Neurology India最新文献

{"title":"Impact of Iodized Salt Fortified with Folic Acid, Vitamin B12 and Iron on Reproductive-Aged Women in India.","authors":"Vijayasekhar V Manda, Vijaya Kancherla, Madhu Narayana Rao Kottakki, Phani Madhavi Kajana, Hayagriva Rao Bhaganagarapu, Azadeh Vatandoust, M G Venkatesh Mannar, Levente Diosady, Jogi V Pattisapu","doi":"10.4103/neurol-india.Neurol-India-D-26-00255","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00255","url":null,"abstract":"<p><strong>Background: </strong>India has a high prevalence of anemia, vitamin B12 deficiency, and maternal folate insufficiency with associated spina bifida and anencephaly (SBA). Fortifying household iodized table salt can be a strategy to prevent several micronutrient deficiencies.</p><p><strong>Objective: </strong>To examine the effectiveness of quadruple fortified salt (QFS) on serum folate, vitamin B12, and iron concentrations after 4 months of intervention.</p><p><strong>Method and material: </strong>A nonrandomized controlled trial using a pre- and post-intervention evaluation design was implemented from July 1, 2022, to November 30, 2022 in four remote rural villages in India. Study participants included non-pregnant, non-lactating women of reproductive age. Serum levels were analyzed at baseline and after 4 months of consuming QFS. The QFS was made using commercially available edible iodized salt (containing 22 ppm iodine), fortified with 37 ppm folic acid, 0.35 ppm vitamin B12, and 1080 ppm iron. Descriptive statistics were assessed, and a two-tailed Wilcoxon signed-rank test for paired samples measured median differences, and mean differences were measured using paired sample t-tests.</p><p><strong>Results: </strong>A total of 91 participants were examined. The median serum folate concentration increased 3-fold from 18.3 nmol/L [interquartile range (IQR), 13.6-21.1 nmol/L ] at baseline to 54.4 nmol/L (IQR, 24.7-54.4 nmol/L; the ceiling effect) at the study endpoint. Median serum vitamin B12 concentration increased 2.6-fold from 287 pg/mL (IQR, 241-341 pg/mL) to 735 pg/mL (IQR, 624-890 pg/mL), and median serum iron concentration increased 1.7-fold, from 74 mcg/dL (IQR, 50-95 mcg/dL) to 128 mcg/dL (IQR, 97-156 mcg/dL) at endpoint. All increases were statistically significant (P < 0.0001). There were no complaints regarding QFS acceptability or adverse side effects.</p><p><strong>Conclusion: </strong>Our study showed significant rises in serum levels of folate, vitamin B12, and iron after the intervention. Since over 80% of households use iodized salt in India, addition of other micronutrients provides an excellent reach to prevent anemia, SBA, and other disorders effectively.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"74 5","pages":"885-891"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956385","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":"Surgical Experience and Literature Review of Sellar and Suprasellar Arachnoid Cysts: Endoscopic Management and Surgical Anatomy-Based Reorganization.","authors":"Ramanadha Reddy Kanala, Vasundhara S Rangan, Pasham Amarendra, Thirumal Yerragunta, Suchanda Bhattacharjee, Vamsi Krishna Yerramneni","doi":"10.4103/neurol-india.Neurol-India-D-25-00819","DOIUrl":"10.4103/neurol-india.Neurol-India-D-25-00819","url":null,"abstract":"<p><strong>Background: </strong>The suprasellar cistern containing major neurovascular structures is accessible by various microscopic and endoscopic approaches. While literature strengthening the case for skull-base endoscopic management of neoplastic sellar-suprasellar lesions abounds, a straightforward algorithm for endoscopically managing sellar/suprasellar arachnoid cysts (SAC) has not been set forth. This is likely due to their low incidence and the wide variation in both nomenclature and surgical management described in the literature.</p><p><strong>Methods: </strong>All (10) cases of SAC managed at our institution over the past 5 years have been analyzed and included in this retrospective study. All cases underwent endoscopic surgery as deemed appropriate by the managing teams. All studies published after 2010 describing endoscopic management of six or more SAC cases were reviewed.</p><p><strong>Results: </strong>Endoscopic fenestration of the cyst with wall biopsy was done in all cases. Wide cysto-cisternostomy was done in all large suprasellar cysts. This was performed via the endonasal route in cases with a large(r) sellar + suprasellar component (anterior to the dorsum sellae) or via transventricular endoscopy in cases with a large(r) premesencephalic/prepontine (retrosellar) component. Postoperatively, all patients in our series experienced relief of symptoms with no complicating CSF leaks or evidence of recurrence at last follow-up. Literature review revealed gross inconsistencies in the nomenclature of each cyst type while largely describing successful endoscopic management. We encountered three main types of cysts and found that the most useful method of grouping SACs to aid surgical approach selection is based on their predominant cisternal location. Therefore, we suggest that they be organized into the intrasellar, sellar-suprasellar, and premesencephalic/prepontine types.