Indian Journal of Neurosurgery最新文献

{"title":"Challenging Management of an Acute Traumatic Carotid-Cavernous Fistula in a 2-Year-Old Child with Literature Review","authors":"Frank G. Solis, Luis Macha, Mauro Toledo, R. Gálvez, Rosa L. Ecos","doi":"10.1055/s-0043-1772158","DOIUrl":"https://doi.org/10.1055/s-0043-1772158","url":null,"abstract":"Abstract Traumatic carotid-cavernous fistula (TCCF) is a rare occurrence in the pediatric population. However, the neurological sequelae of TCCF are associated with higher morbidity and mortality in pediatric patients. We report the case of a 2-year-old child with TCCF treated at a public hospital in Peru. The etiology of the injury was due to a fall of approximately 5 meters. The diagnosis was made based on the clinical picture and neuroimaging findings. The initial proposed treatment was performed with the hope of preserving the parent artery; however, due to persistence of the TCCF, embolization of the parent artery with coils and embolizing substance was performed. A literature review of similar cases was performed and identified eight cases in children under 10 years of age. Endovascular management of an acute TCCF is a challenge due to the high morbidity and mortality during the acute phase and can be complicated when other traumatic injuries are present. Maintaining the parent artery is important; however, when this is not possible, trapping the parent artery may provide an alternate option when appropriate collaterals exist.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"11 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84283760","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":"What Factors Influence the Final Outcome in Occipital Condyle Fractures?","authors":"U. Srinivasan, Al-Busaidi Ali Sultan, E. Abdalla, Aliya Mubarak","doi":"10.1055/s-0043-1771496","DOIUrl":"https://doi.org/10.1055/s-0043-1771496","url":null,"abstract":"Abstract Introduction  Diagnosis of occipital condyle fracture (OCF) following a trauma needs high awareness among the trauma surgeons. Aim  In our study, we attempt to discern if any factor or a combination of factors influences the final outcome following OCF. Materials and Methods  We prospectively analyzed the outcome in OCF patients admitted during 2017 to 2019 at our center. We had 14 patients with polytrauma with OCF. Among them two were lost for follow-up. So, 12 patients were followed up for 6 months after injury. The following 10 factors were analyzed—age, sex, injury, Glasgow Coma Scale, Injury Severity Score, spinal injury, associated injuries, blood pressure, medical conditions, and surgical intervention. Outcome was divided into good and poor outcomes. Chi-squared test was used. All these patients were treated conservatively for OCF for 3 months. Results  There was no significant factor, since p -value was greater than 0.05 for all variables. Only Injury Severity Score (0.091) was close to the significant p -value. Seven patients had severe head injuries and among them one died and four had the worst outcome. Among the five patients who had spinal injuries, only two had good outcomes. Conclusion  Our results indicate that the outcome following OCF is not determined by any single factor. Injury Severity Score comes close to determining the final outcome. This indicates that the overall patient management especially of associated injuries is the determining factor in the outcome in patients who had sustained OCF.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"40 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91374666","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":"The Falling Bullet","authors":"R. Darwazeh","doi":"10.1055/s-0043-1771497","DOIUrl":"https://doi.org/10.1055/s-0043-1771497","url":null,"abstract":"A 16-year-old male was admitted to the emergency room after a falling bullet injury to the head. Some blood was noticed on the top of his head. A single-entry wound (2.8 (cid:1) 1.1 cm) located on the right parietal bone was observed. He presented with headaches, mild left-sided sensory de fi cits","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"4 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90122975","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":"The WHO CNS 5th Edition: A Quandary for the Surgical Neurooncologist and Adult Diffuse Glioma Patients in LMICs","authors":"J. Balogun","doi":"10.1055/s-0043-1771473","DOIUrl":"https://doi.org/10.1055/s-0043-1771473","url":null,"abstract":"The 2021 World Health Organization (WHO) classi fi cation of brain tumors, 1 as a follow-uptothe 2016 update","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"5 1","pages":"093 - 094"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75977147","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":"Polymorphism of XRCC7 Gene and Risk of Glioma: A Prospective Case–Control Study","authors":"Deepak Choudhary, B. Mahajan, M. Sumi, Binita Dholakia, Sumit Bhandari, Niraj R. Ghimire, S. Saluja, Shaam Bodeliwala, W. Wani, A. Jagetia","doi":"10.1055/s-0043-1771213","DOIUrl":"https://doi.org/10.1055/s-0043-1771213","url":null,"abstract":"Abstract Objective  The aim of this study is to determine association between polymorphism of XRCC7 gene and glioma. Materials and Methods  A case–control study was designed to analyze the prevalence of the various XRCC7 genotypes in 30 cases of histologically proven glioma and 30 age- and sex matched controls. Result  There is significantly higher prevalence of the GT and the TT genotypes of XRCC7 gene in cases of glioma as compared with control. The prevalence was significantly pronounced in two subgroups–middle aged and male gender. The presence of the XRCC7 GT or TT genotype conferred a significantly higher risk of developing glioma (odds ratio: 13.021,2.114–80.213). Conclusion  The presence of the T allele in XRCC7 polymorphism may increase the susceptibility to glioma.