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2019| July-August | Volume 67 | Issue 4
Online since
September 10, 2019
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REVIEW ARTICLES
Deep Brain Stimulation in Parkinson's Disease
Naveed Malek
July-August 2019, 67(4):968-978
DOI
:10.4103/0028-3886.266268
PMID
:31512617
Deep brain stimulation (DBS) has become an established therapeutic tool for treating patients with Parkinson's disease (PD) who have troublesome motor fluctuations and dyskinesias refractory to best medical therapy. In addition to its proven efficacy in patients with late PD, the EARLYSTIM trial not only demonstrated the efficacy of DBS in patients with early motor complications but also showed that it did not lose its therapeutic efficacy as the years passed by. However, like all other therapies for PD, DBS is not offered to patients either as a cure for this disease nor is it expected to stop the progression of the neurodegenerative process underlying PD; these important issues need to be highlighted to patients who are considering this therapy. This article aims to provide an introduction to residents or trainees starting a career in movement disorders of the technical aspects of this therapy and the evidence base for its use. For the latter objective, PUBMED was searched from 1946 to 2017 combining the search terms “deep brain stimulation” and “Parkinson's disease” looking for studies demonstrating the efficacy of this therapy in PD. Inclusion criteria included studies that involved more than 20 patients with a physician confirmed diagnosis of PD and a follow-up of greater than or equal to at least 12 months. The findings from those studies on motor symptoms, medication requirements, quality of life, and independence in activities of daily living in PD patients are summarized and presented in tabulated form in this paper at the end.
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34
CASE REPORTS
Neurogenic Fever in Severe Traumatic Brain Injury Treated with Propranolol: A Case Report
Mayank Garg, Kanwaljeet Garg, Pankaj K Singh, Guru Dutta Satyarthee, Deepak Agarwal, Ashok K Mahapatra, Bhawani S Sharma
July-August 2019, 67(4):1097-1099
DOI
:10.4103/0028-3886.266258
PMID
:31512644
The causes of intractable fever in severe traumatic brain injury (TBI) patients can be diverse. Neurogenic fever (NF) which is a rare entity can develop due to autonomic dysregulation in the absence of infection or any other cause of fever. It manifests as fever, tachycardia, paroxysmal hypertension, dilated pupils, tachypnea, and extensor posturing in cases of severe TBI, brain neoplasms or brain haemorrhage. We found propranolol to be effective in controlling many of the manifestations of neurogenic fever in our patients with severe TBI. Fever in severe TBI patients is not an uncommon phenomenon, but when intractable with negative fever workup, a central cause should be considered. Propranolol is deemed as one of the most efficacious drugs for managing NF due to dysautonomia. We want to apprise the readers about this entity and its treatment with beta-blockers.
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6
REVIEW ARTICLES
The Benefits and Risks of Statin Therapy in Ischemic Stroke: A Review of the Literature
Wang Zhao, Zhi-Jie Xiao, Shui-Ping Zhao
July-August 2019, 67(4):983-992
DOI
:10.4103/0028-3886.266274
PMID
:31512619
Statins are effective cholesterol-lowering drugs for reducing the risks of mortality and morbidity of cardiovascular diseases. Increasing evidence has shown that statin use is associated with a significant beneficial effect in patients with ischemic stroke. Both pre-stroke and post-stroke statin use has been found to be beneficial in ischemic stroke. Furthermore, good adherence is associated with a better clinical outcome, and statin withdrawal is associated with a poor functional outcome in patients with ischemic stroke. High-intensity statin therapy is advocated for the treatment of ischemic stroke. However, there are concerns regarding the adverse effects associated with statin use in ischemic stroke such as intracranial hemorrhage. In this review, we summarize the beneficial effect of statin use in ischemic stroke and discuss the potential risks associated with statin therapy.
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20
Eye Signs in Pituitary Disorders
Yan Chen, Zhihong Liu, Zhihui Lin, Xiaozhe Shi
July-August 2019, 67(4):979-982
DOI
:10.4103/0028-3886.266265
PMID
:31512618
The eye is a vital sense organ and plays a vital role in conveying the underlying physical and mental state of wellbeing of an individual. A comprehensive examination of the eye is often required in patients presenting with systemic complaints. Many endocrine disorders have characteristic manifestations pertaining to the eye, the classical being the exophthalmos in thyrotoxicosis. However, a cursory eye evaluation may lead to the identification of early features that can help in the diagnosis of other endocrine disorders. This is more common in cases of pituitary mass lesions, who often present with the functional hormonal alterations rather than the visual symptoms. The definitive therapy during the late stages of the disease leads to persisting visual disabilities and affects the quality of life. Hence, the endocrinologists and ophthalmologists need to be aware of various ophthalmic features in the pituitary disorders. In this review, we highlight the eye signs in pituitary disorders, along with a brief description of uncommon ocular-pituitary syndromes.
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META ANALYSIS - ORIGINAL ARTICLE
Role of Aspirin in Tuberculous Meningitis: A Systematic Review and Meta-analysis
Imran Rizvi, Ravindra K Garg, Hardeep S Malhotra, Neeraj Kumar, Ravi Uniyal
July-August 2019, 67(4):993-1002
DOI
:10.4103/0028-3886.266232
PMID
:31512620
Objectives:
Aspirin is a drug that has been found to be useful in reducing the incidence of infarctions. This systemic is aimed at review evaluating the benefits of aspirin in the management of tuberculous meningitis.
Methods:
A systematic literature search was performed using PubMed, Cochrane Central Register of Controlled Trials, and SCOPUS for articles published on or before September 22, 2018. The meta-register of controlled trials and bibliography was also searched. Randomized controlled trials wherein aspirin was used were included in the systematic review. The data was extracted using a predetermined format. The risk ratio (RR) for dichotomous data was calculated and a random-effects model was used to combine the data. Death and occurrence of new infarctions were considered as primary outcomes. The quality of evidence was assessed using the GRADE approach.
Results:
Four trials including 546 patients were found eligible. The addition of aspirin to anti-tuberculosis drug regimens did not significantly reduce mortality [RR = 0.66 (0.42–1.02); low-quality evidence] but significantly reduced the risk of new infarctions [RR = 0.52 (0.29–0.92); moderate-quality evidence]. Aspirin did not differ from the placebo with regard to the adverse event outcome.
Conclusion:
Aspirin reduces the risk of new infarctions in patients with tuberculous meningitis but does not affect mortality (moderate-to-low level of evidence).