</p><p><strong>Conclusion: </strong>Reorganizing SACs based on their anatomical extent simplifies academic communication and aids in choosing the surgical approach. In our experience treating these rare cysts, transventricular as well as transnasal endoscopic surgery has proven safe and efficient.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"853-861"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897158","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":"Conquer Your Hesitation and Show the Neurosurgeon's Valor in \"No Man's Land\"! Surgical Tips and Nuances on Giant Cavernous Sinus Hemangioma.","authors":"Arun K Srivastava, Suyash Singh, Kamlesh S Bhaisora, Ved P Maurya, Kuntal K Das","doi":"10.4103/neurol-india.Neurol-India-D-25-01048","DOIUrl":"10.4103/neurol-india.Neurol-India-D-25-01048","url":null,"abstract":"<p><strong>Background: </strong>Because of their location and vascularity, cavernous sinus hemangiomas (CSH) are uncommon, benign vascular diseases that present considerable surgical problems. Even if stereotactic radiosurgery (SRS) is being used more often, surgical excision is still essential for big lesions. One of the large single-center surgical series on CSH utilizing transcavernous microsurgical techniques, and interdural splitting is presented in this work.</p><p><strong>Methods: </strong>A retrospective review of 15 patients who underwent surgery between January 2023 and April 2025 and had CSH confirmed by radiological and histological means was carried out. Analyses were conducted on the following data: Surgical technique, intraoperative blood loss, tumor volume, clinical presentation, demographics, amount of resection, and complications. Additionally included were qualitative observations from the surgeon's reflections and the operation notes. SPSS 24.0 was used for statistical analysis.</p><p><strong>Results: </strong>Gross total resection (GTR) was achieved in 80% ( n = 12) of patients, and near-total resection (NTR) was achieved in 20% ( n = 3). The mean intraoperative blood loss was significantly lower in the GTR group (1133.3 ± 427.7 mL) compared to the NTR group (1766.7 ± 208.2 mL; P = 0.03). Larger tumor volume positively correlated with higher intraoperative blood loss (r = 0.52, P = 0.04). At 6-month follow-up, 66.7% ( n = 10) of patients showed symptomatic improvement. Postoperative cranial nerve deficits occurred in 13.3% ( n = 2), with no mortality. The extent of resection was not significantly associated with short-term functional outcome ( P = 0.58).</p><p><strong>Conclusion: </strong>The interdural and transcavernous approach is a safe and effective microsurgical technique for resection of gCSH, enabling high rates of total resection with minimal morbidity. Although larger tumor size increases intraoperative bleeding risk, GTR can still be achieved with proper anatomical planning and technique. In select cases, NTR may be a reasonable alternative without compromising short-term neurological outcomes.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"811-819"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897668","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":"Restless Legs Syndrome: Expanding Pathophysiology and Evolving Therapeutics.","authors":"Okan Sokmen","doi":"10.4103/neurol-india.Neurol-India-D-26-00179","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00179","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"938-939"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796136","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":"Two Routes, One Goal: Early Optic Nerve Decompression from Above and Below in Minimal Access Tuberculum Sellae Meningioma Surgery.","authors":"Ashutosh Carpenter, Jaskaran Singh Gosal, Mohammedali Shefna, Raju Revathy, R Gokulvijay, Utkarsh Kumar, U Jagadeeshwar, Abhishek Jasrotia, Sampada Pramod Wankhede, H V Easwer, Prakash Nair","doi":"10.4103/neurol-india.Neurol-India-D-25-00977","DOIUrl":"10.4103/neurol-india.Neurol-India-D-25-00977","url":null,"abstract":"<p><strong>Abstract: </strong>Early optic nerve decompression in tuberculum sellae meningiomas is critical for visual preservation, as postoperative visual dysfunction is primarily attributable to manipulation-induced ischemia, independent of the surgical approach. This video demonstrates this principle through both endoscopic endonasal and transcranial routes. The extended endoscopic endonasal approach(EEEA) provides direct access to the inferomedial optic canal, lateral and medial opticocarotid recesses(LOCR/MOCR), paraclival internal carotid artery, and limbus chiasmaticus, permitting 270° optic canal unroofing and controlled inferomedial optic sheath fenestration. The transcranial corridor enables extradural-intradural falciform ligament division, medial optic canal drilling under direct visualization, and superior-lateral optic sheath decompression. Extended endonasal endoscopy is optimal for inferomedial optic canal invasion, providing direct access to the preforaminal-canalicular corridor. However, the transcranial route remains indicated for tumors with supradiaphragmatic extension, a prefixed chiasm, or complex vascular encasement involving the A1-ACom-ICA segments. Early optic nerve decompression, whether performed endonasally or transcranially, remains a key determinant of postoperative visual outcome in tuberculum sellae meningioma surgery.