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2017| March-April | Volume 65 | Issue 2
Online since
March 10, 2017
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ORIGINAL ARTICLES
Potential for differentiation of glioma recurrence from radionecrosis using integrated
18
F-fluoroethyl-L-tyrosine (FET) positron emission tomography/magnetic resonance imaging: A prospective evaluation
Shanti K Sogani, Amarnath Jena, Sangeeta Taneja, Aashish Gambhir, Anil K Mishra, Maria M D’Souza, Sapna M Verma, Puja P Hazari, Pradeep Negi, Ganesh K. R. Jadhav
March-April 2017, 65(2):293-301
DOI
:10.4103/neuroindia.NI_101_16
PMID
:28290392
Purpose:
To assess the utility of
18
F-fluoroethyl-L-tyrosine (FET) positron emission tomography/magnetic resonance imaging (PET/MRI) in distinguishing recurrence from radionecrosis.
Materials and Methods:
Thirty-two patients (25 males, 7 females) of glioma who had already undergone surgery/chemoradiotherapy and had enhancing brain lesions suspicious of recurrence were evaluated using integrated
18
F-FET PET/MRI, and followed up with histopathology or clinical follow-up and/or MRI/PET/MRI imaging. Manually drawn regions of interest over areas of maximal enhancement or FET uptake were used to calculate tumor to background ratios [TBR
max
, TBR
mean
], choline: creatine ratio [Cho: Cr ratio], normalized relative cerebral blood volume [N rCBV
mean
] and apparent diffusion coefficient [ADC
mean
]. Correlations were evaluated using Pearson's coefficient. Accuracy of each parameter was calculated using independent
t
-test and receiver operator curve (ROC) analysis while utility of all four parameters together using multivariate analysis of variance (MANOVA) for differentiating recurrence vs. radionecrosis was evaluated. Positive histopathology and imaging/clinical follow up served as the gold standard.
Results:
Twenty-four of the 32 patients were diagnosed with recurrent disease and 8 with radiation necrosis. Significant correlations were observed between TBR
max
and N rCBV
mean
(ρ =0.503;
P
= 0.003), TBR
mean
, and N rCBV
mean
(ρ =0.414;
P
= 0.018), TBR
max
and ADC
mean
(ρ = −0.52;
P
= 0.002), and TBR
mean
and ADC
mean
(ρ = −0.518;
P
= 0.002). TBR
max
, TBR
mean
, ADC
mean
, Cho: Cr ratios, and N rCBV
mean
were significant in differentiating recurrence from radiation necrosis with an accuracy of 94.1%, 88.2%, 80.4%, 96.4%, and 89.9%, respectively. MANOVA indicated that combination of all parameters demonstrated better evaluation of recurrence vs. necrosis than any single parameter. The diagnostic accuracy, sensitivity, and specificity using all MRI parameters were 93.75%, 96%, and 85.7%, and using all FET PET/MRI parameters was 96.87%, 100%, and 85.7%, respectively.
Conclusions:
Synergetic effect of multiple MR parameters evaluated together in addition to FET PET uptake highlights the fact that integrated
18
F-FET PET/MRI might have the potential to impact management of patients with glioma by timely and conclusive recognition of true recurrence from radiation necrosis.
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NI FEATURE: THE EDITORIAL DEBATE II-- PROS AND CONS
Traumatic brain injury in India: A big problem in need of data
Andrew I R Maas
March-April 2017, 65(2):257-258
DOI
:10.4103/0028-3886.201848
PMID
:28290383
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255
ORIGINAL ARTICLE
A systematic review of quantitative research on traumatic brain injury in India
Benjamin B Massenburg, Deepa K Veetil, Nakul P Raykar, Amit Agrawal, Nobhojit Roy, Martin Gerdin
March-April 2017, 65(2):305-314
DOI
:10.4103/neuroindia.NI_719_16
PMID
:28290394
Introduction:
Over a quarter of the world's trauma deaths occur in India, with traumatic brain injury (TBI) as the leading cause of death and disability within trauma. With little known about TBI in India, we set out to do a systematic review to characterize the quantitative literature on TBI in India.
Materials and Methods:
The following databases were searched from their inception to December 31, 2015: PubMed, Cochrane, Web of Science, and the World Health Organization's Global Health Library, using the keywords: neurotrauma, brain injury, traumatic brain injury, TBI, head injury, and India. Articles were screened by two independent reviewers, with disagreements arbitrated by discussion or a third reviewer.
Results:
A total of 72 manuscripts were included, encapsulating 19962 patients over 27 years in 14 states of India. The sample-size-weighted mean age was 31.3 years, male-to-female ratio was 3.8:1, and sample-size-weighted mean in-hospital mortality was 24.6%. Age and mortality did not change significantly over time. Road traffic accidents (55.5%) and falls (29.2%) were the most commonly reported mechanisms of injury for TBI in India. The mean quality of reporting on TBI in India was 65.7%, according to the appropriate EQUATOR guideline score.