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13
ORIGINAL ARTICLES
Post-stroke Visual Gait Measure for Developing Countries: A Reliability and Validity Study
Kamal Narayan Arya, Shanta Pandian, Vikas Kumar, GG Agarwal, Akash Asthana
July-August 2019, 67(4):1033-1040
DOI
:10.4103/0028-3886.266273
PMID
:31512628
Background:
Visual gait assessment is a cost-effective clinical method to assess post-stroke gait deviations. The Rivermead Visual Gait Assessment (RVGA) is a one such measure that assesses the kinematic aspect of the gait deviations in stroke. However, the available information on psycho-clinocometric properties of the measure is not adequate.
Objective:
To establish reliability and validity of RVGA using walking-videos of the post-stroke subjects.
Methods:
Design: Observational study.
Setting:
A rehabilitation institute Participants: A convenience sample of 40 chronic stroke patients.
Outcome Measures:
RVGA, Fugl–Meyer assessment (lower extremity), 10-m walk test, Time up and go test, and Berg balance scale (BBS).
Procedure:
Walking was video-taped from the anterior aspect, posterior aspect, affected side, and less-affected side. After coding the tapes, a research staff member provided them to four different raters in a random order. Each rater scored the coded video on the RVGA data collection sheet twice: one at the baseline and another after 1 month to eliminate any recollection of the initial assessment.
Results:
The findings exhibit that there was good-to-excellent agreement between the scores of the raters and also between the assessments (correlation coefficient = 0.94 to 0.95;
P
< 0.001). The measure also exhibits acceptable validity when correlated with scores of BBS (
r
= 0.4;
P
< 0.001).
Conclusion:
Video-based RVGA is a reliable and valid tool to assess gait-related impairment in post-stroke hemiparesis. This cost-effective measure may be incorporated in the clinical and research practice to discern and quantify complex phenomenon of the gait deviation. RVGA may be considered as a useful tool, especially in developing countries where expensive gait analyzer is usually not available.
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2
NEUROIMAGES
Bare Orbit Sign/Empty Orbit Sign – Is It Really Empty?
Ramakrishna Narra, Sushil Kumar Kamaraju, Anusha Putcha
July-August 2019, 67(4):1166-1166
DOI
:10.4103/0028-3886.266298
PMID
:31512673
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7,718
73
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CORRESPONDENCE
MRI Findings in a Case of Genetically Proven CADASIL with Emphasis on Differential Diagnosis
Suganya Subbulakshmi, Garg P Rattanlal, Devanand, Rajakumar
July-August 2019, 67(4):1171-1173
DOI
:10.4103/0028-3886.266275
PMID
:31512678
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7,366
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COMMENTARY
Tuberculous Meningitis – Adjunctive Therapy: Corticosteroids, Aspirin, or Both
J M K Murthy
July-August 2019, 67(4):1003-1005
DOI
:10.4103/0028-3886.266280
PMID
:31512621
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6,363
136
1
LETTERS TO EDITOR
Cerebellar Demyelination: Rare Presentation of HIV Infection
Vijay Sardana, Parag Moon
July-August 2019, 67(4):1142-1145
DOI
:10.4103/0028-3886.266287
PMID
:31512662
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ORIGINAL ARTICLES
Clinical Significance of Fractional Anisotropy Measured in Peritumoral Edema as a Biomarker of Overall Survival in Glioblastoma: Evidence Using Correspondence Analysis
Eduardo Flores-Alvarez, Coral Durand-Muñoz, Filiberto Cortes-Hernandez, Onofre Muñoz-Hernandez, Sergio Moreno-Jimenez, Ernesto Roldan-Valadez
July-August 2019, 67(4):1074-1081
DOI
:10.4103/0028-3886.266284
PMID
:31512638
Introduction:
Fractional anisotropy (FA), a diffusion tensor image (DTI) derived biomarker is related to invasion, infiltration, and extension of glioblastoma (GB). We aimed to evaluate FA values and their association with intervals of overall survival (OS).
Materials and Methods:
Retrospective study conducted in 36 patients with GB included 23 (63.9%) males, 46 ± 14 y; and 13 (36.1%) females, 53 ± 13; followed up for 36 months. We measured FA at edema, enhancing rim, and necrosis. We created two categorical variables using levels of FA and intervals of OS to evaluate their relationships. Kaplan-Meier method and correspondence analysis evaluated the association between OS (grouped in 7 six-month intervals) and FA measurements.
Results:
Median FA values were higher in healthy brain regions (0.351), followed by peritumoral edema (0.190), enhancing ring (0.116), and necrosis (0.071). Pair-wise comparisons among tumor regions showed a significant difference,
P
< 0.001. The median OS for all patients was 19.3 months; variations in the OS curves among subgroups was significant χ
2
(3) = 8.48,
P
= 0.037. Correspondence analysis showed a significant association between FA values in the edema region and the survival intervals χ
2
(18) = 30.996,
P
= 0.029.
Conclusions:
Alternative multivariate assessment using correspondence analysis might supplement the traditional survival analysis in patients with GB. A close follow-up of the variability of FA in the peritumoral edema region is predictive of the OS within specific six-month interval subgroup. Further studies should focus on predictive models combining surgical and DTI biomarkers.
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ORIGINAL ARTICLE
Antiplatelets versus Anticoagulants in the Treatment of Extracranial Carotid and Vertebral Artery Dissection
VS Vineetha, Sapna E Sreedharan, PS Sarma, PN Sylaja
July-August 2019, 67(4):1056-1059
DOI
:10.4103/0028-3886.266290
PMID
:31512634
Background:
Very few studies have compared the safety and efficacy of antiplatelets and anticoagulants in the treatment of extracranial carotid and vertebral artery dissection. Our study was aimed at comparing the two types of antithrombotic treatment in extracranial dissection and to study the predictors of outcome in these patients.
Materials and Methods:
Prospective data of 200 consecutive patients with a confirmed diagnosis of extracranial carotid (
n
= 132) or vertebral (
n
= 68) artery dissection (76% males; mean age, 43.5 ± 13 years) treated with antiplatelets (
n
= 136) or anticoagulants (
n
= 64) were analyzed retrospectively. The presenting symptom was stroke in 74.5%, transient ischemic attack (TIA) in 18.5%, and local symptoms in 7% of the patients. Follow-up was done at three and six months. Primary outcome measures were TIA or stroke and symptomatic intracerebral hemorrhage (SICH) at three months.
Results:
At the three-month follow-up, 106 (53%) patients had an excellent outcome. Recurrent ischemic events occurred in 7 (3.5%) and SICH in 11 (5.55%) patients. Six (4.41%) patients in the antiplatelet group and 1 patient (1.56%) in the anticoagulant group had recurrent ischemic events (
P
= 0.434); SICH was more frequent in the anticoagulant group (9.4% vs 3.7%,
P
= 0.185). On multivariate analysis, significant predictors of a poor three-month outcome were stroke as the presenting event and severity of stroke at onset.
