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Optic chiasmatic-hypothalamic gliomas: Is tissue diagnosis essential?
El Khashab Mostafa,Nejat Farideh
Neurology India , 2011,
Abstract:
Double dermal sinuses: a case study
Mostafa El Khashab, Farideh Nejat, Abolhasan Ertiaei
Journal of Medical Case Reports , 2008, DOI: 10.1186/1752-1947-2-281
Abstract: Here we report a 5-year-old girl who presented with occasional headache. There were two dimples, one on the dorsal aspect of her head and another on her neck.Dermal sinuses are almost always singular and the co-existence of double dermal sinuses has not been reported previously.Dermal sinus tracts are rare congenital lesions located in the midline characterized by a cutaneous pit or dimple. They are defined as developmental anomalies in which the end result can be abnormal communication between the dermis and intracranial structures. They incorporate a tract of cutaneous ectoderm from the dorsal midline skin that extends for a variable distance into the underlying mesenchymal tissue and in many instances penetrates the dura to end within the thecal sac adjacent to, or continuous with the neural tube [1]. Sinuses may be asymptomatic or present clinically with varying degrees of drainage from their cutaneous openings, recurrent bouts of septic or aseptic meningitis, or mass effect on the cerebrospinal fluid (CSF) pathways and consequent hydrocephalus [2].These lesions are almost always solitary and co-existence of double dermal sinuses has not been reported previously. We report a girl with asymptomatic double dermal sinuses.This 5-year-old girl presented with occasional headache. She was the first child of nonconsanguineous parents without significant past medical history. On physical examination, the child was totally normal neurologically and generally. There were two dimples on the dorsal aspect of her head and neck. A fine dimple was noted at the midline occipital area above the inion, surrounded by a small smooth hairless area, harboring a few thick black hairs at the ostium without any discharge (Fig. 1a). The other dimple was at the midcervical area with a large mouth and hemangiomatous skin discoloration around the dimple (Fig. 1b). Brain magnetic resonance imaging (MRI) was performed, which was normal without bone defect and intracranial sinus or tract. Cerv
Why Flushing the Valve Cannot Be A Reliable Method to Evaluate the Ventriculoperitoneal Shunt Function?
Farideh Nejat,Mostafa El-Khashab
Iranian Journal of Pediatrics , 2011,
Abstract:
Congenital dermoid cysts of the anterior fontanel
Majed Masood,Nejat Farideh,El Khashab Mostafa
Indian Journal of Plastic Surgery , 2008,
Abstract:
Possible causes of seizure after spine surgery
Habibi Zohreh,Nejat Farideh,El Khashab Mostafa
Journal of Pediatric Neurosciences , 2010,
Abstract: Seizure after laminectomy for spinal procedure is very rare and has not been reported after lipomyelomeningocele surgery beforehand. Here, two cases of seizure following laminectomy for lipomyelomeningocele are reported. The exact etiology of the event is unknown but anesthetic material, pneumocephalus, intracranial hypotension subsequent to cerebrospinal fluid leakage after spinal procedures, spinal-induced seizure and the potential toxic effect of fat molecules could be considered.
Congenital spinal tumor in a patient with encephalocele and hydrocephalus: a case report
Farid Radmanesh, Farideh Nejat, Fatemeh Mahjoub, Mostafa El Khashab
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-9
Abstract: We report the case of an Iranian girl with a history of encephalocele surgery, who, at the age of four years, developed an intramedullary spinal teratoma, and discuss the pathogenesis of this association.To the best of our knowledge, this is the first report of an association between encephalocele and spinal teratoma.Encephalocele refers to a group of rare congenital anomalies of the central nervous system (CNS), where brain tissue protrudes from a defect in the skull [1]. Its prevalence has been estimated to be 0.8 to four in every 10,000 live births [2].Teratomas are tumors derived from all three germ layers [3]. In children, teratomas are more commonly found in the sacrococcygeal region than in the spinal cord [4], which occurs in one of 38,500 viable births. Intramedullary spinal teratomas are rare tumors [5]. In 41.7% of teratomas, a concomitant anomaly of the vertebral canal is found, most commonly a diastematomyelia, [4]. However to the best of our knowledge, there is nor repot of an association with encephalocele in the English literature.We report a case of encephalocele and lumbar intramedullary teratoma and discuss the possible etiology.A four-year old Iranian girl was referred to the neurosurgical department with severe back pain and motor regression. She was the second child of nonconsanguineous parents, and was delivered by elective Cesarean section due to being repeat. She had a history of occipital encephalocele, which was treated surgically during the neonatal period and she later received a shunt to treat progressive hydrocephalus. She could sit at nine month of age and stand at two years, but was unable to walk. Six months before her referral, she had developed back pain, which was particularly severe at night, and after three months, she was unable to stand.On physical examination, our patient was found to be generally normal, with good mental performance, and normal results from a neurological examination of the arms. She had a head circumferenc
Acquired craniomeningocele in an infant with craniosynostosis: a case report
Mostafa El Khashab, Farideh Nejat, Shahrooz Yazdani, Nima Baradaran
Journal of Medical Case Reports , 2010, DOI: 10.1186/1752-1947-4-104