Conclusion:
The quality of reporting of quantitative studies published on TBI in India is low, and future methodological excellence should be ensured. The demographics and outcomes identified can be used as an epidemiological baseline for future research on TBI in India. Future research can build upon this platform to develop and refine context-appropriate policy recommendations and treatment protocols.
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272
ORIGINAL ARTICLES
Prevalence and risk factors of asymptomatic carotid artery stenosis in Indian population: An 8-year follow-up study
Subhash Kaul, Suvarna Alladi, K Rukmini Mridula, V C S Srinivasarao Bandaru, Matapathi Umamashesh, Darapureddy Anjanikumar, Palli Lalitha, R Chandrasekhar
March-April 2017, 65(2):279-285
DOI
:10.4103/neuroindia.NI_523_16
PMID
:28290390
Background:
Asymptomatic carotid artery stenosis (ACAS) is a marker for cerebrovascular disease, coronary atherosclerosis, and death.
Aim:
To investigate the prevalence of ACAS in the Indian population, and to correlate ACAS with other vascular risk factors.
Materials and Methods:
We prospectively recruited 1500 individuals who were older than 40 years and asymptomatic for cerebrovascular disease between June 2003 and December 2014. Evaluation of vascular risk factors was done for all the participants. Color Doppler of bilateral carotid arteries was performed for all the participants. Carotid stenosis of 1–49% and ≥50% was considered to be mild and significant stenosis, respectively.
Results:
There were 1016 (67.7%) men, with a mean age of 58.1 ± 10.6 years (age range: 40–98 years). The prevalence of significant carotid stenosis was 5.2%. After adjustment using multiple regression analysis, age >70 years (OR: 2.0; 95% CI: 1.48–2.74), hypertension (OR: 1.8; 95% CI: 1.11–2.96), diabetes (OR: 2.3; 95%CI: 1.45–3.89), smoking (OR: 3.6; 95% CI: 2.18–6.03), dyslipidemia (OR: 4.0; 95% CI: 2.52–6.63), history of migraine (OR: 3.6; 95% CI: 2.54–9.13), history of periodontitis (OR: 3.2; 95% CI: 1.90–5.68), and family history of stroke (OR: 7.1; 95% CI: 4.20–12.2) were significantly associated with >50% stenosis. Duration (>15 years) of hypertension (OR: 2.5; 95% CI: 1.33–6.43), diabetes (OR: 6.2; 95% CI: 3.41–11.3), and smoking (OR: 5.2; 95% CI: 2.20–12.1) markedly worsened the risk. During the 8-year follow up, 14 participants (1.4%) with mild stenosis and 3 participants (4.7%) with significant stenosis developed stroke.
Conclusions:
Our study suggests that 5.2% of asymptomatic individuals > 40 years of age harbor significant extracranial carotid artery disease. Presence of multiple vascular risk factors markedly increases the risk of carotid stenosis.
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151
NI FEATURE: CENTS (CONCEPTS, ERGONOMICS, NUANCES, THERBLIGS, SHORTCOMINGS) - COMMENTARY
Endoscopic technique for single-stage anterior decompression and anterior fusion by transcervical approach in atlantoaxial dislocation
Yad Ram Yadav, Shailendra Ratre, Vijay Parhihar, Amitesh Dubey, Neil M Dubey
March-April 2017, 65(2):341-347
DOI
:10.4103/neuroindia.NI_1276_16
PMID
:28290397
Although posterior approaches are being used frequently in most atlantoaxial dislocations (AAD), anterior decompression is also required in some patients in whom the C1-2 dislocation is not properly reduced by the posterior approach. Transnasal and transoral approaches need an additional posterior approach to perform atlantoaxial fusion. They also have an added risk of infection. The endoscopic transcervical approach can be used for single-stage cervical decompression and stabilization that includes an odontoidectomy and anterior fusion. It can be used both in reducible and irreducible AAD. Patients with a high basilar invasion, traumatic or other lesions involving the C1 or C2 facet joint, reducible AAD with Chiari malformation, and patients with a large mandible or a mandible angle lying below the C3 level even after the maximum neck extension, should not be subjected to this procedure. Preoperative X-ray, computed tomography (CT) scan with angiogram, and magnetic resonance imaging of the craniovertebral region should be done to assess the dislocation. The early results of an endoscopic transcervical approach were found to be safe and effective for decompression and fusion in our experience. There was no permanent complication. The procedure avoids a two-stage surgery; thus, odontoidectomy, if needed, can be performed in addition to the C1-2 fusion in a single stage.