Conclusions:
The risk of recurrent ischemic events in carotid and vertebral artery dissection is low and is irrespective of the type of antithrombotic treatment. Stroke as the presenting event and severity of stroke at onset were significant predictors of a poor three-month outcome.
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111
4
ORIGINAL ARTICLES
Impact of Hyperventilation and Sleep Deprivation Upon Visual Evoked Potentials in Patients with Epilepsy
Edyta Dziadkowiak, Ryszard Podemski
July-August 2019, 67(4):1027-1032
DOI
:10.4103/0028-3886.266246
PMID
:31512627
Objectives:
The diagnosis of epilepsy can cause many problems, especially when the routine electrophysiological tests are inconclusive. The aim of the present study was to assess the visual evoked potential (VEP) in patients with epilepsy using various kinds of stimulation and activation tests. The VEP parameters were also presented with reference to the type of seizure and abnormalities in electroencephalogram (EEG), including the response to the activation tests.
Materials and Methods:
This study comprised 81 patients with newly diagnosed epilepsy of unknown etiology before initiation of the treatment. The VEP tests were performed at rest, after hyperventilation, and deprivation of sleep. Visual stimulation included an alternating checkerboard pattern and a uniform flash light (FL) with a frequency of 1.88 and 15 Hz.
Results:
The VEP parameters obtained with the stimulation of a checkerboard pattern did not differ significantly between the patients and controls. Neither the presence of seizure activity in EEG nor the type of seizure significantly affected the VEP parameters. Using the FL stimulation, a significantly prolonged VEP latency was found at the FL frequency of 1.88 Hz and shortened at the frequency of 15 Hz. These changes were augmented after activation tests. In case of the patients with positive intermittent photic stimulation response in EEG, a significant prolongation of P100 latency was shown at rest and after FL stimulation at the frequency of 1.88 Hz.
Conclusion:
Standard activation methods significantly affect the VEP parameters in patients with epilepsy. Changes in the VEP parameters depend on the frequency and the type of the stimulus, as well as the activation method used. These findings suggest a disturbed balance between the glutamatergic and GABAergic systems in the visual excitability of neuronal networks in case of patients with epilepsy.
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1
ORIGINAL ARTICLE
Endoscopic versus Microscopic Pituitary Adenoma Surgery: A Single-center Study
Ajler Pablo, Beltrame Sofia, Toscano Maximiliano, Fainstein Day Patricia, Campero Alvaro, Yampolsky Claudio, Carrizo Antonio
July-August 2019, 67(4):1015-1021
DOI
:10.4103/0028-3886.266241
PMID
:31512624
Background:
Transsphenoidal approach became the gold standard in the surgical treatment of pituitary adenomas in the past years, but the comparative efficacy of microscopic and endoscopic transnasal surgery has not been fully studied.
Aims:
To compare the microscopic and endoscopic transnasal approaches for the treatment of pituitary adenomas.
Settings and Design:
A retrospective analysis was performed, comparing adult patients with pituitary adenomas who had undergone transnasal microscopic surgery between January 2006 and December 2014 with the patients operated on with endoscopic surgery between March 2011 and December 2014 at Hospital Italiano de Buenos Aires.
Material and Methods:
Imaging, hormonal, and ophthalmological studies as well as complications were analyzed.
Statistical Analysis:
Due to the existence of dichotomous variables, Fisher's exact test was used for statistical analysis.
Results:
In all, 259 patients who had undergone microsurgery and 140 patients operated on with endoscopy were included. The pathologies compared were microsurgically resected nonfunctioning adenomas: 38.2% (
n
= 99) versus endoscopically resected: 42.1% (
n
= 59), and microsurgically resected functioning adenomas: 61.8% (
n
= 160) versus endoscopically resected: 57.9% (
n
= 81). A higher number of patients with invasive macroadenomas were reported in the group operated on with endoscopy (35.5% vs. 56.4%). When the patients with invasive pathology of the cavernous sinus were compared, percentages of total resection and hormonal control were higher for endoscopic surgeries (35% vs. 46.8%; 33.3% vs. 64%); however, this difference was not statistically significant. No statistically significant differences were found when postoperative complications were individually analyzed.
Conclusion:
The microsurgical and endoscopic approaches are safe and effective techniques to treat pituitary adenomas. For invasive adenomas, the endoscopic approach may report better results.
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15
CASE REPORTS
Refractory Open Jaw Oromandibular Tardive Dystonia with a Sensory Trick, Treated with Botulinum Toxin: A Case Report
Ali S Shalash, Abdelrahman Ibrahim Abushouk, Mohammed Yasser Elsherbeny, Hanan Elrassas, Taha Kamel
July-August 2019, 67(4):1110-1111
DOI
:10.4103/0028-3886.266235
PMID
:31512647
Jaw-opening oromandibular dystonia (O-OMD) is a clinical subtype of OMD, commonly resistant to treatment. Here, we report a distinct case of tardive O-OMD with a characteristic sensory trick, successfully treated with high-dose botulinum toxin (BTX) injection. A 34-year-old male patient presented with involuntary jaw opening, tongue protrusion, dysarthria, and mild cervical dystonia. The patient reported improved abilities to talk and close his mouth after putting something, like a cigarette, between his teeth. After an unsuccessful treatment with anticholinergic medications, the patient received electromyography-guided BTX injection to the lateral pterygoids (through an extraoral approach), sternocleidomastoids, trapezius, tongue, and platysma muscles. Following the injection, the patient reported marked improvements in his ability to talk and close his mouth without using his sensory trick. One month later, we detected a 58.2% improvement in the Abnormal Involuntary Movement Scale score. Therefore, high-dose BTX injection may be an effective alternative in refractory O-OMD.
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2
NEUROIMAGES
Poland Syndrome with Amastia-athelia
Rudrarpan Chatterjee, Kruti Patel, Deepika Pandey, Bharat Rathod
July-August 2019, 67(4):1167-1167
DOI
:10.4103/0028-3886.266297
PMID
:31512674
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50
1
CASE REPORTS
Parry Romberg Syndrome: A Unique Clinico-radiological Entity
Chirag K Ahuja, Anuj Prabhakar, Vivek Gupta, Manish Modi, Niranjan Khandelwal
July-August 2019, 67(4):1090-1092
DOI
:10.4103/0028-3886.266253
PMID
:31512642
Parry Romberg syndrome (PRS) is an unusual neurological entity characterized by progressive hemifacial atrophy. We describe the case of a 17-year-old male who presented with recurrent seizures and facial asymmetry of 1 year duration. Computed tomography (CT) of the head showed right-sided hemifacial atrophy involving the subcutaneous fat, muscles, and bones alongwith subcortical white matter hypodensity, having parenchymal foci of calcification. The etiology of PRS is debated from being secondary to abnormalities in fat metabolism to autoimmune and inflammatory causes. The treatment is symptomatic and is targeted at relief of seizures and migraine. Steroids and other immunomodulators have proven successful in some cases. Surgical correction may be done once the disease stabilizes.
