Indian Journal of Neurosurgery最新文献

{"title":"Fronto-Temporo-Orbito-Zygomatic Approach with Orbital Reconstruction in Lesions causing Unilateral Non-pulsating Proptosis","authors":"M. Darwish, A. Moawad","doi":"10.1055/s-0042-1744249","DOIUrl":"https://doi.org/10.1055/s-0042-1744249","url":null,"abstract":"\u0000 Background Unilateral non-pulsating proptosis can be caused by lesions with intraorbital extensions compressing the globe including sphenoid wing en plaque meningiomas and paranasal sinuses lesions.\u0000 Patients and Methods We operated on 20 patients with unilateral non-pulsating proptosis using fronto-temporo-orbito-zygomatic (FTOZ) approach with orbital reconstruction in six patients. Eighteen patients had sphenoid wing en plaque meningioma, 1 patient had paranasal sinuses fungal infection with intraorbital and intracranial extension, and 1 patient had frontal sinus dermoid with intraorbital extension.\u0000 Results Proptosis was corrected in 50% of the patients, improved in 25%, and remained stationary in 25%. Vision improved in three patients, remained stationary in three, and deteriorated in one patient. Two patients had temporary oculomotor ophthalmoplegia that resolved within 3 months.\u0000 Conclusion Although it is an invasive approach, FTOZ gives excellent exposure of the orbit and anterolateral skull base that allows the excision of intracranial lesions with orbital extension. If needed, the orbit could be reconstructed easily due to excellent exposure.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90142045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Temporal Meningioma as Exophytic Mass from the External Auditory Canal","authors":"Sundarakrishnan Dharanipathy, Shweta Kedia","doi":"10.1055/s-0042-1757204","DOIUrl":"https://doi.org/10.1055/s-0042-1757204","url":null,"abstract":"A 30-year-old female patient was diagnosed with right medial sphenoid wing meningioma when she was evaluated for her headache and dizziness. She underwent craniotomy and excision and, biopsy showed grade 1 microcystic meningioma with an MIB-1 labeling index of 1 to 2%. Her follow-up magnetic resonance imaging (MRI) at","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72578224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular Catheter Insertion on the Occipital and Parietooccipital Bone: A Nonmetric Complementary Technique","authors":"Turki Elarjani, Othman Bin Alamer, Othman Alhammad","doi":"10.1055/s-0042-1756507","DOIUrl":"https://doi.org/10.1055/s-0042-1756507","url":null,"abstract":"Abstract Background and Study Aim  Hydrocephalus is a common disease of the pediatric population, with cerebrospinal fluid diversion as the management of choice. All current insertion techniques require craniometrics calculation that may not be applicable for pediatric patients, due to significant variation in head circumference. We describe a complementary method of inserting ventricular catheters, devoid of craniometrics. Materials and Methods  The insertion site is based on two imaginary lines on the sagittal plane (superior and inferior limits) and four imaginary lines on the axial plane of a computed tomography/magnetic resonance imaging. The insertion point is chosen based on the shortest location from the outer table of the bone to the ventricle. The length of catheter insertion is calculated based on the distance between the calvarial outer table and the foramen of Monro. Results  Two case examples of ventricular catheter insertions, in pediatric patients with noncommunicating hydrocephalus, are described. External ventricular drain and ventriculoperitoneal shunt were inserted using this technique, with no required craniometrics measurements. Conclusion  This complementary method of inserting ventricular catheters can be easily tailored and implemented by junior neurosurgical residents to senior neurosurgeons as it precludes the measurement of the catheter insertion points.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72482210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Laminectomy Non-Osseous Intraspinal Extradural Tuberculous Granulation Tissue: An Undescribed Entity","authors":"Jeyaselva Senthilkumar Thotlampatti Pachiyappan, Sekar Chinnamuthu","doi":"10.1055/s-0042-1744251","DOIUrl":"https://doi.org/10.1055/s-0042-1744251","url":null,"abstract":"Spinal tuberculosis (TB) is well studied and described in the literature. It is known to occur anywhere along the transverse plane of the spine. Vertebral TB accounts for less than 1% of all TB infections in the body and more than 50% of musculoskeletal infections. It is considered the most serious type of skeletal TB, with possible neurological symptoms due to compression of neural structures. It may also lead to deformity and significant vertebral structure destruction and instability. Though non-osseous intraspinal extradural tuberculous granulation tissue is reported in several instances, to the best of our knowledge and thorough literature search, the post-laminectomy occurrence of extradural tuberculous granuloma is not reported in the literature so far. Whether it is the reactivation of previously dormant tuberculous infection or naive infection is elusive. Surgical excision and anti-tuberculous therapy is the mainstay of treatment.