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"67 1","pages":"168 - 173"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73593381","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":"Glioma, The Road Ahead","authors":"A. Jagetia","doi":"10.1055/s-0043-1772672","DOIUrl":"https://doi.org/10.1055/s-0043-1772672","url":null,"abstract":"Glioma is themost common primary central nervous system tumor involving all age groups. In our setup where we are often triaging our patients and sorting out the wait list, glioblastoma (GBM) multiforme is categorized under “the lost battle.” Yet, occasionally we have seen the survivors of GBM refuting all the literature quoting poor survival. The recent WHO 2021 classification has brought in significant changes in the classification of gliomas and based them completely on their genetic makeup.1 Diffuse midline gliomas H3K27M altered are one such category unfortunately with limited treatment options. The review article included in this issue highlights the differences between the adult and pediatricmidline glioma.2 The authors have done a commendable job of reviewing 97 articles for this study. At present, research focuses on identifying the new targeted therapies, but we are miles away from any practical utility. This issue of our journal abounds in information pertaining to glioma and the recent advances made in the field. The prospective case control study assessing the role of polymorphic XRCC7 gene as a risk factor for glioma is a the first-ever study done on the Indian population.3 This is a study with small sample size (30), but it managed to show a significant prevalence of the GT and the TT genotypes in cases of glioma in middle-aged men. If we could successfully find blood markers suggesting the prognosis of the glioma patient, it will be a boon for our limited resources. The two review articles in the current issue dealing with molecular imaging of the glial tumors and the connectomic network are also great read.4,5 The fast-changing advances in neuro-oncology make it essential to keep ourselves updated. The two advances, one in the field of molecular imaging and the other in connectomic network, are such examples. Connectomic studies have revealed large-scale brain network with structural and functional reorganization. Analyzing these networks in the preoperative setup assists in planning the approach to the tumor and deciding on the extent of tumor removal. In the current era of advanced target therapy and radiosurgery, it is imperative that patients are functionally intact postsurgery. Soft neurological signs have often been missed and connectomics helps us look into that aspect of outcome. It will always remain debatable to choose between obvious tumor residue and preserving unseen soft signs, but in most of the cases that are planned well, we can be in an advantageous position with the information obtained from connectomics. The authors in the article on molecular imaging for glial tumors have beautifully reviewed the established and emerging positron emission tomography (PET) tracers, which have a potential clinical impact on decision-making. They are of great importance in differentiating a tumor from an infective pathology, delineating the tumor extent, and further differentiating tumor relapse from radiation changes. The autho","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"11 1","pages":"095 - 096"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80772252","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":"H3 K27M-Altered Diffuse Midline Gliomas: A Review","authors":"K. Wiśniewski, Andrew Ghaly, K. Drummond, Andreas Fahlstrӧm","doi":"10.1055/s-0043-1771192","DOIUrl":"https://doi.org/10.1055/s-0043-1771192","url":null,"abstract":"Abstract Diffuse midline glioma H3 K27M-altered is a recently renamed high-grade glioma in the 2021 World Health Organization (WHO) Classification of Central Nervous System Tumors, previously being labelled diffuse midline glioma H3 K27M-mutant in the 2016 update and diffuse intrinsic pontine glioma prior to 2016. After identification of multiple alterations causing H3 K27 hypomethylation, the definition of this tumor subtype was changed. To further characterize this new entity in both the pediatric and adult population, we conducted a review of the current literature, investigating genetic, epidemiological, clinical, radiological, histopathological, treatment and prognostic characteristics, particularly highlighting the differences between adults and children. This tumor is more common in children, and has a poorer prognosis. Additionally, childhood H3 K27-altered gliomas are more common in the brainstem, but more common in the thalamus in adults. Sadly, limited treatment options exist for these tumors, with radiotherapy the only treatment shown to improve overall survival.