[ABSTRACT]
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1
Longitudinally Extensive Transverse Myelitis with Aquaporin-4 Antibody Positivity in Renal Cell Carcinoma: Rare Occurrence
Rohan R Mahale, Anish Mehta, Kiran Buddaraju, Mahendra Javali, Abhinandan K Shankar, Aju Abhraham John, Rangasetty Srinivasa
July-August 2019, 67(4):1087-1089
DOI
:10.4103/0028-3886.266293
PMID
:31512641
The occurrence of longitudinally extensive transverse myelitis (LETM) in an elderly patient should evoke search for underlying systemic malignancy. Intramedullary spinal cord metastases and paraneoplastic myelopathy are the most common etiology for LETM in patients with systemic malignancy. The occurrence of LETM in association with renal cell carcinoma with aquaporin-4 (AQP4) antibody positivity has not been reported. We report an elderly woman who presented with acute paraplegia and was diagnosed as having LETM with AQP4 positivity and renal cell carcinoma.
[ABSTRACT]
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5
BOOK REVIEW
Closed Doors, Open Windows: The Autobiography of Prof. P. N. Tandon
Sanjay Behari
July-August 2019, 67(4):1180-1183
DOI
:10.4103/0028-3886.266279
[FULL TEXT]
[PDF]
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COMMENTARY
Post-stroke Gait Analysis in Rehabilitation Set-up: Observational or Instrumental!
Anupam Gupta, AB Taly
July-August 2019, 67(4):1041-1042
DOI
:10.4103/0028-3886.266276
PMID
:31512629
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
5,095
101
2
ORIGINAL ARTICLE
The Correlation of Endothelial Nitric Oxide Synthase (
eNOS
) Polymorphism and Other Risk Factors with Aneurysmal Subarachnoid Hemorrhage: A Case-Control Study
Subhas K Konar, Shruthi Ramesh, Rita Christopher, A Prasanthi, Dhananjaya I Bhat, Dhaval Shukla, R Bharath, B Indira Devi
July-August 2019, 67(4):1006-1012
DOI
:10.4103/0028-3886.266231
PMID
:31512622
Objective:
Endothelial nitric oxide synthase gene (
eNOS
) polymorphism is an association with cerebral aneurysm formation, rupture, and vasospasm and plays a role in the a functional outcome.
Patients and Methods:
The aim of the study was to evaluate the role of
eNOS
gene polymorphism and further assess the predictors of outcome in the aneurysmal subarachnoid hemorrhage (aSAH). A prospective case-control study was conducted from 2009 to 2012 among those who presented with aSAH. A serum sample was collected from aSAH patients along with age and sex-matched healthy controls. The frequency of polymorphism of
eNOS
gene and other factors (demographic and aneurysmal) were correlated with functional outcome at six month of follow-up.
Results:
100 patients with aSAH and 100 healthy controls were enrolled in the cohort. The mean age of the patient group was 51.61 years and control group was 45.81 years with a male:female ratio of 1:1.38 and 1:1.08 for patients and controls, respectively. Among all
eNOS
polymorphisms, 4BB (65%) 24-VNTR, TT (71%) of T-786C, and GG (71%) of G947T were the most common and frequency was similar in the control group. The occurrences of hypertension, smoking, diabetes were 32%, 37%, and 7% respectively in the patient group. Maximum patients were in WFNS grade 1 (53%) followed by 23% grade 2 and only 10% in grade 4. Fisher grade 3 (57%) was the most common followed by Fisher grade 4 (28%). Most aneurysms (97%) were in anterior circulation. 83% of the aneurysms were clipped and 10% underwent coiling. Size-wise most of the aneurysms were in the middle group (6–9 mm) followed by bigger group (>10 mm) (37%); only 6% aneurysms were in the small aneurysm (<6 mm) group. 33% of the patients had evidence of vasospasm. TT of G894T polymorphism (60%) had the highest incidence of vasospasm. Univariate analysis showed smoking (OR: 3.19, CI: 1.19–8.84,
P
= 0.01), 4AA (OR: 12.15, CI: 1.13–624.9,
P
= 0.03) variety of 24-VNTR polymorphism, CC (OR: 15.39, CI: 1.60–762.8,
P
= 0.01) variety of T786C polymorphism, Fisher grade 4 (OR: 3.43, CI: 1.24–9.68,
P
= 0.01), WFNS grade (poor vs. good) (OR: 3.42, CI: 1.17–10.12,
P
= 0.02), vasospasm (OR: 3.84, CI: 1.42–10.75,
P
= 0.006), intraoperative rupture (OR: 4.77, CI: 1.55–15.27,
P
= 0.004) were significantly related with unfavorable outcome at 6 months follow-up. In regression analysis, smoking (CI: 0.06–0.69,
P
= 0.01), Fisher grade 4 (CI: 0.09–1.00,
P
= 0.05), and intraoperative rupture (CI: 0.05–0.89,
P
= 0.03) were correlated with an unfavorable outcome at 6 months follow-up.
Conclusion:
The eNOS
gene polymorphism, smoking, clinical grade (WFNS), Fisher grade, intraoperative rupture, and vasospasm play a role in functional outcome after the treatment of cerebral aneurysms.