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91
NI FEATURE: PATHOLOGY PANORAMA - COMMENTARY
Indian Society of Neuro-Oncology consensus guidelines for the contemporary management of medulloblastoma
Tejpal Gupta, Chitra Sarkar, Vedantam Rajshekhar, Sandip Chatterjee, Neelam Shirsat, Dattatreya Muzumdar, Sona Pungavkar, Girish Chinnaswamy, Rakesh Jalali
March-April 2017, 65(2):315-332
DOI
:10.4103/0028-3886.201841
PMID
:28290395
Introduction:
The high success rate in the management medulloblastoma achieved in the western world is not exactly mirrored in developing countries including India. Socio-demographic differences, health-care disparity, and lack in uniformity of care with resultant widespread variations in the clinical practice are some of the reasons that may partly explain this difference in outcomes. Patients with medulloblastoma require a multi-disciplinary team approach involving but not limited to neuro-radiology, neurosurgery; neuropathology, molecular biology, radiation oncology, pediatric medical oncology and rehabilitative services for optimizing outcomes.
Methods:
The Indian Society of Neuro-Oncology (ISNO) constituted an expert multi-disciplinary panel with adequate representation from all stakeholders to prepare national consensus guidelines for the contemporary management of medulloblastoma.
Results:
Minimum desirable, as well as preferable though optional recommendations (as appropriate), were developed and adopted for the pre-surgical work-up including neuroimaging; neurosurgical management including surgical principles, techniques, and complications; neuropathology reporting and molecular testing; contemporary risk-stratification in the molecular era; appropriate adjuvant therapy (radiotherapy and chemotherapy); and follow-up schedule in medulloblastoma.
Conclusions:
The current document represents a broad consensus reached amongst various stakeholders within the neuro-oncology community involved in the contemporary curative-intent management of children with medulloblastoma. It provides both general as well as specific guidelines and recommendations to be adopted by physicians and health care providers across India to achieve uniformity of care, improve disease-related outcomes, and compare results between institutions within the country.
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1,791
ORIGINAL ARTICLE
Imaging biomarker correlates with oxidative stress in Parkinson's disease
Rajini M Naduthota, Rose D Bharath, Ketan Jhunjhunwala, Ravi Yadav, Jitender Saini, Rita Christopher, Pramod Kumar Pal
March-April 2017, 65(2):263-268
DOI
:10.4103/neuroindia.NI_981_15
PMID
:28290386
Background:
While oxidative stress (OS) may be one of the crucial factors determining the initiation and progression of Parkinson's disease (PD), its correlation with gray matter (GM) atrophy is not known.
Aims:
To determine the GM volume (GMV) changes using voxel-based morphometry (VBM) and correlation with OS marker serum malondialdehyde (MDA) in PD.
Materials and Methods:
Seventy-two patients with PD were clinically evaluated and underwent magnetic resonance imaging (MRI) on a 3T MRI scanner using a 32-channel head coil. Lipid peroxidation product MDA levels were measured by spectrophotometry. MDA levels and regional GM differences using VBM were compared with 72 healthy controls.
Results:
The mean age of the patients was 51.3 ± 10.6 years and that of controls was 50.8 ± 10.4 years. The mean age of onset of symptoms in PD was 45.2 ± 11.3 years. In PD, serum MDA level was significantly higher than that in controls (0.592 ± 0.89 μmol/l vs. 0.427 ± 0.055 μmol/l;
P
< 0.0001). Compared to controls, patients had greater regional GM atrophy in all the brain lobes (
P
< 0.001, uncorrected). A significant positive correlation was found between GMV and MDA in the caudate nucleus (CN) and posterior cingulate gyrus (PC) in the patient group (
P
< 0.001, uncorrected).
Conclusions:
We observed GM atrophy in all major brain lobes of patients when compared to controls. Only in the patient group, a significant positive correlation was observed in CN and PC with MDA. These findings suggest that, even though the whole brain is affected in PD, some of the non-substantia nigra regions of the brain, such as CN, may have some differential compensatory mechanism, which are preserved from oxidative damage.
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90
COMMENTARY
Oxidative stress and Parkinson's disease
Charulata Savant Sankhla
March-April 2017, 65(2):269-270
DOI
:10.4103/0028-3886.201842
PMID
:28290387
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62
ORIGINAL ARTICLE
The evaluation of sexual function in women with stroke
Halim Yilmaz, Haluk Gumus, Sema D Yilmaz, Halil E Akkurt, Faruk O Odabas
March-April 2017, 65(2):271-276
DOI
:10.4103/neuroindia.NI_1102_15
PMID
:28290388
Background:
Although very common, sexual dysfunction is a neglected disorder in women with stroke.
Aim:
To investigate the physical, psychological and sexual changes in women with stroke, and to determine the factors related to these changes.
Settings and Design:
This descriptive study was conducted at a tertiary care university hospital.
