Kesava Reddy | Vinayaka Missions University (original) (raw)
Papers by Kesava Reddy
Journal of Neurosurgery, 1989
Although posttraumatic syringomyelia is a well-established clinicopathological entity, there is a... more Although posttraumatic syringomyelia is a well-established clinicopathological entity, there is a paucity of information on the ultrastructural features of this condition. This study documents the light and electron microscopic features of posttraumatic syringes obtained from two patients who underwent surgical cordectomy. The syringes were lined largely by cell processes of astrocytes. Small regions near the caudal end were lined by flattened ependymal cells that lacked surface specializations. These were thought to represent remnants of the central canal ependyma. The ultrastructural appearance of the syrinx was similar to that of the communicating syringomyelia as well as the periventricular changes that accompany hydrocephalus. The authors conclude that the changes represent the nonspecific sequelae of a distensile force within the syrinx cavity.
Journal of Neurosurgery, 1988
The influence of vasoconstrictors of intracranial arteries on the amplitude and configuration of ... more The influence of vasoconstrictors of intracranial arteries on the amplitude and configuration of the intracranial pulse wave (ICPW) was investigated. Continuous pressure recordings from the descending aorta (systemic arterial pressure) and the third cerebral ventricle (intracranial pressure) were obtained from anesthetized cats. Computerized analysis of the configuration, amplitude, and frequency spectrum of ventricular wave (ICPW) and aortic pulse wave (SAPW) was performed. Artificial cerebrospinal fluid (CSF), blood, or 5-hydroxytryptamine (5-HT) was injected intracisternally. In 24 control cats, 2 ml artificial CSF was injected into the cisterna magna. This produced a significant increase in amplitude of the ICPW but no change in the SAPW. Ten animals received 14 intracisternal injections of 2 ml autologous blood which caused narrowing of the amplitude of the ICPW as well as of all its components (P1, P2, and P3), with no significant change in the SAPW's. Eight animals were also subjected to cisternal injection of 2 ml of a 10(-4)-M solution of 5-HT, resulting in findings similar to those produced by autologous blood. Frequency spectrum of the intracranial and aortic pulse waves showed a high degree of correlation between wave amplitudes and height of the fundamental wave in the FFT record. These results suggest that the cerebral vasospasm that follows cisternal injections of blood and 5-HT in cats can be diagnosed by analysis of the ICPW. This method may allow early diagnosis and continuous monitoring of cerebral vasospasm in humans.
Journal of Trauma-injury Infection and Critical Care, 1990
A postmortem report of a patient with traumatic internal carotid artery dissection, along with ev... more A postmortem report of a patient with traumatic internal carotid artery dissection, along with evidence strongly suggestive of a car seatbelt as a causative factor, is presented. In this 5-foot subject, the shoulder harness could have been high, over the anterior cervical area. The authors feel this mechanism deserves consideration as one of the important causes of traumatic carotid dissection. If supported by further studies, remedial measures in the form of changes in seatbelt design, or the use of alternate protective measures may be warranted.
Surgical Neurology, 1990
Reddy K, Lesiuk H, West M, Fewer D. False aneurysm of the cavernous carotid artery: a complicatio... more Reddy K, Lesiuk H, West M, Fewer D. False aneurysm of the cavernous carotid artery: a complication of transsphenoidal surgery. Surg Neurol 1990;33:142-5.
Journal of Neurosurgery, 2007
The repair of dural defects is controversial in contemporary neurosurgery. To date, collagen-base... more The repair of dural defects is controversial in contemporary neurosurgery. To date, collagen-based products remain a continued area of interest in the development of dural grafts. The authors conducted a prospective case-control study in which they evaluated collagen matrix in the repair of dural defects following cranial and spinal surgery by using specific clinical and magnetic resonance (MR) imaging outcome measures. Enrolled in the study were 79 patients, 36 male (45.6%) and 43 female (54.4%), with a mean age of 53 +/- 15.8 years. The pathological diagnosis was brain tumor in 49 cases (62%), vascular conditions in 16 (20.2%), degenerative spine in 10 (12.7%), trauma in two (2.5%), and other in two (2.5%). Most of the patients underwent supratentorial craniotomy (57; 72.2%), whereas 11 patients (13.9%) each underwent posterior fossa and spinal surgery. Sixty-three patients (79.7%) completed the study, which included clinical and MR imaging evaluations at 3 months postsurgery. There were no cerebrospinal fluid (CSF) leaks or delayed hemorrhages. The neurosurgical wound infection rate was 3.8%: superficial wound infection in two cases and deep infection and brain abscess in one case (recurrent brain tumor following radiation therapy). Among the 63 patients in whom 3-month postsurgery imaging data were available, asymptomatic small pseudomeningoceles were detected on MR imaging in two (3.2%); a minor subgaleal fluid collection, which resolved spontaneously, was apparent in another patient (1.6%). Nonspecific dural enhancement was demonstrated on images obtained in seven patients (11.1%), and asymptomatic spinal epidural enhancement was observed on images obtained in two of three patients who had undergone lumbar laminectomy for spinal stenosis. When used as a dural onlay graft, collagen matrix had a 100% CSF containment rate but might be associated with occult radiological abnormalities.