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82018410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Lockdown on Neurosurgery Trauma Patients in a Tertiary Care Hospital in India","authors":"Ashutosh Roy, S. Jaiswal, A. Bajaj, Awdhesh Yadav, M. Jaiswal, B. Ojha, A. Chandra, C. Srivastava","doi":"10.1055/s-0042-1744243","DOIUrl":"https://doi.org/10.1055/s-0042-1744243","url":null,"abstract":"Abstract Background  With an increasing number of cases of COVID-19 disease, the Indian government announced a complete lockdown on March 24, 2020, and the country remained under complete lockdown in April 2020. After ramping up health infrastructure and although cases were on the rise, the lockdown was ordered to gradually lift in May 2020. Methodology  It was a retrospective cross-sectional study of all patients admitted to our medical college trauma center in April 2020 and who were compared with April 2019. We studied the prevalence and outcome of road traffic accidents (RTA), assault, and fall from height (FFH) victims admitted to our trauma center. Data were collected using an Excel sheet, and statistical analysis was done using the latest available SSPS software. Results  Our study groups included 124 trauma patients from April 2020 as compared with 322 trauma patients from April 2019. The intense lockdown resulted in a decrease in the number of RTA (−72%), FFH (–29%), and assault patients (–7%). There was no statistically significant change in patients' care and management at our center in terms of mortality and morbidity. No Covid-19-positive neurosurgery trauma patients were admitted in April 2020 to our center. Conclusion  During the stringent lockdown period of April 2020, there was a significant decrease in the number of trauma victims, especially RTAs. The intense lockdown resulted in a significant decrease in the proportion of trauma victims under the influence of alcohol, head injuries, fractures, and dislocations along with a decrease in the number of cases of assaults and FFH as compared with the unlock period.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78740428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervicomedullary Purely Solid, Giant Pilocytic Astrocytoma","authors":"H. Prajapati, Mohd Faheem, S. Kannaujia, Anurag Yadav","doi":"10.1055/s-0042-1757206","DOIUrl":"https://doi.org/10.1055/s-0042-1757206","url":null,"abstract":"Abstract Pilocytic astrocytomas are well-circumscribed, predominantly cystic mass lesions that have a discrete mural nodule. Giant, solid pilocytic astrocytoma is uncommon. Its characteristic imaging features are described.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83670393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Assessment and Prediction of Consistency of Intracranial Meningioma Utilizing the Apparent Diffusion Coefficient Values","authors":"Venkatesh Pothula, Ajay Kumar, Sameer Vyas, V. Bhatia, B. Radotra, S. Gupta","doi":"10.1055/s-0042-1750357","DOIUrl":"https://doi.org/10.1055/s-0042-1750357","url":null,"abstract":"\u0000 Objectives Consistency of meningioma is important for preoperative planning, surgical resection, and predicting surgical outcomes. We prospectively evaluated the utility of the apparent diffusion coefficient (ADC) values to assess the consistency of meningioma.\u0000 Methods Preoperative magnetic resonance imaging (MRI) was performed on 23 patients with meningioma before undergoing surgical resection and the average/mean of ADC minimum (ADCmin), maximum (ADCmax), and mean (ADCmean) values were calculated. Intraoperatively, the meningiomas were characterized as firm or soft and correlated with ADC values.\u0000 Results ADCmin, ADCmax, and ADCmean values of soft and firm meningiomas were significantly different with a p-value of < 0.05. ADCmin value of < 691.3 × 10−6 mm2/s had 80% sensitivity and 84.6% specificity for identifying firm from the soft tumors with the area under the curve (AUC) = 0.862, p-value of 0.004, positive predictive value (PPV) 80, and negative predictive value (NPV) 84.6. ADCmax value of < 933.6 × 10−6 mm2/s had 70% sensitivity and 84.6% specificity for identifying firm from the soft tumors with AUC = 0.823, p-value of 0.009, PPV 77.8, and NPV 78.6. ADCmean value of < 840.8 × 10−6 mm2/s had 90% sensitivity and 76.9% specificity for identifying firm from the soft tumors with AUC = 0.900, p-value of 0.001, PPV 75, and NPV 90.9.\u0000 Conclusion Diffusion-weighted MRI using ADC minimum, ADC maximum, and ADC mean values can be used to differentiate firm from soft meningiomas. Meningiomas with hard consistency showed relatively low ADC values.