Material and Methods:
A total of 112 women (51 stroke patients, 61 healthy controls) were included in the study. The independence level of stroke patients was evaluated with the Modified Rankin Scale (mRS); the severity of stroke and the clinical status of patients after stroke, with the National Institute of Health Stroke Scale (NIHSS); depression levels, with the Beck Depression Inventory (BDI); and, patients' sexual function, with the Female Sexual Function Inventory (FSFI).
Statistical Analysis:
The Kolmogorov-Smirnov, the student's
t
, the Chi-square and the Mann- Whitney-U tests, and the Spearman's correlation analysis were performed in the appropriate conditions.
Results:
While the scores of total FSFI and FSFI subgroups in women with stroke were lower than in healthy controls, BDI scores were found to be higher than those of controls. A negative correlation was detected between the total FSFI scores, and BDI, MRS, NIHSS, age, duration of marriage and number of children in women with stroke, while a positive correlation was found between total FSFI scores and educational level.
Conclusion:
Sexual dysfunction is a commonly seen disorder in women with stroke, and is influenced by the severity of disease, level of dependence and accompanying depression. Therefore, evaluation of sexual dysfunction, depression and levels of physical function should be done in women with stroke during their follow up.
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63
LETTERS TO EDITOR
Primary central nervous system dural-based anaplastic large cell lymphoma: Diagnostic considerations, prognostic factors, and treatment modalities
Mayur V Kaku, Amey R Savardekar, Yasha Muthane, A Arivazhagan, Malla Bhaskara Rao
March-April 2017, 65(2):402-405
DOI
:10.4103/neuroindia.NI_1272_15
PMID
:28290414
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6
3,671
48
Dyke–Davidoff–Masson syndrome
Charan S Jilowa, Parth S Meena, Jitendra Rohilla, Mahendra Jain
March-April 2017, 65(2):413-414
DOI
:10.4103/neuroindia.NI_1004_15
PMID
:28290419
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6
4,548
57
Cerebellar liponeurocytoma presenting as multifocal bilateral cerebellar hemispheric mass lesions
Laxminadh Sivaraju, Saritha Aryan, Nandita Ghosal, Alangar S Hegde
March-April 2017, 65(2):422-424
DOI
:10.4103/neuroindia.NI_1379_15
PMID
:28290424
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6
3,987
41
A case of infectious intracranial dissecting aneurysm
Xiaoli Zhong, Xiaobo Li, Si Shao, Xiaoping Yang, Xuejun Fan
March-April 2017, 65(2):405-407
DOI
:10.4103/neuroindia.NI_1223_15
PMID
:28290415
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5
3,973
34
NI FEATURE: FACING ADVERSITY…TOMORROW IS ANOTHER DAY! - LETTERS TO EDITOR
Massive epistaxis resulting from radiation-induced internal carotid artery pseudoaneurysm
Pouya Nazari, Lee A Tan, Joshua T Wewel, Roham Moftakhar, Manish K Kasliwal
March-April 2017, 65(2):380-382
DOI
:10.4103/neuroindia.NI_1259_15
PMID
:28290404
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5
5,361
37
LETTERS TO EDITOR
Rapid spontaneous regression of a lumbar juxta-facet cyst
Necati Ucler, Sait Ozturk, Arif Gulkesen, Metin Kaplan
March-April 2017, 65(2):417-418
DOI
:10.4103/neuroindia.NI_596_16
PMID
:28290421
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3
4,311
26
Craniopharyngioma with malignant transformation: Review of literature
S Narla, J Govindraj, K Chandrasekar, P Sushama
March-April 2017, 65(2):418-420
DOI
:10.4103/neuroindia.NI_528_16
PMID
:28290422
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3
5,739
59
NEUROIMAGES
Bilateral retropharyngeal internal carotid artery: A rare and potentially fatal anatomic variation
Mahesh Prakash, S Abhinaya, Ajay Kumar, Niranjan Khandelwal
March-April 2017, 65(2):431-432
DOI
:10.4103/neuroindia.NI_1210_15
PMID
:28290430
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3
6,803
36
NI FEATURE: FACING ADVERSITY…TOMORROW IS ANOTHER DAY! - LETTERS TO EDITOR
Role of 5HT1A and 5HT2A receptors and default mode network in olanzapine-induced somnambulism
Sourav Das, Ravi Gupta, Mohan Dhyani, Divyashree Sah, Jitamanyu Maity
March-April 2017, 65(2):373-374
DOI
:10.4103/neuroindia.NI_481_15
PMID
:28290400
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3
5,777
62
COMMENTARY
Sexual dysfunction in women post stroke: The hidden morbidity
Santosh K Chaturvedi, Poornima Bhola
March-April 2017, 65(2):277-278
DOI
:10.4103/0028-3886.201880
PMID
:28290389
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2
4,429
55
CORRESPONDENCE
The 'reverse' evaluation!
