often cause local mass symptoms and represent one-third of pituitary adenomas. GH- and ACTH-producing adenomas each account for 10–15% of pituitary adenomas, while TSH-producing adenomas are rare. Pituitary adenomas are infrequent in childhood: fewer than 10% of pituitary adenomas are diagnosed before 20 years of age.3These adenomas can be either microor macroadenomas. The natural course of microadenomas is that a few tumors enlarge over a period of more than eight years.Although several genes and signaling pathways have been identified as important factors in the development of pituitary tumors, our understanding of pituitary tumorigenesis remains incomplete and is the focus of current research. The reason for this is that current treatment modalities fail to completely control this disorder and prevent the associated morbidity and mortality. This article reviews the advances in our understanding of pituitary adenoma, especially in the field of pathogenesis of pituitary tumors, and the possibility of new therapeutic approaches.

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