Rakesh Redhu - Academia.edu (original) (raw)

Papers by Rakesh Redhu

Research paper thumbnail of Diabetes insipidus associated with a thickened pituitary stalk in a case of Langerhans Cell Histiocytosis

Journal of pediatric neurosciences, 2011

Diabetes insipidus (DI) associated with a thickened pituitary stalk is a diagnostic challenge in ... more Diabetes insipidus (DI) associated with a thickened pituitary stalk is a diagnostic challenge in the pediatric population. Langerhans Cell Histiocytosis (LCH) is a rare cause of this entity. A 4-year-old male child presented with central DI of 1-year duration, associated with a thickened pituitary stalk. The etiology for the same remained elusive as the patient had no other manifestation to suggest LCH. A year later, the patient developed a left frontal scalp swelling. Neuroradiology demonstrated multiple punched out osteolytic lesions in both the frontal bones. The infundibulum was thickened and showed post-contrast enhancement. Histology and immunohistochemistry (IHC) of the biopsy specimen confirmed LCH. The child was administered chemotherapy according to LCH protocol, which resulted in 33% reduction in the size of the skull lesions. The DI was controlled with medical management. The present case highlights the need for serial follow-up and magnetic resonance (MR) imaging that l...

Research paper thumbnail of Infratorcular Meningoencephalocele with Dermoid Cyst

Pediatric Neurosurgery, 2010

Encephalocele represents one end of the spectrum of open neural tube defects. We report an infant... more Encephalocele represents one end of the spectrum of open neural tube defects. We report an infant with Chiari type 3 malformation manifesting as infratorcular occipital meningoencephalocele with dermoid cyst. To our knowledge, this is the first time that this association is described. The pathogenesis, surgical treatment, prognosis and management difficulties are also being discussed.

Research paper thumbnail of Primary amenorrhea due to empty sella: an underestimated entity

Turkish Neurosurgery, 2011

We report a 16-year-old girl who had stunted growth and primary amenorrhea presenting with headac... more We report a 16-year-old girl who had stunted growth and primary amenorrhea presenting with headache and vomiting. MRI of brain showed posterior fossa dermoid cyst with hydrocephalus and empty sella. Growth hormone (GH), Leutinizing hormone (LH) and Follicular stimulating hormone (FSH) were grossly reduced on endocrinological work-up. She underwent suboccipital midline craniectomy and complete excision of dermoid cyst .She had no additional deficit after the surgery. She had menarche six months after the surgery and developed adequate secondary sexual characters, however her height remains subnormal at follow-up after 2 years as compared to age matched controls. We briefly review the radiological features, pathogenesis and outcome of this underestimated entity.

Research paper thumbnail of Supratentorial glioblastoma multiforme with spinal metastases

Journal of Craniovertebral Junction and Spine, 2010

Glioblastoma multiforme is the most common malignant brain tumor in adults. Metastasis of intracr... more Glioblastoma multiforme is the most common malignant brain tumor in adults. Metastasis of intracranial glioblastoma via the cerebrospinal fl uid to the spine is a rare occurrence. We present two cases of glioblastoma multiforme with spinal leptomeningeal spread who presented with back pain and paraparesis.

Research paper thumbnail of Giant cell tumor of dorsal vertebral body

Journal of Craniovertebral Junction and Spine, 2012

A 30-year-old female patient presented with complaints of backache, weakness in both lower limbs ... more A 30-year-old female patient presented with complaints of backache, weakness in both lower limbs and bladder/ bowel dysfunction. Imaging showed an osteolytic lesion at tenth dorsal (D10) vertebra with anterior compression on the spinal cord. Complete intralesional tumor excision with reconstruction was carried out using the anterolateral extrapleural approach. Histopathological examination was suggestive of giant cell tumor (GCT). Because of complete intralesional tumor excision and fear of post-radiation osteonecrosis of bone used for delayed bony union, a conservative approach was used, and radiation therapy was not given. After one year of follow-up patient is doing well without any recurrence of the tumor and is ambulant with support. GCT of dorsal vertebral body is an uncommon entity and total en bloc excision is diffi cult. Therefore, the treatment strategy is not well-defi ned. We discuss in brief about incidence, presentation and various treatment modalities available for spinal GCT.

