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Byline: Soumen. Kanjilal, Kuntal. Das, Arun. Srivastava, Anant. Mehrotra, Kamlesh. Bhaisora, Awadhesh. Jaiswal, Raj. Kumar Meningiomas based on the anterior clinoid process, also called clinoidal meningiomas (CMs), are daunting tumors, [...]

Byline: Kuntal. Das, Amanjot. Singh, Prabhakar. Mishra, Deepak. Khatri, Balachandar. Deivasigamani, Aanchal. Datta, Kamlesh. Bhaisora, Anant. Mehrotra, Arun. Srivastava, Awadhesh. Jaiswal, Sanjay. Behari, Raj. Kumar Background: Studies on insular gliomas [...]

Byline: B. Anil Kumar, Kuntal. Das, Pooja. Tataskar, Awadhesh. Jaiswal, Priyadarshi. Dikshit, Raj. Kumar Ependymomas are one of the most common intracranial neoplasms in the pediatric age group[1] and frequently [...]

Byline: Nazrin. Hameed, Ravi. Manogaran, Abhishek. Dubey, Govind. Bhuskute, Kanika. Arora, Amit. Keshri, Anant. Mehrotra, Awadhesh. Jaiswal, Kuntal. Das, Kamlesh. Bhaisora, Arun. Srivastava, Raj. Kumar, Ramandeep. Virk The lateral recess [...]

Byline: Ashutosh. Kumar, Kamlesh. Bhaisora, Kamlesh. Rangari, Prabhakar. Mishra, Vandan. Raiyani, Jayesh. Sardhara, Ved. Maurya, Pawan. Verma, Kuntal. Das, Anant. Mehrotra, Arun. Srivastav, Awadhesh. Jaiswal, Raj. Kumar, Sanjay. Behari Objective: [...]

This article discusses a rare case of an intradural extramedullary persistent neuroenteric canal with an intramedullary component. The authors present the first instance of this condition, which was successfully managed using a transpedicular corridor. Neuroenteric cysts are uncommon congenital anomalies, and the intramedullary subtype is even rarer. The article provides details of the surgical procedure and includes a video link for further reference. The document describes a surgical procedure to remove an intramedullary neuroenteric cyst with a persistent neuroenteric canal. The surgery involved carefully separating the cyst from the spinal cord and removing it, as well as repairing the dural defect. The patient experienced improvement in lower limb strength and complete resolution of myelopathy after the surgery. The document also discusses the importance of preoperative imaging, the surgical approach used, and the potential complications and pitfalls of the procedure. [Extracted from the article]

Byline: Deepak. Khatri, Awadhesh. Jaiswal, Kuntal. Das, Satyadeo. Pandey, Kamlesh. Bhaisora, Raj. Kumar Introduction: With improvements in overall and progression-free survival in gliomas, current focus in neurosurgical oncology has largely [...]

Byline: Chaitanya. Godbole, Sanjay. Behari, Kamlesh. Bhaisora, Jayesh. Sardhara, Arun. Srivastava, Anant. Mehrotra, Kuntal. Das, Raj. Kumar, Awadhesh. Jaiswal Background: Superior hypophyseal artery (SHA) aneurysms form a unique subgroup of [...]

Byline: Ram. Rao, Deepti. Mishra, Preeti. Agrawal, Raj. Kumar Sir, Primary B-cell central nervous system lymphoma (PCNSL) is an uncommon aggressive lymphoma accounting for 1% of all intracranial tumors [sup][1],[2] [...]

Byline: Raj. Kumar, R. Sahu, A. Srivastav, Anant. Mehrotra, Kuntal. Das Sir, Post-traumatic intradiploic leptomeningeal cyst (PTIDLMC) is a rare variant of a growing skull fracture and occurs in pediatric [...]

Byline: Arun. Tungaria, Rabi. Sahu, Raj. Kumar, Arun. Srivastava Sir, Intratumoral hemorrhage in brainstem glioma, although previously reported in children, has not been reported in adults, hence this letter to [...]

Byline: Arun. Srivastav, Arun. Tungaria, Raj. Kumar, Rabi. Sahu Sir, Intracranial schwannomas account for 8-10% of all primary intracranial tumors, [sup][1] and brainstem schwannomas have rarely been reported. [sup][2],[3],[4],[5] A [...]

Byline: Prakash. Nair, Arun. Srivastava, Raj. Kumar, Kapil. Jain, Rabi. Sahu, Mukul. Vij, Manoj. Jain Sir, A 20-year old female presented with progressively increasing holocranial headache, unsteadiness of gait, and [...]

Byline: Raj. Kumar, Nitin. Malik, Arun. Tungaria, Priyanka. Kawal Background: Glioblastoma multiforme (GBM) is a highly malignant central nervous system tumor that is extremely refractory to therapy due to its [...]

The article presents a case study of a 17-year-old boy with one episode of generalized tonic-clonic seizure (GTCS) two months prior to admission. It discusses results of his physical examination, neurological examination, computed tomography (CT) of the head, reconstructed CT and magnetic resonance imaging (MRI) of the brain. He was diagnosed of post-traumatic intradiploic leptomeningeal cyst (PTIDLMC) and suggested to cranioplasty with synthetic constructs or autologous bone.

