Neurology India最新文献

{"title":"Craniotomy versus Endoscopic Membranectomy in the Treatment of Non-Homogeneous Chronic Subdural Hematoma: A Pilot Randomized Parallel-Group Active-Controlled Trial (EMiT CSDH 2).","authors":"K P Priyadharshan, M Kodeeswaran, S Prasad","doi":"10.4103/neurol-india.Neurol-India-D-25-00844","DOIUrl":"10.4103/neurol-india.Neurol-India-D-25-00844","url":null,"abstract":"<p><strong>Background: </strong>Chronic subdural hematoma (CSDH) is a prevalent neurosurgical condition with persistent challenges related to recurrence. Endoscopic membranectomy (EM) has shown promising results in managing symptomatic non-homogenous (SNH)-CSDH, but comparative evidence against craniotomy with membranectomy (CM) is lacking.</p><p><strong>Objectives: </strong>To compare the safety and efficacy of EM versus CM in managing SNH-CSDH.</p><p><strong>Materials and methods: </strong>A pilot randomized parallel-group active-controlled open- labeled superiority trial from September 2023 to November 2024 at Government Kilpauk Medical College, Chennai, India. Sixty patients with SNH-CSDH were randomized into EM and CM groups. Recurrence was the primary outcome. Secondary outcomes included operative time, complications, radiological indices, pain, hospital stay, and functional recovery. All patients were followed for six months.</p><p><strong>Results: </strong>No recurrence was observed in either group at six months. Two CM patients required reoperation on postoperative day one ( P = 0.15). EM was associated with shorter operative time ( P = 0.02), lower incidence of post-operative subdural residual fluid ( P = 0.015), better early hematoma reduction/subdural space reduction index ( P = 0.008), midline shift/symmetry improvement index ( P = 0.001), and lesser surgical site swelling ( P < 0.001). All patients were ambulant and had a Glasgow coma scale (GCS) 15 at discharge and at six months (including reoperated patients). Pain scores and functional recovery were comparable. EM patients had shorter hospital stays ( P = 0.004) and no significant complications.</p><p><strong>Conclusion: </strong>EM demonstrated favorable early radiological outcomes, fewer complications, and comparable functional recovery and recurrence versus CM in SNH-CSDH. Independent reproduction and larger multicentric trials are needed for validity and generalizability.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"844-852"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796208","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":"Microvascular Decompression for Trigeminal Neuralgia - How Far Yet and How Far to Get.","authors":"Manjul Tripathi, Pratyush Mishra, Aman Batish, Rajeev Chauhan, Avondeep Dhaliwal, Sandeep Mohindra","doi":"10.4103/neurol-india.Neurol-India-D-25-00966","DOIUrl":"10.4103/neurol-india.Neurol-India-D-25-00966","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to share a single surgeon's experience among patients with primary and secondary trigeminal neuralgia (TGN) managed with microvascular decompression (MVD), detailing immediate and last follow-up results and identifying the prognostic factors associated with various outcomes and recurrences.</p><p><strong>Methods: </strong>A retrospective observational analysis of 136 consecutive patients (78.2% primary, 21.8% secondary TGN) managed with MVD between June 2018 and January 2025, with at least 3 months of follow-up, was conducted. Surgical results, complications, and recurrence rates were reviewed along with factors affecting these outcomes.</p><p><strong>Results: </strong>A total of 101 patients were analyzed with a mean preoperative duration of symptoms of 4 years. V2V3 segment was the most common pain-harboring region. Superior cerebellar artery was the most common conflicting vessel. Immediate complete pain relief was achieved in 94.8% of cases (94.7% in primary and 95.2% in secondary TGN groups). At a mean latest follow-up of 266 (range: 10-2250 days) days, 84.2% of primary TGN and 95.2% of secondary TGN patients had experienced persistent pain relief (Barrow Neurological Institute [BNI] I). Poor immediate pain relief correlated strongly with poor outcomes at both first and final follow-up ( P < 0.001). The most frequent complication was facial hypoesthesia (19.6%). The recurrence rate at last follow-up was 31.6%. Redo MVD stood out as the most efficient treatment modality.</p><p><strong>Conclusion: </strong>MVD still enjoys being the most coherent management strategy for drug-resistant TGN, with age being no bar. Favorable outcomes with shorter preoperative duration prompt the need for increasing patient awareness, improving multidisciplinary communications, and expeditious referral to a neurosurgical unit to amplify the patient's welfare. A duration of preoperative symptoms of more than 4 years, >2 vessels in conflict, and lack of immediate postoperative relief in symptoms herald the increased risk of pain recurrence.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"828-836"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881174","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":"Nicotinamide Mononucleotide Adenylyltransferase 2 (NMNAT2) - Related Polyneuropathy - An Unusual Symptom, and a Rare Disease.","authors":"Sricharan Vijayakumar, Pooja Mailankody, B N Nandeesh, Rohan Mahale","doi":"10.4103/neurol-india.Neurol-India-D-26-00074","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00074","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"930-932"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796141","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":"Epidural Steroid Injections Compared with Oral Treatment for Lumbosacral Radicular Pain - A Comparative Efficacy Study.","authors":"T K Abins, Nitesh Manohar Gonnade, Nagma Sheenam, Arindam Ghosh","doi":"10.4103/neurol-india.Neurol-India-D-25-00928","DOIUrl":"10.4103/neurol-india.Neurol-India-D-25-00928","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"923-924"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796189","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":"Apnea-Induced Hypertensive Crisis During Intraoperative O-Arm Imaging in Patients with Biochemically Active Paraganglioma Undergoing Spine Fusion.","authors":"James Thapa Magar, Ramamani Mariappan","doi":"10.4103/neurol-india.Neurol-India-D-25-01047","DOIUrl":"10.4103/neurol-india.Neurol-India-D-25-01047","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"925-927"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796191","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":"H3K27me3 