Sureswar Mohanty

Role of histamine in traumatic brain edema: An experimental study in the rat

The possibility that histamine plays a role in the formation of traumatic brain edema was investigated in the rat. A 3 mm deep and 3 mm long stab injury was performed in the right parietal cortex under urethane anaesthesia. The brain water content and histamine levels in plasma and brain were measured at the end of 1, 2 and 5 h periods after trauma. There was a 3.46% increase in brain water content in the traumatized hemisphere from the value in the control group at 5 h. The histamine content was increased by 107% in plasma and 51% in the traumatized brain hemisphere from the control value at this time period. The increased brain water content as well as the elevated plasma and brain histamine levels were prevented by prior treatment with the histamine H2-receptor antagonist cimetidine. Mepyramine (a histamine H1-receptor antagonist) failed to reduce the increased brain water content and the histamine levels in plasma and brain remained high. The results strongly indicate that histamine has a role in the formation of early traumatic brain edema and that this reaction can be influenced by pharmacological procedures.

Plasma biogenic amines in head injury

The circulating levels of plasma catecholamines (norepinephrine and epinephrine) and serotonin (5-HT) were estimated in 65 cases of head injury. The plasma levels of these amines of patients were compared with those of normal healthy volunteers. The levels were significantly higher in severe head injuries as compared to mild injuries and have prognostic significance.

Intradural enterogenous cyst.

A 23 year old woman with an intradural extramedullary enterogenous cyst in the cervical region, unassociated with vertebral cleft, presented with two episodes of neurological disturbance at an interval of five years. Subtotal excision of the anteriorly placed cyst at C6 vertebral level was followed by rapid and complete recovery.

Intramedullary neurofibroma of the cervical spinal cord: case report with review of the literature.

A case of cervical intramedullary neurofibroma diagnosed and surgically treated is reported. This patient, a 27-year-old man, had no evidence of von Recklinghausens disease. The case is discussed, and a review of literature is presented.

Hydrocephalus induced by cyclophosphamide in chick embryos.

Cyclophosphamide was injected into the yolk sac of chick embryos for 6 days (Days 0-5). Embryos collected on the 21st day of incubation had a 37% incidence of hydrocephalus. Agenesis or stenosis of the aqueduct, as well as hypertrophy of the choroid plexus, was observed in 20% of the embryos.

Acute hemorrhage within intradural extramedullary schwannoma in cervical spine presenting with quadriparesis.

Schwannoma with acute hemorrhage is rarely seen. A 44-years-old male patient presented with complaint of neck pain and acute onset of quadriparesis. Magnetic resonance imaging (MRI) of his cervical spine revealed evidence of an intradural extramedullary tumor with intratumoral acute hemorrhage. He was operated in emergency and the mass was found to be schwannoma with acute hemorrhage. Post operatively the patient improved significantly. Though schwannomas show microscopic intratumoral hemorrhage and necrosis at times, schwannoma with acute hemorrhage resulting acute onset of neurological deficit is very uncommon.

Congenital dermal sinus in mid-dorsal spine with large intramedullary dermoid cyst in an 18-months-old child

Intramedullary dermoid cyst is a rare entity. It is usually associated with spinal dysraphism and dermal sinus. Our case is an 18-months-old female child who presented with history of fever and mild difficulty in moving left leg. She had a sinus in mid dorsal spine since birth with history of intermittent discharge from it. On magnetic resonance imaging of spine she was diagnosed to have large intramedullary epidermoid/dermoid cyst in the D2-7 vertebral level with a sinus tract. A dermoid cyst along with the sinus tract was excised. Post-operative follow up period was uneventful with full recovery.

Esthesioneuroblastoma with early drop metastasis to spinal cord

436 Neurology India | Jul-Aug 2012 | Vol 60 | Issue 4 normal capillary bed within the subcutaneous fatty layer of the scalp.[2] Most patients with scalp AVMs complain of headache, tinnitus and a subcutaneous (SC) mass with a palpable thrill. Enlargement of the mass over time can lead to worsening of these symptoms. Factors such as trauma, birth, and hormonal imbalance have been suggested as possible causes for the progression of these lesions.[3] They grow by having feeders from subcutaneous or intracranial vessels. The hemodynamic changes within the AVM can result in aneurysm formation. A few decades ago manual compression of the feeding artery used to be a method of treatment with an expectation of disappearance of scalp AVM over a period of time. However, the results were never encouraging. Various therapeutic modalities available to manage these lesions include: surgical excision, vessel ligation, transarterial and transvenous embolization, injection of sclerosant into the nidus, and electrothrombosis.[4] Scalp AVMs are generally treated by surgical excision. However, there is a risk of recurrence due to collateral supply. Surgical excision is associated with large skin incision, blood loss, and sometimes damage to the facial nerve. Endovascular treatment is used as an adjunct to the surgery or in isolation. Injection of the AVM has been done directly or by using ultrasound guidance. Embolization of AVM can be done using liquid embolizing material e.g. NBCA, ethanol or solid material like surgecele and gelfoam. Some authors have used a combination of trombin and transarterial coil placement. As there is no method which can avoid recurrence, the endovascular procedures have an edge due to their minimally invasive nature. There are three stages of scalp AVM.[1] Type 1 (a and b) and Type 2 are the most suitable AVMs for endovascular procedures.

Acute spontaneous cervical spinal posterior epidural hematoma in a young adult patient

Cervical laminectomy was done from C4 to C7 level. About 15 g of solid blood clot was evacuated beneath the ligamentum flavum [Figure 2]. No vascular malformation or tumor was seen. Pathological examination of the clot reveals no malignant cells or vascular malformation. The term “spontaneous” has been named here as no precipitating factor or etiology could be identified after investigation and operation. The patient showed gradual improvement of symptoms by 7th post-operative day and was asymptomatic after 3 weeks of follow-up.

Hemifacial spasm caused by arachnoid cyst

The authors report a rare case of left cerebellopontine angle arachnoid cyst in a 38 year old man presenting with hemifacial spasm. Decompression of the cyst was followed by a total recovery from hemifacial spasm. Various space occupying lesions in the cerebellopontine angle have been reported to be associated with hemifacial spasm. The most common cause of hemifacial pasm observed is vascular compression of facial nerve. However, arachnoid cyst at the cerebellopontine angle is a very rare cause of hemifacial spasm.