Background: Congenital spondylolisthesis is characterized by dysplasia of the facet joint or congenital defect in the pars., Objective: Our study highlights the clinical and radiological profile, various treatment options, and outcomes in patients with pediatric congenital lumbar and lumbosacral spondylolisthesis., Methods: A retrospective analysis and follow-up of 22 patients were conducted presented with radiological diagnosis of congenital lumbar/lumbosacral spondylolisthesis (2018-2021)., Results: Twenty patients (91%) had L5-S1 listhesis and two patients (9%) had L4-L5 listhesis. Six (27.3%) patients had low-grade listhesis (grades 1-2), 16 (72.7%) had high-grade listhesis (grades 3-5). Seventeen (77.3%) had S1, three (13.6%) had L5, and two (9%) had both L4-L5 radiculopathy. All patients had neurogenic claudication. One had an associated spina bifida occulta. Six (27.3%) patients underwent two-level fixation, and 16 (72.7%) underwent three-level fixation. Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) was done in two patients. Revision of at least one screw was done in three patients. After one year of follow-up, all the patients had 75-100% relief in radicular pain and neurogenic claudication. The Oswestry Disability Index (ODI) score in preop for all patients was 41-60% and postoperatively they showed an improvement in ODI score (0-20). The postoperative low back pain score on the Numeric Rating Scale was 0-1 for all patients., Conclusion: Congenital lumbar spondylolisthesis usually presents with high-grade listhesis. Management of such cases is a surgical challenge but posterior decompression resulted in relief of pain in all patients. However, in situ fixation without reduction is also effective in selective cases where attempts to reduce the listhesis result in a decline in intraoperative neuromonitoring parameters., (Copyright © 2024 Copyright: © 2024 Neurology India, Neurological Society of India.)

Background: While literature suggests the need for routine postoperative volumetric estimation of the EOR and residual tumour volume (RTV) in all cases of gliomas, the utility and feasibility of this protocol in resource-constrained centers remain underinvestigated., Objectives: Our objective was to study the feasibility of volumetric EOR in routine neurosurgical practice and determine correlation with surgeons' intraoperative estimation of EOR. The secondary objective was to determine the survival impact of EOR and RTV on survival., Methods and Materials: A prospective study of pathologically proven high-grade gliomas (WHO grades 3 and 4) in adults was conducted at a tertiary care center. Pre- and postoperative magnetic resonance imaging (MRI) was obtained for volumetric analysis using OsiriX software and manual segmentation. Overall survival and predictors were studied using Kaplan-Meier and Cox regression analysis., Results: Postoperative volumetry was feasible in 31% patients (n = 25) of study eligible patients (n = 84). The median EOR, CE-PTV, and CE-RTV were 79.1%, 69.8 cm3, and 8.7 cm3, respectively. There was a poor correlation of surgeons' intraoperative impression and volumetric data (P = 0.359). Interestingly, the EOR was not significantly associated with the survival time (P = 0.920), while tumor grade, molecular profile, Ki 67 score, and postoperative functional status showed statistically significant impact., Conclusion: Logistic difficulties impede routine implementation of this protocol in developing countries. MRI volumetry is clearly more accurate than surgeons' intraoperative estimation of EOR. Notwithstanding the role of EOR in survival, our study reveals a perhaps bigger impact of tumor biology and postoperative functional status in this equation., (Copyright © 2024 Copyright: © 2024 Neurology India, Neurological Society of India.)

Competing Interests: None

The cerebellopontine angle (CPA) is a rare site for the growth of choroid plexus papilloma (CPP). The clinicoradiological diagnosis of this tumor in the CPA is difficult because of the nonspecific clinical presentation and radiological features. Five cases of choriod plexus papilloma (3 males, 2 females) operated upon at this center are reviewed. All the cases were operated upon by retromastoid suboccipital craniectomy. As they all presented with a typical CPA syndrome without any distinctive radiological feature, a clinicoradiological diagnosis of CPP could not be reached in any of these. The diagnosis of CPP could only be suspected at the operation table and established on histopathological examination. Two patients developed recurrences at the primary site following surgery. One patient developed recurrence twice despite gross total excision of tumor in each sitting. Subsequently, this patient remained symptom free for a follow-up period of 1 year. Another patient developed recurrence 2 years following surgery, but he died due to septicemia and aspiration pneumonitis. Therefore definitive surgery could not be performed. Radiotherapy was offered to one of the patients having residual mass post operatively, to render her symptom free for a 4 year follow-up. The remaining two patients have also showed progressive improvement in their symptoms following surgery for 4 years on follow-up. Hydrocephalus was a common feature in all the cases preoperatively, but only one required shunt CSF diversion, because of rapid deterioration in visual equity. In all other cases, hydrocephalus was managed conservatively. Surgery remains the main modality of treatment for CPP, both for primary and recurrent tumors, but radiotherapy may have a role in cases of recurrence, which are quite frequent.

Seven premature hydrocephalics presenting with lambdoid positional moulding (LPM) were reviewed. All were treated for hydrocephalus secondary to aqueductal stenosis, Dandy Walker Syndrome and infection. Parenchymal hemorrhage, intraventricular bleed, cortical atrophy, septal agenesis, cortical anomalies and subdural hygroma were the other common associations. These children did not show expected improvement in their higher mental functions at 6 months to 5.4 years of follow-up, following the management of hydrocephalus. It was not the LPM but associated intracranial anomalies, which were most probably responsible for their poor outcome. The differentiation from posterior plagiocephaly is also highlighted.