[ABSTRACT]
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5,060
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1
LETTERS TO EDITOR
Miller Fisher Syndrome Following Tetanus, Diphtheria, and Pertussis (Tdap) Vaccine
Rajat Garg, Shyam S Moudgil
July-August 2019, 67(4):1122-1123
DOI
:10.4103/0028-3886.266262
PMID
:31512652
[FULL TEXT]
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[PubMed]
5,010
39
3
CASE REPORTS
Malignant Transformation of Pediatric Low-grade Gliomas: Report of Two Cases and Review of a Rare Pathological Phenomenon
KS Avinash, Sumit Thakar, Saritha Aryan, Nandita Ghosal, Alangar S Hegde
July-August 2019, 67(4):1100-1106
DOI
:10.4103/0028-3886.266259
PMID
:31512645
Low-grade gliomas (LGGs) are the commonest benign central nervous system (CNS) tumors seen in children. Unlike LGGs in adults, pediatric LGGs rarely undergo malignant transformation. The incidence of malignant transformation of LGGs in the pediatric population has been reported to be up to 10%. Of these, a few patients have demonstrated this phenomenon even without adjuvant radiation therapy. We report two such unusual cases. A 7-year-old girl presented with a left temporal lesion that was operated upon and was reported as pilocytic astrocytoma (WHO grade I). She presented with a malignant transformation of the tumour 8 years later. The second case was a 10-year-old boy, who had a left frontoparietal ganglioglioma (WHO grade I) that demonstrated malignant transformation to an anaplastic ganglioglioma (WHO grade III) 10 months after the initial surgery. Multiple studies have thrown light on the molecular genetics behind malignant transformation of LGGs in children. These genetic changes can perhaps serve as targets for potential future therapeutic interventions. It is important that patients with LGGs at risk of malignant transformation must be identified early so that a more aggressive treatment strategy can be adopted.
[ABSTRACT]
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4,864
48
3
LETTERS TO EDITOR
HyperCKemia Can Occur Due to This! A Less Recognized Etiology
Rohan R Mahale, Anish Mehta, Abhishek Miryala, Rangasetty Srinivasa
July-August 2019, 67(4):1136-1137
DOI
:10.4103/0028-3886.266288
PMID
:31512658
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
4,773
48
1
Tuberculous Meningitis in a Patient with Cushing's Disease: Glucocorticoid-mediated Immunosuppression: Case Report, and Review of the Literature
Gregoire P Chatain, Gautam U Mehta, Lynnette K Nieman, Susmeeta Sharma, Susan Yuditskaya, Ray Y Chen, Lynne Yockey, Steven M Holland, Prashant Chittiboina
July-August 2019, 67(4):1128-1130
DOI
:10.4103/0028-3886.266237
PMID
:31512655
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
4,756
40
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ORIGINAL ARTICLES
Endovascular Nuances in Management of Multiple Intracranial Aneurysms
MN Tejus, Daljit Singh, Anita Jagetia, Hukum Singh, Monica Tandon, Rajiv Chawla, P Ganjoo
July-August 2019, 67(4):1062-1065
DOI
:10.4103/0028-3886.266249
PMID
:31512636
Background:
Endovascular treatment of aneurysm is the accepted standard of treatment. Multiple intracranial aneurysms are frequently detected due to advances in imaging.
Objective:
The purpose of this study was to determine aneurysm properties, management strategies, and outcome of patients with multiple intracranial aneurysms managed by endovascular approach.
Materials and Methods:
Data of all patients with multiple intracranial aneurysms who were managed at our institute over a period of 1 year were retrospectively studied. Data of 20 consecutive patients with single aneurysm who were endovascularly managed during the same study period were also collected. Patient demographics, intraprocedural radiation exposure, hardware used, and clinical and angiographic outcome at discharge were analyzed.
Results:
A total of 112 patients with intracranial aneurysm were managed during the study period, of which 11 patients had multiple intracranial aneurysms, with a total of 23 aneurysms. Incidence was more among females (63.6%). Proximal of multiple aneurysms ruptured more commonly (63.6%), and internal carotid artery (ICA) bifurcation was the most common site (45.4%). Of the 23 aneurysms, 18 were coiled. Seven patients had good outcome and it was found to be influenced by preoperative Hunt and Hess scale. Based on Raymond–Roy grading, 17 of 18 aneurysms (94.4%) were completely coiled; angiographic outcome was comparable in both the groups. Patients with multiple aneurysm had statistically significant high radiation exposure (4.5 vs 3.8 m SV) as compared to patients with single aneurysm (
P
< 0.05), but had low stochastic effect. In patients with aneurysm involving different arterial compartment, 66.2% required change of microcatheter.
Conclusion:
Single-stage treatment of multiple aneurysm can be achieved with good outcome. Even though radiation exposure is high while treating multiple aneurysm as compared to single aneurysm cases, its stochastic risks are low.
[ABSTRACT]
[FULL TEXT]
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4,541
71
3
LETTERS TO EDITOR
Proximal Myopathy as a Presenting Manifestation of Wilson's Disease
Hansashree Padmanabha, Aruna Sethuraman, Gosala RK Sarma
July-August 2019, 67(4):1152-1153
DOI
:10.4103/0028-3886.266239
PMID
:31512666
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
4,460
53
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The Syndrome of Acute Bilateral Basal Ganglia Lesions in a Patient with Diabetes Mellitus and Uremia
Kubra Mehel Metin, Ceyla Ataç, Burç Esra Şahin, Tahir Kurtuluş Yoldaş
July-August 2019, 67(4):1163-1165
DOI
:10.4103/0028-3886.266236
PMID
:31512672
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
4,390
53
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CASE REPORTS
Pathophysiological Evaluation in a Case of Wernicke's Encephalopathy by Multimodal MRI
Yuelei Lyu, Tao Jiang
July-August 2019, 67(4):1112-1115
DOI
:10.4103/0028-3886.266252
PMID
:31512648
To report a patient with Wernicke's encephalopathy (WE) using multimodal magnetic resonance imaging (MRI) including conventional MRI, diffusion-weighted MRI (DWI), arterial spin labeling (ASL), and proton MR spectroscopy (MRS). A 50-year-old woman of WE with a history of cholecystectomy and acute pancreatitis was given MRI scans including DWI, MRS, and ASL pre- and post-thiamine treatment. Two weeks after admission, the patient's condition rapidly improved. The typical MRI findings and lesions in the frontal cortex at baseline disappeared or resolved partially. The reduced apparent diffusion coefficient value in part of the thalamus lesion, the elevated cerebral blood flow in the frontal cortex, the lactate doublet peak in the right thalamus lesion, and in cerebral spinal fluid, all resolved after treatment. The combination of conventional MRI with DWI, proton MRS, and ASL, offers a powerful diagnostic tool and a better understanding of the pathophysiological and hemodynamic mechanisms.
[ABSTRACT]
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[CITATIONS]
[PubMed]
4,390
45
1
ORIGINAL ARTICLE
Neurological Manifestations Do not Affect Cumulative Survival in Indian Patients with Antineutrophil Cytoplasmic Antibody Associated Vasculitis
Aman Sharma, Roopa Rajan, Manish Modi, Benzeeta Pinto, Aadhaar Dhooria, Manish Rathi, Tarun Mittal, Susheel Kumar, Kusum Sharma, Varun Dhir, Ritambhra Nada, Ranjana W Minz, Surjit Singh
July-August 2019, 67(4):1043-1047
DOI
:10.4103/0028-3886.266234
PMID
:31512630
Background:
Neurological manifestations are an important cause of morbidity in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). It is not clear whether or not they are indicative of a severe disease course with multiple organ involvement and shortened survival.