Immunohistochemistry as a Molecular Surrogate in Oligodendrogliomas: An Addition to the Literature.","authors":"Sofia Dondapati, Megha S Uppin","doi":"10.4103/neurol-india.Neurol-India-D-26-00167","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00167","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"940-942"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796203","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":"Stroke Clinical Trials in India: Bridging the Gaps in Public Health Outreach.","authors":"Ray Suman, Maan Pratibha, Chavan Chandrashekhar","doi":"10.4103/neurol-india.Neurol-India-D-26-00401","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00401","url":null,"abstract":"<p><strong>Abstract: </strong>For stroke treatment and rehabilitation, various types of medicine and therapies are available; however, they need to evolve continuously through evidence-based research. The present study analyzed clinical trials on stroke in India, registered at the Clinical Trials Registry of India (CTRI) to delineate the trends, advances, gaps, and challenges on stroke from clinical perspectives. The study analyzes randomized clinical trials (RCTs) on stroke, registered at the CTRI database, since the inception of CTRI (2007) till July 2025. Search was done using the keywords \"stroke,\" \"Brain attack,\" and \"cerebrovascular accident\" in the fields \"Scientific Title,\" \"Public Title,\" and \"Health conditions.\" A total of 2102 trials related to stroke were retrieved from the CTRI database that reduces to 1109 after removing duplicates. Out of these, only 578 trials were interventional RCTs, and 560 trials were being conducted in India. The study revealed: (i) major contribution of the private sector, (ii) more public hospitals involved in the multicentric/multi-intervention RCT, (iii) disparity in RCTs across states, (iv) maximum (62%) of studies were of satisfactory quality as per modified Jaded scale, (v) public hospitals performed slightly better in terms of quality parameters and sample size, and (vi) physiotherapy dominated among types of interventions being tested. Representation of the population of all states is necessary so that strategies may be developed on regional basis. Prioritizing stroke-prevalent regions for clinical trial activities can bridge critical gaps in public health outreach and empower local communities. Participation of government institutes and sponsorship must be increased, and collaboration should be encouraged.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"898-903"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796299","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":"Editor's Choice Article.","authors":"Girish Menon","doi":"10.4103/neurol-india.Neurol-India-D-26-00685","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00685","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"74 5","pages":"773-774"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956318","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":"Microvascular Decompression with Selective Use of MVD-Plus for Classical Trigeminal Neuralgia: Outcomes, Predictors, and Role in Redo Surgery.","authors":"Himanshu Prasad, Shail S Chauhan, Mohit Agrawal, Raghavendra K Sharma, Vikas Janu, Jaskaran S Gosal, Mayank Garg, Bhaskar Suryanarayanan, Deepak K Jha","doi":"10.4103/neurol-india.Neurol-India-D-26-00145","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00145","url":null,"abstract":"<p><strong>Background: </strong>Classical trigeminal neuralgia (TN) is a severe facial pain disorder most commonly caused by neurovascular conflict (NVC) at the trigeminal root entry zone. Microvascular decompression (MVD) provides durable pain relief by addressing the underlying vascular compression. However, Indian data evaluating predictors of failure, early relapse, redo surgery, and the role of adjunct nerve combing (MVD-plus) remain limited.</p><p><strong>Objective: </strong>To evaluate functional outcomes after MVD for classical TN and identify predictors of early failure, pain relapse, redo surgery, and the role of MVD-plus.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 108 consecutive patients who underwent MVD for classical TN at a tertiary neurosurgical center in India between August 2018 and July 2025. Demographic characteristics; trigeminal division involvement; laterality; NVC grade; offending vessel; operative technique (Teflon alone vs. Teflon with adjunct nerve combing); complications (Ibañez classification); preoperative, immediate postoperative, and long-term Barrow Neurological Institute (BNI) pain scores; pain relapse; redo MVD; and history of dental or tooth extraction were analyzed. Kaplan-Meier survival analysis was used to assess pain-free survival.</p><p><strong>Results: </strong>The mean age at surgery was 51.39 years, with right-sided involvement in 62% of patients. V2-V3 involvement was the most frequent trigeminal division pattern (22.1%). Severe preoperative pain was universal (BNI IV-V). Ten patients (9.3%) underwent MVD-plus (Teflon with adjunct nerve combing), including six patients (5.6%) undergoing redo MVD for early failure or relapse. At a mean follow-up of 22.7 months, outcomes were BNI I in 41 patients (37.9%), BNI II in 57 (52.8%), and BNI III in 10 (9.3%), yielding a 90.7% pain-free rate (BNI I-II). Severe NVC (Grades 2-3) and arterial compression correlated with superior outcomes, while venous compression and early postoperative residual pain predicted relapse ( P < 0.05). The overall complication rate was 18.5%, predominantly minor, with no mortality.</p><p><strong>Conclusion: </strong>MVD is a safe and highly effective treatment for classical TN. NVC severity, offending vessel type, and early postoperative pain relief significantly influence outcomes. MVD-plus is valuable in cases where unfavorable anatomy does not allow adequate vascular decompression, redo surgery, and early failure.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"820-827"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897713","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":"Autopsy-Confirmed Disseminated Human NeuroCoenurosis: First Report from India.","authors":"Thejas N Javagal Amith, Valakunja Harikrishna Ganaraja, Jitender Saini, Aishwarya Iyer, B N Nandeesh, M Netravathi","doi":"10.4103/neurol-india.Neurol-India-D-26-00071","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00071","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"919-922"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796152","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}