Moududul Haque

Intramedullary spinal cord tumour associated with neurofibromatosis type 1

SummaryWe investigated the characteristic features of intramedullary spinal cord tumour associated with neurofibromatosis type 1 (NF-1). We have experienced 44 cases of pathologically confirmed intramedullary spinal cord tumour. Diagnosis of NF-1 was done according to the criteria set by the National Institute of Health Consensus Development Conference. Within the described population NF-1 was diagnosed in two patients. Both the patients were male and histopathologically the tumours were anaplastic astrocytoma and glioblastoma multiforme respectively. 6 cases of NF-1 associated with intramedullary spinal cord tumour based on the above diagnostic criteria have so far been reported, including our 2 cases. Of these 6 cases, 5 were male and in one sex was not described. The tumour was an astrocytoma in all 6 cases. This finding suggested that intramedullary spinal cord tumour associated with NF-1 tends to occur predominantly in males and that histopathologically the tumour is likely to be an astrocytoma. We conclude that the criteria proposed by the National Institute of Health Consensus Development Conference are contributory in making an accurate pre-operative pathological diagnosis of intramedullary spinal cord tumour associated with NF-1.

Interictal Patterns of Cerebral Glucose Metabolism, Perfusion, and Magnetic Field in Mesial Temporal Lobe Epilepsy

Summary:  Purpose: To characterize the epileptogenic condition of patients with mesial temporal lobe epilepsy, the interictal patterns of glucose metabolism, perfusion, and magnetic field in the temporal lobe were evaluated by using [18F]fluorodeoxyglucose–positron emission tomography, [99mTc]‐ethylcysteinate dimer–single photon emission computed tomography, and magnetoencephalography (MEG).

Aetiology of Delayed Facial Palsy after Vestibular Schwannoma Surgery: Clinical Data and Hypothesis

Summary A patient developed delayed facial nerve palsy at the level of House-Brackmann grade I to grade III 10 days after vestibular schwannoma surgery by the suboccipital transmeatal approach. The palsy had completely recovered after one month. Immunological study showed reactivation of herpes simplex and magnetic resonance (MR) imaging demonstrated an abnormal enhancement pattern of the facial nerve; intense enhancement of the distal intracanalicular segment and labyrinthine segment, similar to the MR findings for Bells palsy. A prospective control study on the enhancement pattern of the functionally preserved facial nerve after vestibular schwannoma surgery in six cases showed a similar pattern to that of the normal facial nerve. Based on these findings, we propose the hypothesis that herpes simplex reactivation is an underlying cause of delayed facial palsy after vestibular schwannoma surgery.

Development of Lumbosacral Spina bifida: Three-Dimensional Computer Graphic Study of Human Embryos at Carnegie Stage Twelve

There is still some controversy as to whether sacral spina bifida in humans is the result of a defect of the primary or secondary neural tube. As somites are related to the development of vertebrae and the primary neural tube is related to the development of the spinal cord in embryos, it is very important to determine the number of somites in normal human embryos at the time of closure of the primary neural tube to understand the contribution of primary neural tube defects to the development of spina bifida. However, in the literature, the number of somites in stage 12 human embryos is still controversial. The aim of this study is to find the number of somites in human embryos at Carnegie stage 12. Four human embryos at Carnegie stage 12 were selected from the laboratory of the Congenital Anomaly Research Center in Japan. The neural tube and somites were reconstructed from their slices by a three-dimensional computer graphic reconstruction technique. The reconstructed embryos were examined from multidirectional magnified images. Thirty-three pairs of somites were present in all these reconstructed embryos. As the 33rd pair of somites corresponds to the fifth sacral segment, the presence of 33 pairs of somites at Carnegie stage 12 suggests that spina bifida develops from defects of the primary neural tube.

Intracranial adenoid cystic carcinoma of suprasellar region.

Summary Adenoid cystic carcinoma (ACC) is a relatively common head and neck tumor which grows slowly but locally aggressive and prone to recurrence. ACC most commonly arises in the major and minor salivary glands, Some rare cases of intracranial ACC with an unknown primary site have been reported. The authors present the first case of primary intracranial ACC of the suprasellar region. A 34 year-old female presented with one months duration of visual disturbance and galactorrhea. Magnetic resonance image (MRI) showed intra- and suprasellar mass mimicking a craniopharyngioma. There was no evidence of invasion from an extracranial site. The operative findings showed the mass existed under the arachnoid membrane and seemed to originate from the pituitary stalk. Pathological diagnosis was ACC. After the first operation, local recurrence and CSF dissemination to the lower clivus occurred within two months. Recurrence repeatedly treated by Gamma knife radiosurgery 10 times and 4 times by surgery during a 3 year follow-up period. But total removal of the tumor at the first operation along with radiosurgery may control the lesion and prevent further recurrence.

A Case of Pineal Region Meningioma without Dural Attachment, Presented with Bilateral Hearing Impairment

Pineal region meningioma without dural attachment and presenting with bilateral hearing impairment is very rare. Only a few cases have been reported. We had a patient presented with bilateral central deafness. Magnetic resonance imaging study showed well-enhanced pineal region mass. Operative ®ndings showed no dural attachment. Chordoid meningioma was con®rmed by histopathology. Hearing of the patient was improved after operation.

Craniotomy repair with titanium miniplates

Craniotomy repair with newly designed titanium miniplates is described. The miniplates, made of malleable titanium, include burr hole covers and kerf covers for use over the craniotomy line. The plates are easily contoured by hand and have been successfully placed in 39 cases with no incidence of infection and no cosmetic problems.

The morphological development of human basal ganglia

ABSTRACT  Human embryos were studied to clarify controversies surrounding the developmental morphology of the basal ganglia and related structures. Eleven human embryos at Carnegie stages 12 through 21 were examined and reconstructed by the three‐dimensional computer graphics technique. Findings on the neural morphology and telencephalic arteries reveal that (1) all parts of the basal ganglia and the amygdala are telencephalic structures; (2) the medial part of globus pallidus, preoptic area and medial septal nucleus originate from the medial ganglionic eminence; (3) the olfactory bulb, prepiriform area, caudate head, caudate body, caudate tail, nucleus accumben septi, putamen, lateral part of globus pallidus and the amygdala originate from the lateral gangiionic eminence.