Journal of Spinal Disorders, 2000
Stenosis of the lumbar spinal canal is a major cause of disability and lost productivity. Compute... more Stenosis of the lumbar spinal canal is a major cause of disability and lost productivity. Computed tomography (CT) is used commonly to assess the presence and severity of spinal stensosis, because it is relatively inexpensive, readily available, and has few adverse effects. The ability of four surgeons to agree about the presence and severity of lumbar spinal stenosis based on plain CT scans was evaluated from 30 scans of varying stenosis severity (normal to severe). Kappa, a measure of chance-corrected agreement, was calculated. Surgeons exhibited moderate agreement for the presence or absence of spinal stenosis (kappa = 0.58+/-0.06). Agreement regarding the severity of stenosis, when present, was poor (kappa = 0.26+/-0.04). The ability of surgeons to agree was not improved when individual features of the CT scans were assessed (facet joint arthrosis, ligamentum flavum hypertrophy, disk protrusion, and nerve root impingement). This study suggests that CT scans are not a reliable method by which to examine the severity of lumbar spinal stenosis.
Journal of Emergency Medicine, 2000
e Abstract-Stab wounds to the spinal cord are relatively uncommon in North America, but even rare... more e Abstract-Stab wounds to the spinal cord are relatively uncommon in North America, but even rarer is the presentation of such an injury in a delayed fashion. We report a case of a 31-year-old male who presented with neurologic deficit 4 weeks after a stab wound injury to the spine. Because of worsening neurologic deficit, the retained knife fragment was operatively removed, and the patient had an uneventful recovery. The management of such an injury is discussed, with a review of the literature.
Journal of Neurosurgery, 1989
Although posttraumatic syringomyelia is a well-established clinicopathological entity, there is a... more Although posttraumatic syringomyelia is a well-established clinicopathological entity, there is a paucity of information on the ultrastructural features of this condition. This study documents the light and electron microscopic features of posttraumatic syringes obtained from two patients who underwent surgical cordectomy. The syringes were lined largely by cell processes of astrocytes. Small regions near the caudal end were lined by flattened ependymal cells that lacked surface specializations. These were thought to represent remnants of the central canal ependyma. The ultrastructural appearance of the syrinx was similar to that of the communicating syringomyelia as well as the periventricular changes that accompany hydrocephalus. The authors conclude that the changes represent the nonspecific sequelae of a distensile force within the syrinx cavity.
Journal of Neurosurgery, 1988
The influence of vasoconstrictors of intracranial arteries on the amplitude and configuration of ... more The influence of vasoconstrictors of intracranial arteries on the amplitude and configuration of the intracranial pulse wave (ICPW) was investigated. Continuous pressure recordings from the descending aorta (systemic arterial pressure) and the third cerebral ventricle (intracranial pressure) were obtained from anesthetized cats. Computerized analysis of the configuration, amplitude, and frequency spectrum of ventricular wave (ICPW) and aortic pulse wave (SAPW) was performed. Artificial cerebrospinal fluid (CSF), blood, or 5-hydroxytryptamine (5-HT) was injected intracisternally. In 24 control cats, 2 ml artificial CSF was injected into the cisterna magna. This produced a significant increase in amplitude of the ICPW but no change in the SAPW. Ten animals received 14 intracisternal injections of 2 ml autologous blood which caused narrowing of the amplitude of the ICPW as well as of all its components (P1, P2, and P3), with no significant change in the SAPW's. Eight animals were also subjected to cisternal injection of 2 ml of a 10(-4)-M solution of 5-HT, resulting in findings similar to those produced by autologous blood. Frequency spectrum of the intracranial and aortic pulse waves showed a high degree of correlation between wave amplitudes and height of the fundamental wave in the FFT record. These results suggest that the cerebral vasospasm that follows cisternal injections of blood and 5-HT in cats can be diagnosed by analysis of the ICPW. This method may allow early diagnosis and continuous monitoring of cerebral vasospasm in humans.