Shashwat Mishra
March-April 2017, 65(2):433-433
DOI
:10.4103/neuroindia.NI_1253_16
PMID
:28290431
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2
2,931
41
“Magister neurochirurgiae”: A 3-year 'crash course' or a 5-year 'punctilious pedagogy'?
George C Vilanilam, HV Easwer, Girish R Menon, Vikram Karmarkar
March-April 2017, 65(2):434-437
DOI
:10.4103/neuroindia.NI_1175_16
PMID
:28290432
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2
4,278
61
NI FEATURE - COMMENTARY: TIMELESS REVERBERATIONS
The element fluorine and its effects on human health including its neurological manifestations
D Raja Reddy
March-April 2017, 65(2):238-239
DOI
:10.4103/neuroindia.NI_108_17
PMID
:28290377
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2
4,723
95
NI FEATURE: JOURNEY THROUGH THE EONS - COMMENTARY
Deep tendon reflex: The background story of a simple technique
Kalyan B Bhattacharyya
March-April 2017, 65(2):245-249
DOI
:10.4103/neuroindia.NI_1177_16
PMID
:28290379
Wilhelm Erb and Carl Otto Westphal from Prussia first described the knee jerk in the same issue of the journal Archiv für Psychiatrie und Nervenkrankheiten in January 1875. This article retraces the history of development of 'deep tendon reflex' as an integral clinical sign during every neurological examination. The history of the evolving shapes of the reflex hammer, the iconic trademark and the ultimate signature of a neuroscientist, is also presented.
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206
COMMENTARY
Hybrid PET/MR imaging for evaluation of recurrence in gliomas: Standard of care or luxury?
BR Mittal, Shashank Singh
March-April 2017, 65(2):302-304
DOI
:10.4103/0028-3886.201846
PMID
:28290393
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1
3,961
63
LETTERS TO EDITOR
Improvements in non-motor and motor fluctuations in parkinson's disease after intermittent apomorphine treatment
Sevda Erer, Mehmet Zarifoglu
March-April 2017, 65(2):388-389
DOI
:10.4103/neuroindia.NI_437_15
PMID
:28290407
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1
3,701
44
Neurological manifestation of Erdheim Chester disease: A series of 3 patients
Bhavesh Trikamji, Shrikant Mishra
March-April 2017, 65(2):392-393
DOI
:10.4103/neuroindia.NI_1120_15
PMID
:28290409
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1
3,861
52
Anti-N-methyl-D-aspartate receptor encephalitis during relapse of herpes simplex encephalitis in a young boy: A brief review of literature
Varsha A Patil, Shilpa D Kulkarni, Anaita Udwadia-Hegde, Rafat J Sayed, Meenal Garg
March-April 2017, 65(2):393-397
DOI
:10.4103/neuroindia.NI_1218_15
PMID
:28290410
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1
4,487
65
Dropped head syndrome in brachial plexus injury: A technical note
Ashish Kumar, Dacosta Leodante
March-April 2017, 65(2):411-413
DOI
:10.4103/neuroindia.NI_1160_15
PMID
:28290418
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1
3,895
41
Malignant temporal muscle myofibroblastoma with an early recurrence in a child
Saraj K Singh, Amol A Raheja, Aman K Jagdevan, Pankaj K Singh, Suvendu Purkait, Vaishali A Suri
March-April 2017, 65(2):408-410
DOI
:10.4103/neuroindia.NI_1241_15
PMID
:28290416
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1
4,117
41
Persistent trigeminal artery trunk giant aneurysm and its management
Vivek Gupta, Anuj Prabhakar, Chirag K Ahuja, Ankur Bajaj, Sunil K Gupta, N Khandelwal
March-April 2017, 65(2):400-402
DOI
:10.4103/neuroindia.NI_259_16
PMID
:28290413
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1
3,312
40
NEUROIMAGES
Nuclear third nerve palsy as a presenting manifestation of breast carcinoma
Biplab Das, Vinny Wilson, Sahil Mehta, Balan Gaspar, Vivek Lal
March-April 2017, 65(2):430-431
DOI
:10.4103/neuroindia.NI_1349_15
PMID
:28290429
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1
3,434
33
Rapidly progressive dementia with myoclonus: Not Creutzfeldt-Jakob disease
M Saini, NM Varghese, Khin Hnin Su Wai, NK Loh
March-April 2017, 65(2):426-427
DOI
:10.4103/neuroindia.NI_57_16
PMID
:28290426
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1
6,488
68
NI FEATURE: FACING ADVERSITY…TOMORROW IS ANOTHER DAY! - LETTERS TO EDITOR
Pedicle screw loosening – reassessing short segment fixation in dorsolumbar junctional fractures
Prasad Krishnan, Rajaraman Kartikueyan, Sachinkumar M Patel, Subhasis Deb
March-April 2017, 65(2):382-385
DOI
:10.4103/neuroindia.NI_1156_15
PMID
:28290405
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5,152
60
Extraosseous cement leakage after vertebroplasty producing intractable low back pain
Boby V Maramattom
March-April 2017, 65(2):375-376
DOI
