Neurology India最新文献

{"title":"Unique Challenge of Saving Two Lives in Pregnancy with Severe Traumatic Brain Injury: A Narrative Review.","authors":"Archana Kamble, Ninad Sawant, Anjali Chandra, Pooja Sharma Dimri, Kokkula Praneeth, Shivanand Gamanagatti, Shashank Kale, Deepak Gupta","doi":"10.4103/neurol-india.Neurol-India-D-23-00467","DOIUrl":"10.4103/neurol-india.Neurol-India-D-23-00467","url":null,"abstract":"<p><p>A pregnant patient is a body with two lives. Saving the mother and baby after severe head injuries during pregnancy requires intensive monitoring and multidisciplinary team based management. There are many neurosurgical challenges in cases of pregnancy with severe traumatic brain injury (TBI) during pregnancy and the postpartum period due to changes in physiological and anatomical changes due to pregnancy. The strategy to treat post traumatic hydrocephalus using a ventriculoperitoneal shunt is also risky as it tends to malfunction due to a gravid uterus. The challenges and issues faced by the multidisciplinary team of the level I apex trauma center while managing pregnancy complicated by severe TBI and its consequences, like a threat to continue of pregnancy, post traumatic hydrocephalus, anesthesia management if there is requirement of surgery, and perioperative management, are discussed in this review based on available literature. A \"one size fits all\" approach is slowly being replaced by individualized approaches in children and pregnant women. This is affected by novel diagnostics, advanced monitoring, and multispeciality teams in dedicated trauma centers.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"215-221"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Dexmedetomidine on Dynamic Cerebral Autoregulation in Patients Undergoing Supratentorial Tumor Surgery.","authors":"Ritesh Lamsal, Girija P Rath, Surya K Dube, Hirok Roy, Shashwat Mishra","doi":"10.4103/neurol-india.Neurol-India-D-24-00131","DOIUrl":"10.4103/neurol-india.Neurol-India-D-24-00131","url":null,"abstract":"<p><strong>Background: </strong>Dexmedetomidine is gaining popularity in neuroanesthesia, but its effect on cerebral autoregulation (CA) is unclear. It is important to maintain CA in patients undergoing surgery for intracranial lesions. Previous studies have not examined the effect of dexmedetomidine on CA in anesthetized patients who have pre-existing intracranial pathology.</p><p><strong>Objective: </strong>The study was done to assess the effect of dexmedetomidine on dynamic CA (dCA) in patients with supratentorial tumors under sevoflurane anesthesia.</p><p><strong>Methods and material: </strong>Forty American Society of Anesthesiologists physical status 1 and 2 patients with supratentorial tumors were randomized to receive either a bolus of dexmedetomidine (1 µg/kg over 10 min) or a matching placebo. The middle cerebral artery (MCA) was insonated using a handheld transcranial Doppler probe and used to calculate the transient hyperemic response ratio, which is the surrogate measure of dCA. This test was repeated before and after administration of the test drug. Variables that can influence dCA like end-tidal carbon dioxide, blood pressure, and depth of anesthesia were tightly controlled throughout the conduct of Doppler studies.</p><p><strong>Results and conclusion: </strong>The MCA flow velocity was comparable in both groups after administration of the test drug (58.05 ± 7.41 cm/s vs 59.95 ± 8.99 cm/s, P = 0.47). The transient hyperemic response ratio was also similar (1.30 ± 0.11 vs. 1.26 ± 0.07, P = 0.22). In anesthetized patients with supratentorial tumors, a bolus dose of dexmedetomidine does not affect dCA.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"280-285"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POLR3-Related Leukodystrophy: A Case Series from the Indian Scenario.","authors":"Ankit Kumar Meena, Arvinder Wander, Aakash Mahesan, Gautam Kamila, Atin Kumar, Biswaroop Chakrabarty, Prashant Jauhari, Sheffali Gulati","doi":"10.4103/neurol-india.Neurol-India-D-24-00198","DOIUrl":"10.4103/neurol-india.Neurol-India-D-24-00198","url":null,"abstract":"<p><p>POLR3-related leukodystrophy is a spectrum of hypomyelinating leukodystrophy caused by biallelic POLR3A, POLR3B, POLR1C, and POLR3K variants. This series of case reports aims to provide a concise overview of the spectrum of rare hypomyelinating leukodystrophy caused by POLR3 variants and adds to the existing knowledge regarding clinical details of a rarer subset caused by POLR1C variant. A retrospective review of four cases in the POLR3-related leukodystrophy spectrum was done. Data pertaining to the clinical details, radiological features, and genetic results of the patients were retrieved and analyzed. Hypomyelination, hypodontia, and hypogonadotrophic hypogonadism are the core features of this spectrum of disorders, and our children from North India also had similar presentation. Sensorineural hearing loss is a newly reported feature, seen in our patients. Further research and larger studies are needed on the pathogenetic cellular mechanisms in this form of hypomyelinating leukodystrophy to guide development of therapeutic targets.