Abstract: We report the case of a 3-month-old Caucasian boy with multiple suture craniosynostosis and with acquired craniomeningocele presenting as a bulging mass in the lateral occipital area.To the best of our knowledge, this is the first report of a patient with multiple suture craniosynostosis and acquired craniomeningocele.The incidence of non-syndromic craniosynostosis is approximately 0.4 to 1 in 10,000 live births. A single suture is most commonly implicated. Syndromic craniosynostosis, with a more generalized pattern, is much less common [1]. The majority of patients with craniosynostosis have various skull alterations, which are severe in syndromic type and are mainly considered to have arisen from compensatory growth of the skull after stenosis of some sutures and high intracranial pressure. Skull deformities and beaten copper pattern are common findings in craniosynostosis. Lückensch?del (lacunar skull) is rarely observed, occuring in approximately 10% of patients with craniosynostosis [2,3]. To the best of our knowledge, cranial meningocele has not been reported with craniosynostosis before. We describe a patient with craniosynostosis with acquired craniomeningocele and hypothesize probable causes for this abnormal presentation.A 3-month-old Caucasian boy was referred to our hospital due to abnormal shape of his head and a bulging mass in the left occipital area. The mass had been found one month before referral with a gradual increase in size, and fluctuation in size during crying and sleeping. The lesion was 1.5 × 2 cm in maximum diameter (Figure 1), very tense, non-tender, and pulsatile. His head circumference was on the 25th percentile for his age class. There was apparent hypertelorism with exophthalmia and age-appropriate developmental milestones. Askull X-ray (Figure 2) and a brain computed tomography (CT) scan showed fusion of coronal, lambdoid and basal sutures with a diffuse beaten copper appearance (Figure 3). Hydrocephalus was not found in the CT scan
Progressive skin necrosis of a huge occipital encephalocele
Andarabi Yasir,Nejat Farideh,El-Khashab Mostafa
Indian Journal of Plastic Surgery , 2008,
Abstract: Objects: Progressive skin necrosis of giant occipital encephalocoele is an extremely rare complication found in neonates. Infection and ulceration of the necrosed skin may lead to meningitis or sepsis. We present here a neonate with giant occipital encephalocoele showing progressive necrosis during the first day of his life. Methods: A newborn baby was found to have a huge mass in the occipital region, which was covered by normal pink-purplish skin. During the last hours of the first day of his life, the sac started becoming ulcerated accompanied with a rapid color change in the skin, gradually turning darker and then black. The neonate was taken up for urgent excision and repair of the encephalocele. Two years after the operation, he appears to be well-developed without any neurological problems. Conclusion: Necrosis may have resulted from arterial or venous compromise caused by torsion of the pedicle during delivery or after birth. The high pressure inside the sac associated with the thin skin of the encephalocoele may be another predisposing factor. In view of the risk of ulceration and subsequent infection, urgent surgery of the necrotizing encephalocele is suggested.
Sudden deterioration due to intra-tumoral hemorrhage of ependymoma of the fourth ventricle in a child during a flight: a case report
Ali Mahdavi, Nima Baradaran, Farideh Nejat, Mostafa El Khashab, Maryam Monajemzadeh
Journal of Medical Case Reports , 2010, DOI: 10.1186/1752-1947-4-143
Abstract: We report the case of a two-and-a-half-year-old Caucasian, Iranian boy with a hemorrhaging brain tumor. He had a posterior fossa midline mass and severe hydrocephalus. He had been shunted for hydrocephalus four weeks earlier and was subsequently referred to our center for further treatment. The hemorrhage occurred in an infra-tentorial ependymoma, precipitated by an approximately 700-mile air journey at a maximum altitude of 25,000 feet.A pre-existing intra-cranial mass lesion diminishes the ability of the brain to accommodate the mild environmental disturbances caused by hypercarbia, increased venous pressure and reduced cerebral blood flow during long air journeys. This is supported by a literature review, based on our current knowledge of physiological changes during air travel.Hemorrhage into brain neoplasms is a relatively uncommon but not a rare occurrence with obvious relevance to the neurosurgeon. In general, about 5% to 10% of all brain tumors develop hemorrhage of some type. The tissue type of the tumor itself is clearly related to its propensity to bleed, as metastatic lesions are known to carry a high risk of hemorrhage. Of the primary brain tumors, glioblastoma appears to be the most common source of intra-cerebral hemorrhage. Oligodendrogliomas, astrocytomas, ependymomas and medulloblastomas have also been associated with intra-cranial hemorrhage. Less commonly, benign tumors such as pituitary adenomas and meningiomas have also been demonstrated to bleed [1].Several pathophysiological factors have been described to account for spontaneous hemorrhage within brain tumors, including coagulation defects and vascular abnormalities [2]. However, only a few cases of hemorrhage precipitated by air travel have been reported. Some physiological changes are well-documented to occur during commercial flights. These include decreased barometric pressure, cerebral hypoperfusion or hypoxemia, mild degrees of hypercarbia and local hemostatic abnormalities which may be
Umbilical Hernia and Ventriculoperitoneal Shunt Complications
Maryam Ardalan,Ali Hoseinpoor Rafati,Faridh Nejat,Mostafa El-Khashab
Iranian Journal of Pediatrics , 2011,
Abstract: No Abstract
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