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"797-802"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796292","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":"Anti-Tubercular Therapy Induced Trapezoid Body Edema in Pons.","authors":"Ataur Rahman, Sahoo Biswajit, Manoj K Nayak","doi":"10.4103/neurol-india.Neurol-India-D-25-00584","DOIUrl":"10.4103/neurol-india.Neurol-India-D-25-00584","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"943-944"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796180","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":"Rescue Stenting in Refractory Middle Cerebral Artery Thrombectomy Using Drug-Eluting Stent with Short-Duration Tirofiban Infusion.","authors":"Rasmiranjan Padhi, K Ariharan, Parvathy Giridas, Jagadeesan Dhanasekaran, Virag Shethna, Vaishali Madhariya","doi":"10.4103/neurol-india.Neurol-India-D-25-00990","DOIUrl":"10.4103/neurol-india.Neurol-India-D-25-00990","url":null,"abstract":"<p><strong>Abstract: </strong>Intracranial atherosclerotic disease (ICAD) is an essential cause of failed first-pass mechanical thrombectomy (MT) requiring rescue techniques. Rescue intracranial stenting (RIS) is a successful technique for repeated recanalization failure during MT; however, optimal antithrombotic management to maintain stent patency while mitigating bleeding risk remains an area of research. In this report, we propose a short-duration tirofiban infusion protocol for RIS with more than one year of stent patency follow-up. We performed a retrospective case series study of ten patients who underwent RIS after failed revascularization attempts in middle cerebral artery occlusion due to ICAD and were treated with intra-arterial tirofiban bolus, followed by dual antiplatelet loading and intravenous tirofiban infusion for four hours. We analyzed recanalization rate, 90-day functional outcome, symptomatic hemorrhage, and long-term stented-artery patency. Successful reperfusion (mTICI 2b-3) was achieved in all patients. At 90 days, eight patients achieved a favorable functional outcome (modified Rankin Scale 0-2), with a median mRS of 0 (range 0-6). One patient experienced a symptomatic intracranial hemorrhage. One patient died during follow-up. Clinical or angiographic follow-up beyond one year was available for nine patients; among the five patients who underwent conventional angiographic, four demonstrated no in-stent restenosis, while one developed severe (>70%) restenosis at two-year follow-up. In this descriptive case series of ten patients, a short-duration tirofiban infusion protocol following RIS was feasible and was not associated with a high rate of hemorrhagic complications. These observations are hypothesis-generating and require validation in larger, controlled cohorts.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"892-897"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796231","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":"Roach Tash Sign in Hypoplastic Rostral Superior Sagittal Sinus.","authors":"Sharath Kumar Goddu Govindappa, Chaitra Parameshwara Adiga, Lakshmikanth N Goolahally, A S Yashwanth","doi":"10.4103/neurol-india.Neurol-India-D-26-00024","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00024","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"949-950"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796268","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":"Seeing the Unseen: The Hippocampal Dot Sign in Transient Global Amnesia.","authors":"Sandhya Manorenj, S Sravan Kumar","doi":"10.4103/neurol-india.Neurol-India-D-26-00076","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00076","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"933-935"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897811","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":"Complete or Not? A Critical Appraisal of Expansive Duraplasty in Cervical Spinal Cord Injury.","authors":"Ali Imran Ozmarasali","doi":"10.4103/neurol-india.Neurol-India-D-26-00019","DOIUrl":"10.4103/neurol-india.Neurol-India-D-26-00019","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":" ","pages":"936-937"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796187","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}