Journal of neurosciences in rural practice
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J Neurosci Rural Pract · Apr 2015
Retrospective analysis of perioperative factors on outcome of patients undergoing surgery for Moyamoya disease.
The short term outcome of patients undergoing surgery for Moyamoya disease can be affected by various perioperative factors. However, due to lesser prevalence of this disease in our country, data relating the effect of perioperative factors on the overall neurological outcomes of these patients is lacking. ⋯ Maintaining the intraoperative EtCO2 between 31-35 mmHg may be associated with short hospital stay when compared to those who have intraoperative EtCO2 either less than 31 mmHg or more than 35 mmHg.
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J Neurosci Rural Pract · Apr 2015
Acute dizziness in rural practice: Proposal of a diagnostic procedure.
Acute dizziness is a frequent index symptom in the emergency department as well as in the rural practice office. Most acute dizziness, however, is not dangerous, but some types are highly dangerous. Clinical routine acute dizziness can be separated into frequent benign syndromes including benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Meniθre's disease or vestibular migraine, and what is here referred to as the "white shark" of dizziness, i.e. a stroke in the posterior circulation or more rarely a tumor in the posterior fossa. A practical concept is presented to clarify most frequent acute dizziness syndromes using clinical and low budget methods.
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J Neurosci Rural Pract · Jan 2015
Vaginal extrusion of a ventriculo-peritoneal shunt catheter in an adult.
Ventriculo-peritoneal shunts (VPS) are commonly used in the treatment of various neurosurgical conditions, including hydrocephalus and pseudotumor cerebri. We report only the second case of vaginal extrusion of a VPS catheter in an adult, and the first case with a modern VPS silastic peritoneal catheter. A 45-year-old female with a history of VPS for pseudotumor cerebri, Behcet's syndrome, and hysterectomy presented to our institution with the chief complaint of tubing protruding from her vagina after urination. ⋯ Ventricular catheter cultures were positive for diphtheroids. After an appropriate course of antibiotics, a contralateral ventriculo-pleural shunt was placed one week later. Although vary rare, vaginal extrusion can occur in adults, even with modern VPS catheters.
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Sturge-Weber syndrome (SWS), a rare sporadic neurocutaneous disease, is characterized by a congenital unilateral port-wine nevus affecting the area innervated by V1, ipsilateral leptomeningeal angiomatosis, and calcification in the occipital or frontoparietal region and glaucoma/vascular eye abnormality. Three types of SWS have been described in literature: Type I (classic) demonstrates facial and leptomeningeal angioma, often with glaucoma; type II has facial angioma and glaucoma, with no evidence of intracranial lesions; and type III (rarest) presents with only leptomeningeal angioma. ⋯ Recognition of this type of SWS is important, as our patient had been misdiagnosed and received inappropriate antiepileptic drugs for six years. We suggest that in the appropriate clinical scenario, the diagnosis of SWS without facial nevus should be considered before labelling idiopathic or cryptogenic localization-related epilepsy, and gadolinium-enhanced magnetic resonance imaging (MRI) should be done in clinically suspicious cases of SWS, without facial nevus.
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J Neurosci Rural Pract · Nov 2014
Disseminated neurocysticercosis presenting as isolated acute monocular painless vision loss.
Neurocysticercosis, the most common parasitic infection of the nervous system, is known to affect the brain, eyes, muscular tissues and subcutaneous tissues. However, it is very rare for patients with ocular cysts to have concomitant cerebral cysts. ⋯ Although such a vision loss after initiation of antiparasitic treatment has been mentioned previously, acute monocular vision loss as the presenting feature of ocular cysticercosis is rare. We present a brief review of literature along with this case report.