A study of retrospective analysis of the outcome of parasagittal meningioma

Background: Meningioma is a common benign tumours treated by neurosurgeons. They develop from arachnoid cap cells within the thin spider web-like membrane covering the brain and spinal cord. The arachnoid is one of the three protective layers of the central nervous system collectively known as the meninges surrounding the brain and spinal cord. The aim of our study is to analyze the outcome of parasagittal meningioma.Methods: The details of the patients diagnosed with parasagittal meningioma and operated upon during the study period of 2009-2013 were retrospectively collected from the medical records kept in the department of neurosurgery and different study parameters were documented for analysis.Results: Out of the total 40 patients with meningioma 15 (37.5%) patients had parasagittal meningioma in anterior 1/3rd of sagittal sinus, 21 (52.5%) patients had parasagittal meningioma in middle 1/3rd of sagittal sinus and 4 (10%) patients had parasagittal meningioma in posterior 1/3rd of the sagittal sinus and 28 (70%) patients  are treated by gross total resection (GTR), 7 (17.5%) patients were treated by subtotal resection (STR) and 5 (12.5%) patients were treated by dendritic cell (DC) and postoperatively 22 patients (55%) did not develop any complications. Weakness develops for 12 patients (30%), followed by recurrence in 3 patients (7.5%) and 3 patients (7.5%) died.Conclusions: Conservative resection of the tumour with residual lesion within the sagittal sinus followed by adjuvant treatment with modalities like radiotherapy, chemotherapy or targeted therapy for the residual lesion is an accepted mode of treatment.

Pyoderma Gangrenosum with Pure Red Cell Aplasia.

Pyoderma gangrenosum is an inflammatory condition of the skin commonly associated with inflammatory bowel disease and rheumatoid arthritis, but also associated with various hematological malignancies. We describe its association with pure red cell aplasia in a four year old boy who presented with progressive skin lesions, fever and pallor, and improved with corticosteroid therapy.

Usefulness of concomitant nitrate administration for the enhancement of viability detection with myocardial perfusion imaging.

Myocardial viability assessment is crucial in the evaluation of patients who had prior myocardial infarction for revascularisation procedures. Conventional methods include nuclear myocardial perfusion imaging, dobutamine stress echocardiography and positron emission tomography. Utility of nitrate in assessment of viability was assessed. Twenty-five patients with prior myocardial infarction underwent 99mTc-sestamibi single photon emission computed tomography protocol of stress, rest and post 5 mg sublingual isorbide dinitrate. The mean age of the patients was 51.28 years. Eight (32%) had reduction in perfusion defect and increased tracer uptake following nitrate administration. It is concluded that addition of nitrate adds to utility of conventional perfusion imaging in the assessment of myocardial viability.