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"27 1","pages":"104 - 115"},"PeriodicalIF":0.2,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86108658","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":"Intraoperative Squash Cytology and Histopathological Correlation of Glial Tumors at a Tertiary Care Hospital","authors":"Diya Bajaj, Lekha Ramchandani, Shamim A. Ansari, Nishtha Yadav, J. Bajaj, Shailendra Ratre, V. Parihar, M. Swamy, Y. Yadav, Indian J Neurosurg","doi":"10.1055/s-0043-1771448","DOIUrl":"https://doi.org/10.1055/s-0043-1771448","url":null,"abstract":"Abstract Introduction  Central nervous system (CNS) tumors account for around 1 to 2% of all neoplasms, commonest of them being gliomas. Gliomas constitute a large, heterogenous group of tumors known for a wide variation in clinical presentation, gross and microscopic features, and biologic behavior. Squash cytology can be a great asset in the intraoperative diagnosis of CNS pathology. In this article, we correlate it with the histopathology of gliomas. Methods  A prospective analytical study was conducted at the Department of Neuropathology, Super-Speciality Hospital, NSCB Medical College, Jabalpur, India. A total of 75 samples were collected for intraoperative squash cytology. The biopsy samples were collected subsequently after surgery for histopathological correlation. Statistical analysis was done using SPSS software to calculate the sensitivity, specificity, and diagnostic accuracy of squash cytology. Results  Of the total 75 patients clinically and radiologically suspected of having gliomas, 43 (57.33%) were males to give a male-to-female ratio of 1.34:1. The mean age at presentation was 36.50 ± 16.87 years. Right-sided tumors were more common. The most common location was the frontal lobe (46.66%). Concordance with squash cytology was found in 81.33% of cases. Sensitivity, specificity, and diagnostic accuracy of squash cytology in the diagnosis of gliomas were found to be 98.61, 66.66, and 97.33%, respectively. Conclusion  Squash cytology is a rapid, inexpensive, and accurate diagnostic method for intraoperative diagnosis of gliomas that can guide the surgeon on the extent of tumor resection.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"8 1","pages":"163 - 167"},"PeriodicalIF":0.2,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84594572","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":"Endoscopic Excision of Third Ventricle Choroid Plexus Papilloma","authors":"Lavlesh Rathore, Debabrata Sahana, Sanjeev Kumar, Rajiv Sahu","doi":"10.1055/s-0043-1771212","DOIUrl":"https://doi.org/10.1055/s-0043-1771212","url":null,"abstract":"Abstract Introduction  Choroid plexus papilloma is a rare intraventricular tumor in children. Its management poses a challenge. Here we describe such a case of third ventricular choroid plexus papilloma and its endoscopic excision through a single burr hole. Case Description  A 1-year-old child presented with headache, vomiting, and a large head with sunset sign and tense fontanel. Computed tomography (CT) and magnetic resonance imaging brain plain and contrast revealed dilated ventricles with a frondlike mass in the third ventricle with intense contrast enhancement, suggestive of choroid plexus papilloma of the third ventricle. The lesion was excised completely using an endoscope placed through a single burr hole at the right Kocher's point. Postoperative recovery was uneventful. The child was relieved of his symptoms. CT scan revealed complete removal of the lesion. Histopathology confirmed the diagnosis of choroid plexus papilloma. Results and Conclusion  We document our surgical experience and present an edited video of the surgery. The key steps and nuances are described in the audio timeline. The authors acknowledge the feasibility of performing this complex surgery via a minimally invasive method, which has not been accepted routinely for this pathology.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"84 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85890961","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":"Molecular Imaging of Glial Tumors: Established and Emerging Tracers","authors":"Indraja D. Dev, V. Rangarajan, N. Purandare, A. Puranik","doi":"10.1055/s-0043-1770910","DOIUrl":"https://doi.org/10.1055/s-0043-1770910","url":null,"abstract":"Abstract Various positron emission tomography (PET) tracers have been developed and extensively studied in the field of neuro-oncology imaging. In the management of brain tumors, accurate delineation of tumor extent, assessment of treatment response, and detection of early recurrence are the most important factors. At present, conventional anatomical imaging paired with amino acid tracer PET imaging is the recommended imaging modality for glial tumor evaluation. Newer PET tracers targeting various structures in the tumor microenvironment have been extensively studied. This review summarizes the established and emerging PET tracers having potential impact on neuro-oncology practice.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"119 1","pages":"097 - 103"},"PeriodicalIF":0.2,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87338682","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}