:10.4103/neuroindia.NI_591_16
PMID
:28290401
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1
5,722
45
Inadequate expansion lead to delayed Enterprise stent migration
Li Li, Peng Li, Liangfu Zhu, Tianxiao Li
March-April 2017, 65(2):377-378
DOI
:10.4103/neuroindia.NI_946_15
PMID
:28290402
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1
3,607
31
NI FEATURE: JOURNEY THROUGH THE EONS - COMMENTARY
Description of coma and coma arousal therapy in
Caraka Saṁhitā
and its corollary in modern medicine
Dhaval Shukla
March-April 2017, 65(2):250-252
DOI
:10.4103/neuroindia.NI_1110_16
PMID
:28290380
The description of coma and coma arousal therapy in Caraka Saṁhitā is described in sṁtra 24, verses 42–53. It describes the definition of coma, differential diagnosis of coma from other disorders of consciousness, signs of coma, etiology of coma, coma arousal therapy, and emergence from coma. The similarities and differences of these aspects of coma from the perspective of its interpretation in modern medicine are discussed in this article.
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NI FEATURE: THE QUEST - COMMENTARY
Three-dimensional visualization of intracranial tumors with cortical surface and vasculature from routine MR sequences
Zafar Neyaz, Rajendra V Phadke, Vivek Singh, Chaitanya Godbole
March-April 2017, 65(2):333-340
DOI
:10.4103/neuroindia.NI_1167_16
PMID
:28290396
The simultaneous three-dimensional (3D) visualization of intracranial tumors, brain structures, skull, and vessels is desired by neurosurgeons to create a clear mental picture of the anatomical orientation of the surgical field prior to the surgical intervention. Different anatomical and pathological components are usually visualized separately on different magnetic resonance (MR) sequences; however, during surgery, they are tackled simultaneously. Another problem is that most present day MR workstations enable review of two-dimensional (2D) slices only with limited postprocessing options. With recent software developments, a simultaneous 3D visualization simulating the real surgical field is possible using commercial or open source softwares. The authors have reviewed the important concepts and described a technique of interactive 3D visualization from routine 3D T1-weighted, MR angiography, and MR venography sequences using open source FSL (Functional MRI of the brain software library) and BrainSuite softwares.
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6,216
101
ORIGINAL ARTICLES
Effect of propofol anesthesia on resting state brain functional connectivity in Indian population with chronic back pain
Kamath Sriganesh, Rakesh Balachandar, Bhavani Shankara Bagepally, Jitender Saini, GS Umamaheswara Rao
March-April 2017, 65(2):286-292
DOI
:10.4103/neuroindia.NI_782_15
PMID
:28290391
Objective:
Functional magnetic resonance imaging (fMRI) studies in healthy volunteers have shown alterations in brain connectivity following anesthesia as compared to the awake state. It is not known if the anesthesia-induced changes in brain connectivity are different in a pathological state. This study aims to evaluate changes in the resting state functional connectivity in the brain, after propofol anesthesia, in patients with chronic back pain (CBP).
Materials and Methods:
Fourteen adults with CBP were included in this prospective study over 6 months. After excluding structural brain pathology, a resting state fMRI was performed in the awake state, and the sequences were repeated after propofol anesthesia. The primary outcome measure was change in resting state connectivity after propofol. Student's
t
-test was performed between the pre and post-propofol sedation data of all patients with total brain volume as covariates of interest. A repeated measures analysis of variance was used to compare pre- and post-propofol changes in cardiorespiratory parameters.
Results:
There were 8 male and 6 female patients in the study, and the mean age of the study population was 46.9 ± 11.3 years. Propofol sedation resulted in an increased strength of functional connectivity between the posterior cingulate cortex (PCC) and thalamus in patients with CBP, whereas there was a generalized decrease in functional integration within the large scale brain networks. The changes in cardiorespiratory parameters before and after propofol administration were not statistically significant.
Conclusion:
Strengthening of functional connectivity was seen between PCC and thalamus with decrease in large scale brain networks following propofol anesthesia in patients with CBP. These changes are similar to those previously described in normal volunteers.