Research paper thumbnail of Spontaneous tension pneumocephalus in a patient with subdural empyema

Journal of Clinical Neuroscience, 2011

We report a 45-year old male who developed subdural empyema (SE) with tension pneumocephalus. The... more We report a 45-year old male who developed subdural empyema (SE) with tension pneumocephalus. The patient was admitted unconscious with tonic extensor response to pain. A ''gas-forming'' organism, Escherichia coli, was detected. Surgical evacuation of the pus and treatment with the appropriate antibiotic did not result in amelioration of his symptoms and the patient died. We identified a rare clinical situation when the SE cavity had a relatively large air loculus that was clearly related to gas-forming bacteria. It appeared that the patient had developed tension pneumocephalus related to the air produced by the pathogen. To our knowledge, this is the first report of a gas-forming organism in an abscess cavity that resulted in tension pneumocephalus and related symptoms.

Research paper thumbnail of Multicompartmental cerebrospinal fluid dissemination of cerebellar pilocytic astrocytoma at presentation

Journal of Clinical Neuroscience, 2011

A 26-year-old male presented with a rare cerebellar pilocytic astrocytoma with multicompartmental... more A 26-year-old male presented with a rare cerebellar pilocytic astrocytoma with multicompartmental subarachnoid metastases. Cerebrospinal fluid dissemination of low grade astrocytoma at presentation is rare in adults. In the present patient, clinical and neuroradiological follow-up at 4 years, without adjuvant treatment, revealed non progression of tumors. The occurrence of benign dormancy, low grade tumor histology and multifocal involvement of the neuraxis is rare. Close clinical observation is the best approach for management of such a patient. The relevant literature is discussed.

Research paper thumbnail of Simultaneous combined single stage removal of immature teratoma at anterior skull base: A case report

Clinical Neurology and Neurosurgery, 2012

Research paper thumbnail of Spontaneous tension pneumocephalus in a patient with subdural empyema

Journal of Clinical Neuroscience, 2011

We report a 45-year old male who developed subdural empyema (SE) with tension pneumocephalus. The... more We report a 45-year old male who developed subdural empyema (SE) with tension pneumocephalus. The patient was admitted unconscious with tonic extensor response to pain. A ''gas-forming'' organism, Escherichia coli, was detected. Surgical evacuation of the pus and treatment with the appropriate antibiotic did not result in amelioration of his symptoms and the patient died. We identified a rare clinical situation when the SE cavity had a relatively large air loculus that was clearly related to gas-forming bacteria. It appeared that the patient had developed tension pneumocephalus related to the air produced by the pathogen. To our knowledge, this is the first report of a gas-forming organism in an abscess cavity that resulted in tension pneumocephalus and related symptoms.

Research paper thumbnail of Diabetes insipidus associated with a thickened pituitary stalk in a case of Langerhans Cell Histiocytosis

Journal of pediatric neurosciences, 2011

Diabetes insipidus (DI) associated with a thickened pituitary stalk is a diagnostic challenge in ... more Diabetes insipidus (DI) associated with a thickened pituitary stalk is a diagnostic challenge in the pediatric population. Langerhans Cell Histiocytosis (LCH) is a rare cause of this entity. A 4-year-old male child presented with central DI of 1-year duration, associated with a thickened pituitary stalk. The etiology for the same remained elusive as the patient had no other manifestation to suggest LCH. A year later, the patient developed a left frontal scalp swelling. Neuroradiology demonstrated multiple punched out osteolytic lesions in both the frontal bones. The infundibulum was thickened and showed post-contrast enhancement. Histology and immunohistochemistry (IHC) of the biopsy specimen confirmed LCH. The child was administered chemotherapy according to LCH protocol, which resulted in 33% reduction in the size of the skull lesions. The DI was controlled with medical management. The present case highlights the need for serial follow-up and magnetic resonance (MR) imaging that l...

Research paper thumbnail of Infratorcular Meningoencephalocele with Dermoid Cyst

Pediatric Neurosurgery, 2010

Encephalocele represents one end of the spectrum of open neural tube defects. We report an infant... more Encephalocele represents one end of the spectrum of open neural tube defects. We report an infant with Chiari type 3 malformation manifesting as infratorcular occipital meningoencephalocele with dermoid cyst. To our knowledge, this is the first time that this association is described. The pathogenesis, surgical treatment, prognosis and management difficulties are also being discussed.

Research paper thumbnail of Primary amenorrhea due to empty sella: an underestimated entity

Turkish Neurosurgery, 2011

We report a 16-year-old girl who had stunted growth and primary amenorrhea presenting with headac... more We report a 16-year-old girl who had stunted growth and primary amenorrhea presenting with headache and vomiting. MRI of brain showed posterior fossa dermoid cyst with hydrocephalus and empty sella. Growth hormone (GH), Leutinizing hormone (LH) and Follicular stimulating hormone (FSH) were grossly reduced on endocrinological work-up. She underwent suboccipital midline craniectomy and complete excision of dermoid cyst .She had no additional deficit after the surgery. She had menarche six months after the surgery and developed adequate secondary sexual characters, however her height remains subnormal at follow-up after 2 years as compared to age matched controls. We briefly review the radiological features, pathogenesis and outcome of this underestimated entity.

