Medications for Parkinson’s disease (PD) is effective for several years, but is followed by motor fluctuations, dyskinesias and progression of bradykinesia and rigidity. This...

Hyperkalaemia is a common biochemical derangement in the intensive care unit reflecting a diversity of systemic perturbations such as acute renal failure, rhabdomyolysis, extracellular...

Diabetes insipidus (DI) is a syndrome characterised by the excretion of abnormally large volumes of dilute urine. It occurs uncommonly in neurosurgical patients, but...

Trauma is the fifth commonest cause of death in Singapore. In 1996, trauma contributed to 5.4% of mortality. This article is available only as a...

Acoustic neuroma (vestibular schwannoma) patients have greatly benefited from technical advances in neurosurgery. In fact, the evolution of acoustic neuroma surgery is a microcosm...

The outlook for sufferers of severe head trauma is extremely poor. Some 20% of patients died before significant treatment can be administered, and nearly...

A 24-year-old man was referred for hyperhidrosis of more than 15 years duration. It affected both hands, feet and axilla. This article is available only...

Fractures of the atlas comprise approximately 25% of all injuries to the atlanto-axial complex, 10% of all injuries of the cervical spine, and about...

Both intubation and extubation are processes associated with blood pressure and heart rate flux. While many studies have been carried out on the changes...

A 55-year-old man presented with intermittent low back pain of 2 months’ duration which was progressively worsening, fever, anorexia and a 10-kg weight loss....

Neurointensive care has come into being in the past decade as a recognised subspecialty. Pioneering neurointensivists in the United States, such as Allan Ropper...

BCG vaccines are live vaccines derived from a strain of Mycobacterium bovis that was attenuated by Calmette and Guerin at the Pasteur Institute in...

Preoperative shaving for cranial neurosurgical procedures, as recommended in textbooks, is still a traditional practice in Singapore. Hair has been associated with uncleanliness and...

Livedoid vasculitis is a clinicopathological entity that has variously been referred to as atrophie blanche, livedoid vasculopathy or segmental hyalinising vasculitis. It presents with...

Schwannomas are extra-axial neoplasms derived from the nerve sheath of peripheral or cranial nerves. They represent approximately 8% of all intracranial tumours, arising predominantly...

Cleidocranial dysplasia is an autosomal dominant skeletal disorder characterized by short stature, brachycephaly, delayed closure of the fontanelles and sutures, Wormian bones, midface hypoplasia,...

A postnatal finding of intracranial haemorrhage carries potential medico-legal implications for the obstetrician. However, one cannot exclusively attribute this to birth trauma. This article is...

Pyriform sinus fistula is a developmental abnormality of the 3rd or 4th branchial pouch. It usually presents in childhood as acute inflammatory swelling of...

The Singapore shoreline has changed significantly over the last 30 years, but the stonefish (Synanceia sp.) continues to inhabit our native waters and human...

Patients who talk after traumatic brain injury (TBI) and then subsequently deteriorate into a coma are defined as those with an initial Glasgow Coma...

Acquired thoracic spinal canal stenosis is an uncommon condition compared to myelopathy and radiculopathy frequently seen in the cervical and lumbar spine, respectively. Because...

Delusional parasitosis (DP), or delusional infestation, is a condition in which a person has the unshakeable and mistaken belief of being infested with parasites....

Chickenpox (varicella) in adults can be severe. It is frequently associated with pneumonia and immunosuppression as well as increased mortality rates. This article is available...

Trauma remains the fifth most common cause of death in Singapore; it contributed 6.7% of mortality in 2001. Head injury contributes to a significant...

Central serous chorioretinopathy (CSCR) is an idiopathic disorder characterised by serous detachment of the macula, retinal pigment epithelial (RPE) detachment and areas of RPE...

Buprenorphine, more commonly known as Subutex (Reckitt Benckiser Pharmaceuticals), has been released in Singapore since 2002. Initially marketed as an opiate substitute to help...

Photodynamic therapy using verteporfin (Visudyne, Novartis Ophthalmics) has been proven safe and effective for the treatment of predominantly classic, age-related macular degeneration (AMD)-related subfoveal...

Liver abscess has been recognised since the time of Hippocrates. The first report on liver abscess was published by Bright in 1836.1 However, reports...

Most patients with acute ischaemic stroke have arterial thrombi that occlude extra- or intracranial vessels. Intravenously administered tissue plasminogen activator (IV-TPA) induces thrombolysis and...

While the surgical procedure of placing dental implants may seem technically simple, it is not straightforward and requires careful preoperative planning. This article is available...

Dissecting aneurysms of the vertebral artery often present with subarachnoid haemorrhage.1 A high mortality occurs with rupture.2 Currently, the treatment options for vertebral artery...

Pancreatic cancer is notoriously known to be diagnosed in the later stages and this carries with it a poor prognosis. In particular, tumours involving...

In a previous study,1 we reported that patients who had decreased proteinuria also had improvement in renal function. Three out of the 8 patients...

Patients suffering from visual field defects caused by optic nerve or post-chiasmatic injury commonly experience many limitations in their daily activities. The generally accepted...

Holoproscencephaly (HPE) is an uncommon congenital developmental defect of the forebrain structures to divide into separate hemispheres and ventricles during embryogenesis. The prevalence rate...

Renal infarction is a rare disease. Domanovits et al reported an incidence rate of 0.007% (17/248,842) during a study period of 45 months. This article...

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterised by spinal and cortical motor neuron degeneration. Although electro myography, muscle biopsy and motor...

Recognising that severe head injury is a major health problem with significant mortality and morbidity, numerous epidemiological and outcome studies have been conducted in...

Critical limb ischaemia (CLI) is the most severe form of peripheral vascular disease where there is inadequate blood flow to a limb to maintain...

Neovascularisation of the iris is associated with many ischaemia retinal disorders and elevated levels of the vascular endothelial growth factor is found in patients...

The occurrence of an adrenal mass in patients with an underlying malignancy may represent distant metastases, precluding curative surgical resection of the primary malignancy....

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease with an incidence of approximately 0.5/1000 live births (5% to 7% of...

Arteriovenous fistulae (AVF) are created for haemodialysis in patients with end-stage renal failure. While AVF is a lifeline for these patients, its creation is...

In recent years, Singapore has seen a resurgence of dengue fever despite the seemingly successful implementation of a nationwide Aedes mosquito control programme,1 culminating...

Historically, surgery for intractable epilepsy was performed with the patient awake for at least some part of the procedure to facilitate cortical mapping and...

The auditory apparatus and vestibular part of the inner ear are often included in the radiation field treatment of patients with head and neck...

Severe cases of influenza have traditionally generated much interest. The pandemic of 1957 provided instructive materials on the subject, with publications on the pulmonary...

Complete atrioventricular block (AVB) develops in more than 5% of patients with myocardial infarction (MI). These patients have poorer outcomes compared to those without...

Brain tumours in pregnancy are rare with an incidence of 15 per 100,000 and previous reports have shown variable outcomes. We present a case...

Chronic Achilles tendon rupture is a disabling condition resulting in ankle pain, weakened ankle plantarflexion and abnormal gait. Management of chronic ruptures is technically...

Simple cysts are commonly seen in neonatal ovaries. Majority of them are small and resolve spontaneously. Complications such as torsion and haemorrhage rarely occur,...

Invasive fungal infections (IFI) are associated with a high mortality in liver transplant recipients. The incidence of fungal infections after liver transplantation ranges from...