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75
BOOK REVIEW
Arthur conan doyle: The case of lady sannox. medical mysteries and other adventures
Sunil Pandya
March-April 2017, 65(2):448-449
DOI
:10.4103/0028-3886.201849
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3,146
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CORRESPONDENCE
Author's Reply: Neurosurgical training and evaluation – Need for a paradigm shift
Ajit K Banerji
March-April 2017, 65(2):438-438
DOI
:10.4103/0028-3886.201879
PMID
:28290433
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2,864
41
Neurological problem due to Zika virus infection: What should be discussed?
Beuy Joob, Viroj Wiwanitkit
March-April 2017, 65(2):439-440
DOI
:10.4103/neuroindia.NI_912_16
PMID
:28290434
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3,376
35
Hyperdense lenticulostriate sign…or stroke following minor trauma
Mahesh Kamate
March-April 2017, 65(2):439-439
DOI
:10.4103/neuroindia.NI_923_16
PMID
:28290435
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3,014
43
Author's Reply: Zika virus: Some interesting points
Adrija Hajra, Dhrubajyoti Bandyopadhyay, Shyamal Kumar Hajra
March-April 2017, 65(2):440-441
DOI
:10.4103/0028-3886.201875
PMID
:28290436
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2,777
31
Stroke health and research initiatives – Advanced stroke care model and future roadmap
Shriram Varadharajan
March-April 2017, 65(2):441-442
DOI
:10.4103/neuroindia.NI_884_16
PMID
:28290437
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2,959
43
Author's Reply: National program and telemedicine services for stroke care
M Vasantha Padma, Sudhir Sharma
March-April 2017, 65(2):442-443
DOI
:10.4103/0028-3886.201873
PMID
:28290438
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2,822
41
Organized neurosurgery: Additional facts
K Rajasekharan Nair
March-April 2017, 65(2):443-445
DOI
:10.4103/0028-3886.201844
PMID
:28290439
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3,791
40
Author's Reply: Organized neurosurgery
Chandrashekhar E Deopujari
March-April 2017, 65(2):445-447
DOI
:10.4103/0028-3886.201845
PMID
:28290440
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2,979
30
LETTERS TO EDITOR
A rare case of giant solitary calvarial plasmacytoma: Can it grow bigger than this?
Dipanker Singh Mankotia, Sachin A Borkar, Kavneet Kaur, Vaishali Suri, Bhawani S Sharma
March-April 2017, 65(2):420-422
DOI
:10.4103/neuroindia.NI_27_16
PMID
:28290423
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3,541
45
Occult sacral meningocoele associated with spinal dysraphism: Report of an unusual case and a review of literature
Ravi Dadlani, Aditya A Atal
March-April 2017, 65(2):414-416
DOI
:10.4103/neuroindia.NI_599_16
PMID
:28290420
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4,016
40
'Effaced bilateral retromaxillary fat pad sign' in bilateral masseter and temporalis muscle hypertrophy
Kamble J Harsha, K Parameswaran
March-April 2017, 65(2):410-411
DOI
:10.4103/neuroindia.NI_1196_15
PMID
:28290417
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6,312
33
Young onset Parkinsonism in a patient with familial central core disease
P Samuel Joseph, DM Syam Krishnan, Gayathri Narayanappa, Muralidharan Nair
March-April 2017, 65(2):386-388
DOI
:10.4103/neuroindia.NI_746_15
PMID
:28290406
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3,954
63
An unusual cause of bilateral thalamic lesions
Satish Bawri, Moromi Das, Munindra Goswami, Ashok K Kayal
March-April 2017, 65(2):389-391
DOI
:10.4103/neuroindia.NI_293_16
PMID
:28290408
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6,049
85
Hemichorea secondary to non-ketotic hyperglycemia as the presenting manifestation of diabetes mellitus
Lulup Kumar Sahoo, Ashok Kumar Mallick, Geeta Mohanty, Kali Prasanna Swain, Srikanta Kumar Sahoo
March-April 2017, 65(2):397-398
DOI
:10.4103/neuroindia.NI_1180_15
PMID
:28290411
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3,796
50
Anti-NMDAR encephalitis combined with a subependymoma
Duan Xiao, Yihui Lin, Xiaofeng Wang, Canhong Yang, Xiaoyu Huang, Bo Fu, Qingzhu Wei, Tianming Lü
March-April 2017, 65(2):398-400
DOI
:10.4103/neuroindia.NI_1348_15
PMID
:28290412
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3,486
37
NEUROIMAGES
Vein of Trolard thrombosis
Mo Yang, Sabrina Yum, Li Yang
March-April 2017, 65(2):425-425
DOI
:10.4103/neuroindia.NI_670_16
PMID
:28290425
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6,346
58
Posterior inferior cerebellar artery susceptibility sign in lateral medullary syndrome
BM Krishna Vadana, R Adhithyan, C Kesavadas, Veerendra Malik
March-April 2017, 65(2):427-428
DOI
:10.4103/neuroindia.NI_465_16
PMID
:28290427
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4,505
62
Multiple mirror image cervical neurofibromas in neurofibromatosis type 1