Research paper thumbnail of Supratentorial glioblastoma multiforme with spinal metastases

Journal of Craniovertebral Junction and Spine, 2010

Glioblastoma multiforme is the most common malignant brain tumor in adults. Metastasis of intracr... more Glioblastoma multiforme is the most common malignant brain tumor in adults. Metastasis of intracranial glioblastoma via the cerebrospinal fl uid to the spine is a rare occurrence. We present two cases of glioblastoma multiforme with spinal leptomeningeal spread who presented with back pain and paraparesis.

Research paper thumbnail of Giant cell tumor of dorsal vertebral body

Journal of Craniovertebral Junction and Spine, 2012

A 30-year-old female patient presented with complaints of backache, weakness in both lower limbs ... more A 30-year-old female patient presented with complaints of backache, weakness in both lower limbs and bladder/ bowel dysfunction. Imaging showed an osteolytic lesion at tenth dorsal (D10) vertebra with anterior compression on the spinal cord. Complete intralesional tumor excision with reconstruction was carried out using the anterolateral extrapleural approach. Histopathological examination was suggestive of giant cell tumor (GCT). Because of complete intralesional tumor excision and fear of post-radiation osteonecrosis of bone used for delayed bony union, a conservative approach was used, and radiation therapy was not given. After one year of follow-up patient is doing well without any recurrence of the tumor and is ambulant with support. GCT of dorsal vertebral body is an uncommon entity and total en bloc excision is diffi cult. Therefore, the treatment strategy is not well-defi ned. We discuss in brief about incidence, presentation and various treatment modalities available for spinal GCT.

Research paper thumbnail of Spontaneous tension pneumocephalus in a patient with subdural empyema

Journal of Clinical Neuroscience, 2011

We report a 45-year old male who developed subdural empyema (SE) with tension pneumocephalus. The... more We report a 45-year old male who developed subdural empyema (SE) with tension pneumocephalus. The patient was admitted unconscious with tonic extensor response to pain. A ''gas-forming'' organism, Escherichia coli, was detected. Surgical evacuation of the pus and treatment with the appropriate antibiotic did not result in amelioration of his symptoms and the patient died. We identified a rare clinical situation when the SE cavity had a relatively large air loculus that was clearly related to gas-forming bacteria. It appeared that the patient had developed tension pneumocephalus related to the air produced by the pathogen. To our knowledge, this is the first report of a gas-forming organism in an abscess cavity that resulted in tension pneumocephalus and related symptoms.

Research paper thumbnail of Multicompartmental cerebrospinal fluid dissemination of cerebellar pilocytic astrocytoma at presentation

Journal of Clinical Neuroscience, 2011

A 26-year-old male presented with a rare cerebellar pilocytic astrocytoma with multicompartmental... more A 26-year-old male presented with a rare cerebellar pilocytic astrocytoma with multicompartmental subarachnoid metastases. Cerebrospinal fluid dissemination of low grade astrocytoma at presentation is rare in adults. In the present patient, clinical and neuroradiological follow-up at 4 years, without adjuvant treatment, revealed non progression of tumors. The occurrence of benign dormancy, low grade tumor histology and multifocal involvement of the neuraxis is rare. Close clinical observation is the best approach for management of such a patient. The relevant literature is discussed.

Research paper thumbnail of Simultaneous combined single stage removal of immature teratoma at anterior skull base: A case report

Clinical Neurology and Neurosurgery, 2012

Research paper thumbnail of Spontaneous tension pneumocephalus in a patient with subdural empyema

Journal of Clinical Neuroscience, 2011

We report a 45-year old male who developed subdural empyema (SE) with tension pneumocephalus. The... more We report a 45-year old male who developed subdural empyema (SE) with tension pneumocephalus. The patient was admitted unconscious with tonic extensor response to pain. A ''gas-forming'' organism, Escherichia coli, was detected. Surgical evacuation of the pus and treatment with the appropriate antibiotic did not result in amelioration of his symptoms and the patient died. We identified a rare clinical situation when the SE cavity had a relatively large air loculus that was clearly related to gas-forming bacteria. It appeared that the patient had developed tension pneumocephalus related to the air produced by the pathogen. To our knowledge, this is the first report of a gas-forming organism in an abscess cavity that resulted in tension pneumocephalus and related symptoms.