Aims and Objectives:
To characterize the neurological manifestations of AAV and analyze their relationship with other organ system and cumulative survival.
Methods:
This was a retrospective single-center cohort study of AAV patients at a tertiary care hospital in North India. Data was collected from medical records regarding clinical history, neurological examination, Birmingham Vasculitis Activity Score (BVAS), serology, electrophysiology, imaging, and histopathological examination findings of patients.
Results:
Ninety-two patients of systemic vasculitis were identified, 67 with granulomatosis with polyangiitis (GPA), 14 with microscopic polyangiitis, 8 with Churg–Strauss syndrome (CSS), and 3 with undifferentiated AAV. The median BVAS at presentation was 18.0 (interquartile range (IQR): 12.0). The median duration of follow-up was 31.3 months (IQR: 40.5). A total of 45.7% patients had neurological manifestations among which 23.8% presented with neurological complaints. Peripheral neuropathy was the most common manifestation noted in 23.9% of the patients. Among patients with GPA, 40.3% had neurological involvement (seen in 33.3% patients at presentation). Patients with nervous system disease were more likely to have associated musculoskeletal manifestations (
P
= 0.046) and less likely to have renal involvement (
P
= 0.017). The estimated cumulative survival of the subgroup with neurological involvement was 95.1 months from the time of diagnosis, which was not significantly different from the cohort without neurological involvement (113.8 months,
P
= 0.631).
Conclusion:
Neurological morbidity commonly accompanies systemic vasculitis. Nervous system disease does not affect the survival significantly in these patients.
[ABSTRACT]
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4,342
78
2
LETTERS TO EDITOR
Kikuchi Disease: A Rare Cause of Aseptic Meningitis
Dhiren R Patel, Arun B Shah, Hardik R Shah, Kiran B Thorat
July-August 2019, 67(4):1131-1133
DOI
:10.4103/0028-3886.266242
PMID
:31512656
[FULL TEXT]
[PDF]
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[CITATIONS]
[PubMed]
4,309
47
2
EDITORIAL
We Stand on the Shoulders of Our Teachers … So that We Can See Further …
P Sarat Chandra
July-August 2019, 67(4):964-965
DOI
:10.4103/0028-3886.266286
PMID
:31512615
[FULL TEXT]
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[PubMed]
4,172
132
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NI FEATURE: CENTS (CONCEPTS, ERGONOMICS, NUANCES, THERBLIGS, SHORTCOMINGS) - COMMENTARY
Give an Inch and Get a Mile
– Simple Modification in the Pial Stay Suture Technique for Intramedullary Spinal Tumors
Arun Kumar Srivastava, Deepak Khatri, Kamlesh Singh Bhaisora, Kuntal Kanti Das, Ved Prakash Maurya, Sanjay Behari
July-August 2019, 67(4):1082-1085
DOI
:10.4103/0028-3886.266240
PMID
:31512639
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
4,115
80
-
LETTERS TO EDITOR
Chiari Type I Malformation with Syringomyelia Presenting with Isolated Hemi-anhidrosis: Report of a Rare Case
Gautam Dutta, Daljit Singh, Anita Jagetia, Manish Garg, Mohd Iqbal, AK Srivastava
July-August 2019, 67(4):1140-1141
DOI
:10.4103/0028-3886.266256
PMID
:31512660
[FULL TEXT]
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4,122
38
2
A Case Report of Recurrent Hypokalemic Paralysis—missing the “Period”
Siddhesh Rajadhyax, Bhumir Chauhan, Vikram Huded, Siddaramappa J Patil, Anuradha Kannan, Venkatraman Bhat, Subramanian Kannan
July-August 2019, 67(4):1117-1119
DOI
:10.4103/0028-3886.266245
PMID
:31512650
[FULL TEXT]
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4,033
67
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ORIGINAL ARTICLES
Influence of Oncotherapy and Clinical Parameters on Survival of Glioblastoma Patients: A Single Center Experience
Almos Klekner, Judit Tóth, József Virga, Tibor Hortobágyi, Ádám Dér, Csaba Szemcsák, Judit Reményi-Puskár, László Bognár
July-August 2019, 67(4):1066-1073
DOI
:10.4103/0028-3886.266257
PMID
:31512637
Background:
Routine administration of temozolomide (TMZ) in the treatment protocol of glioblastoma in the last few years resulted in improving survival parameters of these patients but efficacy of supplementary bevacizumab (BVC) monotherapy has not been evidently proven. In this study, the effectiveness of different postoperative therapy for glioblastoma patients treated in our institute was evaluated. In addition, the prognostic value of clinical parameters on survival was also analyzed.
Methods:
Accordance of clinical parameters (age, gender, tumor localization, size, side, Karnofsky performance score, and extension of tumor removal), postoperative treatment (radiotherapy [RT], RT + TMZ, RT + TMZ + BVC), and survival data were tested by 104 patients operated on glioblastoma in the Department of Neurosurgery, University of Debrecen between 2002 and 2012.
Results:
Concurrent chemo-RT resulted in significant longer overall survival (OS) than RT alone (
P
RT
vs.
RT
+
TMZ
= 0.0219) and BVC treatment after progression during TMZ also elongated survival significantly (
P
RT vs. RT
+
TMZ
+
BVC
< 0.0001;
P
RT
+
TMZ
vs.
RT
+
TMZ
+
BVC
= 0.0022), respectively. Clinical parameters showed no significant influence on OS in comparison with different methods of postoperative oncotherapy.
Conclusions:
Both TMZ and BVC had a beneficial effect on glioblastoma patients' survival, but tested clinical parameters showed no evident accordance with final outcome. Although neurosurgery has an indispensable role in resecting space occupying tumors and providing good postoperative performance score patients for oncotherapy, the survival of glioblastoma patients depends rather on radio- and chemo-sensitivity than tested clinical parameters.
[ABSTRACT]
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[PubMed]
4,025
51
2
ORIGINAL ARTICLE
Need of Immediate Drug Reduction after Epilepsy Surgery – A Prospective Observational Study
Jitin Bajaj, Sarat P Chandra, Bhargavi Ramanujam, Shabari Girishan, Ramesh Doddamani, Manjari Tripathi
July-August 2019, 67(4):1050-1053
DOI
:10.4103/0028-3886.266282
PMID
:31512632
Background:
Patients undergoing epilepsy surgery are on polytherapy. Drug tapering is usually done after 1 year in adults and after 6 months in children. Sometimes, drugs have to be altered during the perioperative period, which is more commonly seen in hemispherotomy (HS) patients. The present study was done to compare perioperative drug alterations between HS and temporal (TL) lobectomy patients.