Saraj K Singh, Dipankar S Mankotia, Sachin A Borkar, Uditi D Gupta
March-April 2017, 65(2):428-429
DOI
:10.4103/neuroindia.NI_1370_15
PMID
:28290428
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3,629
46
NI FEATURE - COMMENTARY: THE FIRST IMPRESSION
The cover page
March-April 2017, 65(2):237-237
DOI
:10.4103/0028-3886.201839
PMID
:28290376
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3,441
75
NI FEATURE: CITADELS SCULPTING FUTURE - COMMENTARY
Government Medical College Trivandrum – Fifty years of Neurosurgery in Kerala state
Anil Kumar Peethambaran, Raj S Chandran
March-April 2017, 65(2):348-359
DOI
:10.4103/0028-3886.201847
PMID
:28290398
The Department of Neurosurgery founded in the Trivandrum Medical College, Kerala, the first teaching hospital in Kerala state, is celebrating its 50th anniversary. The history of Neurosurgery in this Institute is synonymous with the history of Neurosurgery in the state as this was the first medical college to start a Neurosurgery department within the state.The students after undergoing their rigorous training in the department, went on to establish advanced neurosurgical centres throughout Kerala and in several other parts of the country. This article traces the illustrious history of the Department of Neurosurgery, Trivandrum Medical College and also of the eminent faculty members and residents, who helped in advancing the standards of Neurosurgery in the region as well as the rest of India. The Department of Neurosurgery was founded in the Trivandrum Medical College, Kerala, the first teaching hospital in Kerala state, in the year 1951, and is celebrating its 50th anniversary. The history of Neurosurgery in this Institute is synonymous with the history of Neurosurgery in the state as this was the first medical college to start a Neurosurgery department within the state.The students after undergoing their rigorous training in the department, went on to establish advanced neurosurgical centres throughout Kerala and in several other parts of the country. This article traces the illustrious history of the Department of Neurosurgery, Trivandrum Medical College and also of the eminent faculty members and residents, who helped in advancing the standards of Neurosurgery in the region as well as the rest of India.
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29,646
103
NI FEATURE: FACING ADVERSITY…TOMORROW IS ANOTHER DAY! - LETTERS TO EDITOR
Intraprocedural rupture during catheter angiogram in a case of aggressive dural arteriovenous fistula
Sweta Swaika, Santhosh Kumar Kannath, Jayadevan Enakshy Rajan
March-April 2017, 65(2):378-379
DOI
:10.4103/neuroindia.NI_59_16
PMID
:28290403
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3,208
43
NI FEATURE: JOURNEY THROUGH THE EONS - COMMENTARY
Two founders of Bombay Neurosciences: Professor Gajendra Sinh and Professor Noshir Hormusjee Wadia
Sunil Pandya
March-April 2017, 65(2):240-244
DOI
:10.4103/0028-3886.201840
PMID
:28290378
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5,339
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NI FEATURE: THE EDITORIAL DEBATE I-- PROS AND CONS
Anaesthesia, chronic pain and brain connectivity
Mary Abraham
March-April 2017, 65(2):253-254
DOI
:10.4103/0028-3886.201843
PMID
:28290381
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3,658
44
Role of functional MRI in identifying network changes in chronic pain syndromes
Uday D Patil
March-April 2017, 65(2):255-256
DOI
:10.4103/0028-3886.201853
PMID
:28290382
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3,550
40
NI FEATURE: THE EDITORIAL DEBATE II-- PROS AND CONS
The role of systematic collection of epidemiological data from India in reducing the burden of traumatic brain injury
Peter Reilly
March-April 2017, 65(2):259-260
DOI
:10.4103/0028-3886.201851
PMID
:28290384
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3,284
48
Quantitative research on traumatic brain injury in India: The travails and the new optimism
Virendra Deo Sinha, Amit Chakrabarty
March-April 2017, 65(2):261-262
DOI
:10.4103/0028-3886.201852
PMID
:28290385
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5,007
106
NI FEATURE: THE FOURTH DIMENSION - COMMENTARY
A summary of some of the recently published, seminal papers in neuroscience
Paritosh Pandey, Mazda K Turel, Manjul Tripathi, Ravi Yadav, PR Srijithesh, Aastha Takkar, Sahil Mehta, Kuntal K Das, Anant Mehrotra
March-April 2017, 65(2):360-372
DOI
:10.4103/0028-3886.201850
PMID
:28290399
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3,222
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OBITUARY
Dr. GM Taori
Guru D Satyarthee, Bhawani S Sharma, Lokendra Singh
March-April 2017, 65(2):450-453
DOI
:10.4103/neuroindia.NI_858_16
PMID
:28290441
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14,375
54
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