Penetrating injury of face by a large machine bolt-a rare case report.

Foreign bodies are often encountered by oral and maxillofacial surgeons and may present a diagnostic challenge, due to many factors such as nature of foreign body material, the size of the object, difficult access and a close anatomical relationship of the foreign body to vital structures. There are foreign bodies like glass pieces, plastic materials, wooden pieces are not seen in routine radiographs and often misdiagnosed. To reduce the chances of complications presence of foreign body in the patients head and neck region must be thoroughly investigated by the surgeon. Penetrating injuries by blunt object is rare finding in maxillofacial region. Here we present an unusual case of penetrating injury by a large machine bolt (15.0 cm) in a 7 year old child, embedded on left side of face.

Epidermoid cyst in the floor of mouth with sub mental component.

Epidermoid cysts in the oral cavity are very rare. They are slow and progressive in growth. Although congenital, they are diagnosed in second or third decayed of life. Epidermoid cyst in the floor of mouth is painless, doughy in consistency, fluctuant lesion and causes no symptoms until they are large enough to interfere with chewing or speech. In this article a 23 years old girl presented with lesion almost filling the oral cavity as well as sub mental component giving appearance of double chin. Lesion was surgically enucleated intraorally. Histopathological examination confirmed the presence of epidermoid cyst. Patient did well post operatively and there was no evidence of recurrence upto 1 year of follow up.

Melanotic neuroectodermal tumor of infancy: Report of a case associated with high urinary excretion of Vanilmandelic acid.

Melanotic neuroectodermal tumor of infancy is a rare congenital neoplasm involving the head and neck region in young patients. A case of melanotic neuroectodermal tumor of infancy is presented. This tumor occurred in right maxillary alveolar ridge in a 4-month-old infant. The present case showed an increased urinary level of vanilmandelic acid, confirming that the tumor is originated from neural crest. Clinical assessment, histologic diagnosis, and laboratory findings supported the diagnosis.

Acute subdural haematoma : a reappraisal.

Acute subdural haematoma is a well-entrenched nosological entity implying subdural collection of blood following acute head injury. Pathologically, it is usually associated with or, for that matter, secondary to cerebral contusion and laceration. Based on cumulated experience, clinical and pathological studies it is proposed that, for too long the neurosurgeons have put emphasis on the clot rather than the totality of the pathological anatomy and that they have focused their therapeutic strategy on removal of the accumulated blood, unmindful of the associated parenchymatous lesion. Not surprisingly, such attempts have been associated with a very high mortality. On the basis of nearly four decades of personal experience and critical review of the literature, evidence has been provided that to reduce the mortality associated with this condition, it is necessary to evolve a strategy, not only to evacuate the blood but comprehensively deal with the associated parenchymatous lesions and the cascade of secondary insult to the underlying brain.

Epileptic seizures in supratentorial gliomas.

Two hundred patients with supratentorial glioma; astrocytoma (pilocytic, fibrillary, gemistocytic) 82, mixed glioma (oligoastrocytoma) 46, oligodendroglioma 8, malignant (anaplastic) astrocytoma 33 and glioblastoma multiforme 31, surgically treated for the tumours and followed up for one to sixteen years, were retrospectively analysed for the incidence of pre and postoperative epileptic seizures. 122 patients (61%) had seizures preoperatively. 62 (50.8%) of them had at least one or more seizures during follow up. Seizures were persistent in 22 patients. Doubtful, or one or two minor seizures occurred in 19 cases. Six patients in this group had seizure only at the time of CT confirmed recurrence, after a seizure free interval of one to nine years. Amongst 78 patients who did not have seizures preoperatively, 24 (30.6%) developed seizures during the postoperative follow up period. Recurrent attacks were reported only by 5 patients while 15 patients had seizure(s) only at the time of recurrence of tumour. Two patients had a few seizures in the early postoperative period and none thereafter, while doubtful seizures were reported by two patients.

The decade of the brain: a brief review.

Recognising the huge burden of neurological and psychiatric disorders and prompted by the potentials of new techniques of molecular biology, biotechnology, genetics and imaging to study these, the 1990s were declared the 'decade of the brain'. This stimulated global scientific efforts to understand the human brain in health and disease. This review summarises some of the major research achievements during the decade. While it is impossible to provide a comprehensive summary of the voluminous data that has been generated, it was decided to provide a bird's eye view of the recent advances in the fields of developmental neurobiology, neurogenetics, neurochemistry and imaging of the brain, which have direct relevance for the clinicians.