Materials and Methods:
Prospective analysis of postoperative HS and TL patients was done. Primary outcomes were drug number, dosage changes, and seizure outcome. Secondary outcome studied was a change in intelligence quotient (IQ) in the two groups.
Results:
At total of 71 patients were included. Perioperative drug stopping (clobazam – CLB) was needed in 3/38 patients in the HS group, due to sedation. Dosage was reduced in 23/38 (60.52%) in HS group, and in 2/33 (6%) in TL group
P
< 0.001. The most common drug was CLB, with reduction in 21/27 (77.77%) patients, with a mean reduction of 41.21 ± 4.01%. Two patients required drug substitution in the HS group. About 64/71 (90.1%) patients achieved Class I outcome at a 1-year postoperative time point (TL – 90.9%, HS – 89.47%). There was no change in IQ in any of the groups.
Conclusion:
Perioperative drug alteration is often needed in the HS patients as compared to TL patients. Benzodiazepines have to be reduced to maintain alertness in the HS patients. The increased sedation postoperatively can be due to decreased cortical drive over the reticular activating system, gamma-aminobutyric acid (GABA) receptor denervation hypersensitivity, or increased activity of drugs over the remaining active hemisphere.
[ABSTRACT]
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[PubMed]
3,913
82
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LETTERS TO EDITOR
Baclofen-induced Coma and Respiratory Depression in a Patient with Cervical Spondylotic Myelopathy with Chronic Kidney Disease
Thotalampatti Pachiyappan Jeyaselvasenthilkumar, Deiveegan Kunjithapatham, Sekar Chinnasamy, Mohamed Abith Ali
July-August 2019, 67(4):1120-1121
DOI
:10.4103/0028-3886.266260
PMID
:31512651
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3,885
56
1
Aspergilloma Masquerading as Meningioma: An Experience of Two Cases and Review of Literature
Ravi Sharma, Kanwaljeet Garg, Manoj Phalak, Vivek Tandon, Kalpana Kumari, Vaishali Suri, Ashish Suri, Ajay Garg, SS Kale, AK Mahapatra
July-August 2019, 67(4):1133-1136
DOI
:10.4103/0028-3886.266244
PMID
:31512657
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3,871
68
1
Sporadic CADASIL: A Rare Occurrence
Amandeep Singh, Sudhir Mehta, Laxmi Kant Goyal, Gunja Jain, Dilip Ramrakhiani
July-August 2019, 67(4):1145-1146
DOI
:10.4103/0028-3886.266292
PMID
:31512663
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,882
56
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Schwartz–Jampel Syndrome Mimicking Myotonia Congenita
Hansashree Padmanabha, Thomas Mathew, T Manjusha
July-August 2019, 67(4):1160-1162
DOI
:10.4103/0028-3886.266261
PMID
:31512670
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3,847
58
1
Varicella-related Multifocal Vasculopathy: Under-recognized Cause of Young Stroke
Amith S Kumar, Darakhshan Naheed, Dheeraj Khurana, Chirag Ahuja
July-August 2019, 67(4):1147-1149
DOI
:10.4103/0028-3886.266233
PMID
:31512664
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,742
54
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CASE REPORTS
Solitary Intracerebral Phaeoid Fungal Granuloma: A Case Report
Sureswar Mohanty, Pranita Mohanty, Lipsa Priyadarshini
July-August 2019, 67(4):1107-1109
DOI
:10.4103/0028-3886.266263
PMID
:31512646
Fungal granuloma in the brain parenchyma caused by pheohyphomycosis is extremely rare. Antifungal drugs are not very effective. The present report is a case of solitary pheohyphomycosis granuloma, which underwent surgical excision followed by antifungal drug treatment with excellent result.
[ABSTRACT]
[FULL TEXT]
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3,696
48
1
NI FEATURE: THE FIRST IMPRESSION - COMMENTARY
The Cover Page
July-August 2019, 67(4):963-963
DOI
:10.4103/0028-3886.266281
PMID
:31512614
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,587
109
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NEUROIMAGES
Marchiafava-Bignami Disease in a Patient with No Alcohol Abuse
Satoshi Sera, Toshihisa Ichiba
July-August 2019, 67(4):1169-1169
DOI
:10.4103/0028-3886.266247
PMID
:31512676
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3,641
43
5
LETTERS TO EDITOR
Dengue-related Longitudinally Extensive Transverse Myelitis
Wendy Tan, Christopher Thiam Seong Lim
July-August 2019, 67(4):1116-1117
DOI
:10.4103/0028-3886.266296
PMID
:31512649
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3,604
58
3
COMMENTARY
The Saga of How to Stitch the Tear …
MV Padma Srivastava
July-August 2019, 67(4):1060-1061
DOI
:10.4103/0028-3886.266270
PMID
:31512635
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,525
80
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CASE REPORTS
Drug Refractory Epilepsy – A Series of Lesions with Triple Pathology
Vivek Tandon, Poodepedi Sarat Chandra, Raghav Singla, Jitin Bajaj, Aanchal Kakkar, Mehar Chand Sharma, Ashok Kumar Mahapatra, Manjari Tripathi
July-August 2019, 67(4):1093-1096
DOI
:10.4103/0028-3886.266289
PMID
:31512643
The associations between gangliogliomas, dysembryoplastic neuroepithelial tumors (DNETs), and cortical dysplasias remain debatable. We report five cases of drug refractory epilepsy with temporal lobe lesions. On resection, histopathological examination showed distinctive areas of gangliogliomas and DNETs with cortical dysplasia. The coexistence of the above three lesions as distinct entities in a single lesion is virtually unknown. This points to the presence of a possible etiological relationship among them. Finally, we also delve into a plausible hypothesis for such a pathogenesis.
