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Objective: To demonstrate a technique of gradual monitored occlusion of the internal carotid artery (ICA) followed by ligation for giant aneurysms as an option for balloon test occlusion followed by permanent ligation of ICA. Materials and Methods: Authors retrospectively analyzed 27 patients with giant and complex ICA aneurysms who underwent carotid artery ligation between January 2001 and December 2010. Clinical presentation included headache, vision loss and diplopia. There were 19 patients with cavernous aneurysm, 5 supraclinoid, 1 ophthalmic, 1 petrous segment and 1 cervical segment aneurysm located extracranially. All demonstrated good cross-circulation. Selverstone clamp was used for gradual occlusion of the ICA over 72 h under closed observation in the intensive care unit. Results: Six patients developed hemiparesis in the postoperative period. Improvement occurred in one patient over two to three weeks while the remaining five patients had residual hemiparesis. One patient developed malignant MCA infarct for which decompressive craniectomy had to be done. There was no mortality in the present series. Conclusions: Gradual monitored occlusion and ICA ligation may be a simple, safe alternative procedure to clipping in surgically inaccessible and complex aneurysms, especially for surgeons with limited experience. Cross circulation study is an absolute requisite for carotid ligation. [ABSTRACT FROM AUTHOR]

Background: Glioblastoma multiforme (GBM) is the most common malignant central nervous system neoplasm. Loss of heterozygosity (LOH) on chromosome 10q in these tumors has been found to show variable association with prognosis. Aim: To evaluate LOH 10q status in cases of GBM, and to correlate these results with patient characteristics, other genetic alterations, and survival. Material and Methods: Fresh tumor tissue and blood samples were obtained for 25 cases of GBM diagnosed over a 2-year period. LOH 10q assay was performed on blood and tumor DNA by a PCR-based method using four microsatellite markers. TP53 mutation analysis and fluorescence in situ hybridization for epidermal growth factor receptor (EGFR) were performed. Histopathology was reviewed and clinical data were analyzed. Results: LOH 10q was identified in 17 of 25 cases (68%). Losses were frequent with markers D10S1765 (12/20 informative cases; 60%) and D10S587 (12/17 informative cases; 70.5%) in the regions of 10q23.3 and 10q26.1, respectively. D10S540 for 10q25.1 showed LOH in 4/12 informative cases (33.3%) and D10S1770 for 10q26-ter in none of the 25 cases. LOH with D10S1765 at the PTEN gene locus was found to correlate with overall LOH 10q status (P = 0.001). LOH 10q was more common in patients older than 40 years (16/19, 84.2%) than in those below (1/6, 16.7%) (P = 0.006). One of three pediatric patients included demonstrated LOH 10q. Survival rates for patients with LOH were lower than for patients with retained heterozygosity. Conclusion: LOH 10q is a frequent genetic abnormality in GBM in Indian patients, is seen more frequently in older adults, and its presence is associated with shorter survival. The single best marker to determine LOH 10q status is D10S1765 at the PTEN region. [ABSTRACT FROM AUTHOR]

Two patients did undergo surgery eventually for uncontrolled biochemical levels, which raises the question once again about why surgery was not the initial modality of treatment. Current guidelines do not support the use of primary GKS for patients with acromegaly unless medical therapy is unavailable, unsuccessful, or not tolerated.[[2]] Yet 16 patients did receive Octreotide. Liu et al., report on 38 patients with acromegaly, who either did not opt for, or else were not suitable for surgical resection.[[1]] All of these patients received primary Gamma knife radiosurgery (GKS). [Extracted from the article]

The article focuses on the functional outcome of spinal accessory nerve transfer to the suprascapular nerve to restore shoulder function. It mentions in patients with greater upper trunk injuries, alternatives to a spinal accessory nerve transfer to the suprascapular nerve should be considered to restore shoulder external rotation; and also mentions a recent meta‑analysis of muscle moment arms across the glenohumeral joint indicated that the subscapularis was an adductor in the coronal plane.

The article discusses a study which discusses observations on selective dorsal root ganglion pulsed radiofrequency lesioning combined with gabapentin in treatment of postherpetic neuralgia. It presents information on use of neuromodulating medications in postherpetic neuralgia. It states that dorsal root ganglion pulsed radiofrequency lesioning improving the immune functioning of these patients.

The article presents letter to the researcher of research paper titled "Demonstration of autonomic dysfunction in traumatic brachial plexus injury" using the quantitative sudomotor axon reflex test. The sender mentions that the researcher has used non affected arm as the control and that their study is not unique as autonomic dysfunction has been widely documented.

The author commends on the results of the study "Elucidating the utility of neuro-navigation in reducing malposition rates in Ommaya reservoir placement: 23-year operative experience at the Louisiana State University" by Andreas Filis and colleagues. These include the meticulous data collection, intellectual honesty, institutional experience and preventive cost from neuronavigational technology, he then suggests the issue on rigid pin fixation of the skull for infrared tracking.