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"325-329"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Porencephalic Cysts and Siderosis in COL4A1 Mutation-Related Disorder.","authors":"Lokesh Saini, Pradeep Kumar Gunasekaran, Sarbesh Tiwari, Kuldeep Singh","doi":"10.4103/neurol-india.Neurol-India-D-24-00628","DOIUrl":"10.4103/neurol-india.Neurol-India-D-24-00628","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"400-401"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case Report of Primary Spontaneous Transclival CSF Rhinorrhoea.","authors":"Pawan Chawla, Basant Kumar Misra","doi":"10.4103/NI.NI_673_20","DOIUrl":"https://doi.org/10.4103/NI.NI_673_20","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"393-395"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midline Scalp Swelling in a Child.","authors":"Madhivanan Karthigeyan, Pravin Salunke, Sripartha Krishna Yerramilli, Keshav Mishra","doi":"10.4103/neurol-india.Neurol-India-D-24-00786","DOIUrl":"https://doi.org/10.4103/neurol-india.Neurol-India-D-24-00786","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"404-405"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normative Data of Montreal Cognitive Assessment (MoCA) in Tamil-Speaking Adults.","authors":"Vcs Arathi, Arya Geetha, Navitha Ulaghanathan","doi":"10.4103/ni.ni_800_22","DOIUrl":"10.4103/ni.ni_800_22","url":null,"abstract":"<p><strong>Context: </strong>Cognitive evaluation to determine possible cognitive decline highlights the need for a thorough neuropsychological assessment for early detection. The Montreal Cognitive Assessment (MoCA), is a commonly used screening tool that is comparatively quick and simple to administer, score, and interpret. Subtests of MoCA assess memory, language, visuospatial functions, and executive functions.</p><p><strong>Aims: </strong>The present study aims to generate normative data for the Tamil version of the Montreal Cognitive Assessment (MoCA-TAM) in Tamil-speaking adults.</p><p><strong>Design and settings: </strong>Cross-sectional study conducted in three districts of Tamil Nadu.</p><p><strong>Methods and material: </strong>A total of 450 healthy Tamil native speakers with varying ages (21-80 years) and education levels (primary level to university) were recruited as participants. The Tamil version of the Montreal Cognitive Assessment (MoCA-TAM) was used for assessing the cognitive domains. Scores were analyzed to see the impact of age, gender, and years of education on MoCA-TAM scores and individual cognitive domains.</p><p><strong>Statistical analysis: </strong>Descriptive statistics and Regression analyses were done to evaluate the mean, standard deviation, impact of age, gender, and education on MoCA-TAM scores and individual cognitive domains.</p><p><strong>Results: </strong>The mean value for MoCA-TAM was 24.89 with SD 2.944. MoCA-TAM scores were lower with increasing age and lower education and no statistically significant relationship was found between gender and MoCA-TAM score.</p><p><strong>Conclusions: </strong>The present study provides the normative data of MoCA-TAM with a single cut-off score (22) to differentiate normal from cognitively impaired.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"306-310"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Control and Long-Term Survival in Non-Functional Pituitary Adenoma Treated with Adjuvant Radiotherapy. A Retrospective Single Institutional Study.","authors":"Ann Christy Saju, Rahul Krishnatry, Jayant Sastri Goda, Abhishek Chatterjee, Ashish Uke, Arpita Sahu, Ayushi Sahay, Sridhar Epari, Shafak Madan, Archya Dasgupta, Vikas Singh, Prakash Shetty, Aliasgar Moyiadi, Tejpal Gupta, Rakesh Jalali","doi":"10.4103/neurol-india.Neurol-India-D-24-00110","DOIUrl":"10.4103/neurol-india.Neurol-India-D-24-00110","url":null,"abstract":"<p><strong>Background: </strong>Radiation therapy (RT) for postoperative residual or progressive non-functioning pituitary adenomas (NFPAs) has excellent long-term local control (LC) although its use has been limited because of the potential late toxicity related to radiation treatments. Newer techniques have led to better precision.