Journal of Trauma-injury Infection and Critical Care, 1990
A postmortem report of a patient with traumatic internal carotid artery dissection, along with ev... more A postmortem report of a patient with traumatic internal carotid artery dissection, along with evidence strongly suggestive of a car seatbelt as a causative factor, is presented. In this 5-foot subject, the shoulder harness could have been high, over the anterior cervical area. The authors feel this mechanism deserves consideration as one of the important causes of traumatic carotid dissection. If supported by further studies, remedial measures in the form of changes in seatbelt design, or the use of alternate protective measures may be warranted.
Surgical Neurology, 1990
Reddy K, Lesiuk H, West M, Fewer D. False aneurysm of the cavernous carotid artery: a complicatio... more Reddy K, Lesiuk H, West M, Fewer D. False aneurysm of the cavernous carotid artery: a complication of transsphenoidal surgery. Surg Neurol 1990;33:142-5.
Journal of Neurosurgery, 2007
The repair of dural defects is controversial in contemporary neurosurgery. To date, collagen-base... more The repair of dural defects is controversial in contemporary neurosurgery. To date, collagen-based products remain a continued area of interest in the development of dural grafts. The authors conducted a prospective case-control study in which they evaluated collagen matrix in the repair of dural defects following cranial and spinal surgery by using specific clinical and magnetic resonance (MR) imaging outcome measures. Enrolled in the study were 79 patients, 36 male (45.6%) and 43 female (54.4%), with a mean age of 53 +/- 15.8 years. The pathological diagnosis was brain tumor in 49 cases (62%), vascular conditions in 16 (20.2%), degenerative spine in 10 (12.7%), trauma in two (2.5%), and other in two (2.5%). Most of the patients underwent supratentorial craniotomy (57; 72.2%), whereas 11 patients (13.9%) each underwent posterior fossa and spinal surgery. Sixty-three patients (79.7%) completed the study, which included clinical and MR imaging evaluations at 3 months postsurgery. There were no cerebrospinal fluid (CSF) leaks or delayed hemorrhages. The neurosurgical wound infection rate was 3.8%: superficial wound infection in two cases and deep infection and brain abscess in one case (recurrent brain tumor following radiation therapy). Among the 63 patients in whom 3-month postsurgery imaging data were available, asymptomatic small pseudomeningoceles were detected on MR imaging in two (3.2%); a minor subgaleal fluid collection, which resolved spontaneously, was apparent in another patient (1.6%). Nonspecific dural enhancement was demonstrated on images obtained in seven patients (11.1%), and asymptomatic spinal epidural enhancement was observed on images obtained in two of three patients who had undergone lumbar laminectomy for spinal stenosis. When used as a dural onlay graft, collagen matrix had a 100% CSF containment rate but might be associated with occult radiological abnormalities.
Journal of Spinal Disorders, 2000
Stenosis of the lumbar spinal canal is a major cause of disability and lost productivity. Compute... more Stenosis of the lumbar spinal canal is a major cause of disability and lost productivity. Computed tomography (CT) is used commonly to assess the presence and severity of spinal stensosis, because it is relatively inexpensive, readily available, and has few adverse effects. The ability of four surgeons to agree about the presence and severity of lumbar spinal stenosis based on plain CT scans was evaluated from 30 scans of varying stenosis severity (normal to severe). Kappa, a measure of chance-corrected agreement, was calculated. Surgeons exhibited moderate agreement for the presence or absence of spinal stenosis (kappa = 0.58+/-0.06). Agreement regarding the severity of stenosis, when present, was poor (kappa = 0.26+/-0.04). The ability of surgeons to agree was not improved when individual features of the CT scans were assessed (facet joint arthrosis, ligamentum flavum hypertrophy, disk protrusion, and nerve root impingement). This study suggests that CT scans are not a reliable method by which to examine the severity of lumbar spinal stenosis.
Journal of Emergency Medicine, 2000
e Abstract-Stab wounds to the spinal cord are relatively uncommon in North America, but even rare... more e Abstract-Stab wounds to the spinal cord are relatively uncommon in North America, but even rarer is the presentation of such an injury in a delayed fashion. We report a case of a 31-year-old male who presented with neurologic deficit 4 weeks after a stab wound injury to the spine. Because of worsening neurologic deficit, the retained knife fragment was operatively removed, and the patient had an uneventful recovery. The management of such an injury is discussed, with a review of the literature.