[ABSTRACT]
[FULL TEXT]
[PDF]
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3,508
65
1
NEUROIMAGES
Susac's Syndrome
Malgorzata Blauciak, Joanna Bladowska, Boguslaw Paradowski
July-August 2019, 67(4):1168-1168
DOI
:10.4103/0028-3886.266278
PMID
:31512675
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3,513
59
2
COMMENTARY
Neurological Manifestations of ANCA-associated Vasculitides: Not Good but Not Bad or Ugly Either
Gagandeep Singh, Amol Nanak Singh
July-August 2019, 67(4):1048-1049
DOI
:10.4103/0028-3886.266269
PMID
:31512631
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3,494
56
1
LETTERS TO EDITOR
Unilateral Tongue Atrophy and Fasciculations in Medullary Hemorrhage
Neeraj Kumar, Ravindra K Garg, Sudhakar Pandey, Arun K Singh, Hardeep S Malhotra, Imran Rizvi, Ravi Uniyal
July-August 2019, 67(4):1162-1163
DOI
:10.4103/0028-3886.266264
PMID
:31512671
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,513
37
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NI FEATURE: CENTS (CONCEPTS, ERGONOMICS, NUANCES, THERBLIGS, SHORTCOMINGS) - COMMENTARY
Know Some Vital Statistics: What is
P
Value?
Kameshwar Prasad
July-August 2019, 67(4):1086-1086
DOI
:10.4103/0028-3886.266277
PMID
:31512640
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,367
120
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LETTERS TO EDITOR
Actinomyeces Cerebral Abscess Masquerading as Tuberculosis: Delayed Presentation following Head Trauma and Scalp Infection
Manish Kumar, Ankur Bajaj, Manjul Tripathi, Bishan D Radotra, Manoj K Tewari, Chirag K Ahuja
July-August 2019, 67(4):1123-1126
DOI
:10.4103/0028-3886.266291
PMID
:31512653
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,419
42
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NI FEATURE: JOURNEY THROUGH THE EONS - COMMENTARY
Navigating Neurosurgery into an Optimal Future
PN Tandon
July-August 2019, 67(4):966-967
DOI
:10.4103/0028-3886.266271
PMID
:31512616
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,260
64
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LETTERS TO EDITOR
A Case of Artery of Percheron Infarct: Need for High Clinical and Radiological Suspicion
Arun K Agrawal, Kuljeet S Anand, Pawan Kumar, Jyoti Garg
July-August 2019, 67(4):1126-1128
DOI
:10.4103/0028-3886.266283
PMID
:31512654
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3,229
66
1
COMMENTARY
Endoscopic Transsphenoidal Surgery: A Revolutionary Evolution
Dhananjaya I Bhat
July-August 2019, 67(4):1024-1026
DOI
:10.4103/0028-3886.266248
PMID
:31512626
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3,197
60
1
eNOS: A Passing Fad or the Crux of the Panacea?
Sivashanmugam Dhandapani
July-August 2019, 67(4):1013-1014
DOI
:10.4103/0028-3886.266243
PMID
:31512623
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,180
45
-
CORRESPONDENCE
Chordoid Glioma of the Third Ventricle
Rajeshwari K Muthusamy, Sangita S Mehta
July-August 2019, 67(4):1178-1179
DOI
:10.4103/0028-3886.266267
PMID
:31512680
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,027
38
-
Multi-functional Magnetic Resonance Imaging and Clinicopathological Characteristics of Ventricular Schwannoma: A Case Report and Review of the Literature
Yan Tan, Hui Zhang, Xiao-Chun Wang, Jiang-Bo Qin, Xiao-Feng Wu, Lei Zhang, Le Wang
July-August 2019, 67(4):1173-1178
DOI
:10.4103/0028-3886.266295
PMID
:31512679
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3,024
35
2
LETTERS TO EDITOR
Upper Limb Monochorea Due to Cerebral Venous Sinus Thrombosis: Rare Occurrence
Rohan Mahale, Anish Mehta, Akshay Konnur, Purushottam Acharya, R Srinivasa
July-August 2019, 67(4):1138-1139
DOI
:10.4103/0028-3886.266255
PMID
:31512659
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
2,954
35
2
CORRESPONDENCE
Assessment of Cardiavascular Changes following Trans-sphenoidal Surgery in Acromegalic Patients
Antonio Ribeiro-Oliveira, Márta Korbonits, Claudia M V Freire
July-August 2019, 67(4):1170-1171
DOI
:10.4103/0028-3886.266294
PMID
:31512677
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
2,948
35
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LETTERS TO EDITOR
Intracranial Bleed Presenting as an Acute Cardiac Failure; Brain Heart Interaction at Its Apogee!
Ajay Prasad Hrishi P, Karen Ruby Lionel
July-August 2019, 67(4):1159-1160
DOI
:10.4103/0028-3886.266254
PMID
:31512669
[FULL TEXT]
[PDF]
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[CITATIONS]
[PubMed]
2,908
47
1
Isolated Cerebellar Abscess by
Burkholderia pseudomallei
in an Immunocompromised Host: A Rare Case
Ashoka Mahapatra, Sagarika Dhal, Sumit Bansal, Jyotirmayee Turuk, Snigdharani Choudhury, Pritinanda Mishra
July-August 2019, 67(4):1149-1152
DOI
:10.4103/0028-3886.266238
PMID
:31512665
[FULL TEXT]
[PDF]
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[PubMed]
2,873
56
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Synchronous Glioma of the Brainstem in a Patient with Recurrent Aggressive Vestibular Schwannoma
Rahul Lath, Pankaj Sharma, Rajesh R Sannareddy, Meenakshi Swain, Alok Ranjan
July-August 2019, 67(4):1153-1155
DOI
:10.4103/0028-3886.266250
PMID
:31512667
[FULL TEXT]
[PDF]
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[EPub]
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2,788
33
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Cyclooxygenase-2 Gene Polymorphisms and Risk of Alzheimer's Disease: A Possible Biomoleular Explanation
Beuy Joob, Viroj Wiwanitkit
July-August 2019, 67(4):1142-1142
DOI
:10.4103/0028-3886.266266
PMID
:31512661
[FULL TEXT]
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2,788
28
4
Changes in Evoked Potentials in a Hybrid Surgery of Spinal Arteriovenous Malformations Associated with Nerve Root AVF
Xiao-Yu Li, Hong-Qi Zhang, Feng Ling, Li-Yong Sun, Jia-Xing Yu, Jian Ren, Jian-Hua He
July-August 2019, 67(4):1156-1158
DOI
:10.4103/0028-3886.266251
PMID
:31512668
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2,768
27
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COMMENTARY
Commentary on “Endoscopic versus Microscopic Pituitary Adenoma Surgery: A Single-center Study ”
Yad Ram Yadav
July-August 2019, 67(4):1022-1023
DOI
:10.4103/0028-3886.266272
PMID
:31512625
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2,722
50
1
Remaining Alert to Sedation by Antiepileptic Drugs Just after Epilepsy Surgery
Parampreet S Kharbanda, Jitupam Baishya
July-August 2019, 67(4):1054-1055
DOI
:10.4103/0028-3886.266285
PMID
:31512633
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