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86117810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Day Care Neurosurgery: Skill and Technical Advancement","authors":"A. Jagetia","doi":"10.1055/s-0042-1757119","DOIUrl":"https://doi.org/10.1055/s-0042-1757119","url":null,"abstract":"DOI https://doi.org/ 10.1055/s-0042-1757119 ISSN 2277-954X Lower back problems are increasing worldwide due to changing lifestyle, prolonged use of digital technology, and increased use of diagnostic modalities such as Xrays, computed tomography (CT) scan, and magnetic resonance imaging. Increased diagnostic yield has led to increase in spine surgery. The conventional surgery for spine diseases are gradually shifting to minimal invasive spine surgery (MISS) using endoscope or microscope considering its advantages over surgery with big incision and massive muscle dissection. The biggest advantage is same day discharge unlike many neurosurgical procedures. This helps in cutting the cost of treatment to a major extent, less infection, resuming the work early, and above all, a person can go home same day, as “Home is oasis.” The microscopic surgery for disc can be done even with the same length of incision as the MISS; however, the muscle dissection and detachment from spinous process in microscopic surgery with conventional retraction of muscle make it a maximal invasive surgery. MISS needs basic understanding of spine anatomy. As the MISS is emerging as superior surgical procedure for majority spinal pathologies, young neurosurgeon would not have much exposure of detailed spinal anatomy as many anatomical structures in MISS use tactile sensations to localize unlike maximal invasive surgery where visual perception dominates. This would require cadaveric dissections, simulators or anatomy can be understood by cases subjected to open maximal invasive dissections not suitable for minimal exposure. However, use of intraoperative Carms, navigation with ultrasound, CT scan, and/or robots will be the future to understand the bony details of spine. Navigation and robotic has increased the accuracy of spinal instrumentation and success rate of MISS. After reading and analyzing the articles by Kumar et al and Dubey and Agrawal,1,2 it seems the skills and advancement in spinal surgery has made day care surgery possible especially for disc surgery. The other day care procedures for spine are ozone nucleolysis, nucleoplasty, etc.3 For complete extruded disc where disc acts as extradural mass, it might be difficult to identify the relation of root with the disc in MISS which can be overcome to some extent by transforaminal disc injection of methylene blue with iodine containing dye (omnipaque) into the disc before giving incision. This makes disc blue and easily distinguishable. Kumar et al described basics of MISS using tubular retractor, nuances, and technique for beginners.1 Dubey and Agrawal2 used posterolateral transforaminal approach for tumor removal, and ultrasound has been used to localize the foramen along with C-arm. Use of tracked ultrasound technology in spine if substantially recognized, the radiation dose can be reduced to all working in the operation room. Use of standalone ultrasound should be cautiously done in spine localization, however, it is","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84873590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress on Folate Supplementation and Spina Bifida Prevention","authors":"N. Zanon","doi":"10.1055/s-0042-1757118","DOIUrl":"https://doi.org/10.1055/s-0042-1757118","url":null,"abstract":"","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72495375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cysticercosis Presenting as an Isolated Cervical Intramedullary Lesion: A Rare Benign Condition at a Dangerous Location","authors":"R. Sihag, Rajkumar Pannem, Ridham Khanderia, R. Arora","doi":"10.1055/s-0042-1750741","DOIUrl":"https://doi.org/10.1055/s-0042-1750741","url":null,"abstract":"The intramedullary lesions affecting cervical cord usually present with signi fi cant neurological de fi cits and the differentials on magnetic resonance imaging (MRI) can be neoplastic, infective, vascular, or demyelinated. 1 We are providing imaging description of an isolated cervical intramedullary cysticercosis, which is very rare, with only 24 cases reported to date. A 21-year-old male patient presented with complaints of neck pain of 3-month duration followed by asymmetric spastic quadriparesis (power ⅕ in both upper limbs, 4 þ /5 in lower limbs), along with graded sensory loss below C4 dermatome, and bladder and bowel involvement of 2-month duration; Modi fi ed Japanese Orthopedic Association (mJOA) score at presentation was 8. Preoperative MRI revealed a well-circumscribed","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82739736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}