</p><p><strong>Objective: </strong>The objective of the study was to review the institutional outcomes of NFPA treated with postoperative RT.</p><p><strong>Methods and materials: </strong>One hundred forty-seven patients of NFPA were treated at our institution from 2006 to 2018. Ninty-one patients who received RT post-surgery were included in the analysis. RT was delivered to a dose of 45Gy in 25 fractions over 5 weeks using contemporary RT techniques. Patients with residual disease or recurrence after debulking surgery were treated with RT. Magnetic resonance imaging (MRI) for response was available in 70 patients. Effects of age, gender, cavernous sinus invasion (CSI), bony erosion, number of surgeries, MIB index, p53 status, and RT technique on overall survival (OS) were analyzed.</p><p><strong>Results: </strong>The median follow-up of the patients was 86.5 months (IQR: 53-126). The 10y OS was 88.9%. Of the 70 patients who had follow-up MRI, the 10y LC post-adjuvant RT was 97.1%. On univariate analysis, multiple surgeries were associated with better OS compared to patients who underwent single surgery (P = 0.012), and the presence of both bony erosion and CSI was significantly associated with poorer OS (P = 0.028).</p><p><strong>Conclusion: </strong>Radiotherapy after debulking surgery in a select group of patients with NFPA gives excellent tumor control and survival. The presence of extrasellar extensions results in poor clinical outcomes.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"257-263"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Characteristics and Radiological Analysis of Rhinoorbital - Cerebral Mucormycosis.","authors":"Rajaram Sharma, Tapendra N Tiwari, Saurabh Goyal, Kritika Sharma, Rinkey Baisoya, Bhumika Dua, Vikash Sharma, Stefy Makadiya, Sunil Chugh","doi":"10.4103/ni.ni_950_21","DOIUrl":"10.4103/ni.ni_950_21","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate the usefulness of magnetic resonance imaging (MRI) in diagnosing important imaging findings in rhino-orbito-cerebral mucormycosis.</p><p><strong>Materials and methods: </strong>This is a retrospective cross-sectional study conducted at three medical colleges over 1 month in the patients diagnosed with coronavirus disease 2019 (COVID-19) and who developed mucormycosis of the paranasal sinuses during the treatment and in the post-recovery phase.</p><p><strong>Results: </strong>A total of 95 patients with male preponderance presented with mucormycosis. All had an association with COVID-19 virus disease. All the patients had a history of steroid use during their COVID-19 virus disease treatment. Painful proptosis was present in 42% of patients. The maxillary sinuses (97.22%) were the most commonly affected. Intraorbital extension was observed in 63% of cases, while intracranial extension was demonstrated in 10% of cases. Three patients had perineural spread, and one patient developed a mycotic aneurysm.</p><p><strong>Conclusions: </strong>MRI plays a very crucial role in the prompt and early diagnosis of rhino-orbito-cerebral mucormycosis, as it is used to evaluate the invasion of the disease into the surrounding structures, as well as in preoperative planning for surgical debridement and to ascertain the prognosis. Diffusion-weighted imaging (DWI) adds specificity to localize the path of disease extension by showing restricted diffusion.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"286-291"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prof Vijay Kumar Kak: Neurosurgeon with Legacy in British Neurosurgery.","authors":"Kishor A Choudhari, Leena K Choudhari","doi":"10.4103/neurol-india.Neurol-India-D-24-00903","DOIUrl":"10.4103/neurol-india.Neurol-India-D-24-00903","url":null,"abstract":"<p><p>Vijay Kumar Kak, who passed away last year, was a great Indian Neurosurgeon trained in Belfast, Northern Ireland, in the 1960s. He served as a Faculty and later as the Head of Department at Postgraduate Institute of Medical Sciences (PGIMER), Chandigarh. The authors, with close links to Northern Ireland, revisit the historical journey of this remarkable Neurosurgeon in the nineteenth sixties highlighting aspects of his training and academic achievements that subsequently benefitted generations of Neurosurgeons trained under his guidance at PGIMER.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"406-409"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}