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Byline: Sandeep. Kandregula, Bharat. Guthikonda [INLINE:1] Gamma knife radiosurgery (GKRS) has revolutionized the management of variety of intracranial disorders. In last five decades, the indications have expanded from functional ailments [...]

Byline: Sandeep. Kandregula, Bharat. Guthikonda [INLINE:1] In the current era, Gamma Knife radiosurgery is being used increasingly due to the proximity of vital neurovascular structures. Extensive skull base approaches are [...]

Byline: Sandeep. Kandregula, Bharat. Guthikonda [INLINE:1] Robotic-assisted spine surgery increased in the last decade around the world. The main advantage offered by the robot is increased precision of the screw [...]

Background: Dementia, a growing concern among the elderly, has an increased poor postoperative outcome that goes unrecognized by many. Our study aims to establish if dementia plays a role in the outcomes of head and neck cancer patients that undergo resections. Methods: We queried the National Inpatient Sample (NIS) database from 2016 to 2019 with a primary diagnosis of head and neck cancer who underwent surgical resection. Outcomes analyzed include postoperative delirium, ICU stay, complications, length of stay, and non‐routine discharge. Results: A total of 77095 patients were included, of which 1140 patients had dementia. The mean age of the patients with dementia was 77.5 years (±9.1) versus 63.2 years (±12.1) with no dementia. Dementia patients had a higher non‐home discharge rate (77.2% vs 46.8%, p = <0.001), extended length of stay (10.9 days ±14.7 vs 7.9 days ±8.8), postoperative delirium (15.4% vs 1.5%, p = <0.001), and longer ICU stay (8.3% vs 5.8%) as compared with patients with no dementia. A higher number of patients with Dementia were placed in long‐term facilities (53.5% vs 14.6%) postoperatively. More dementia patients (7.9% vs 0.9%) were transferred in from another health care facility for surgery. Dementia was associated with higher odds of delirium (OR, 6.36; 95% CI, 5.2–7.77), non‐routine discharge (OR, 2.05; 95% CI, 1.76–2.3), ventilation (OR, 0.8; 95% CI, 0.6–1.05), and length of stay (estimate 3.01, 95% CI, 1.84–4.184). Conclusion: Preoperative dementia significantly impacts postoperative delirium, non‐home discharge, and extended length of stay in head and neck cancer patients undergoing surgery. Level of Evidence: 3 Laryngoscope, 134:1258–1264, 2024 [ABSTRACT FROM AUTHOR]

Byline: Sandeep. Kandregula, Subhas. Konar, Nishanth. Sadashiva, Madhusudhan. Nagesh, Sathya. Kalahasti, Uday. Krishna, Jitender. Saini, Dhaval. Shukla, Vani. Santosh Background: Brainstem gliomas (BSG) constitutes very small proportion in adults brain [...]

Byline: Sandeep. Kandregula, Bharat. Guthikonda Although uncommon, Dural AV fistulas are the most common vascular malformations in the spinal cord. The exact etiology is not known although they are presumed [...]

Byline: Sandeep. Kandregula, Bharat. Guthikonda [INLINE:1] Access to Insular region is challenging because of the surrounding eloquent brain and vascular structures serving essential language and motor functions. Along with the [...]

Byline: Sandeep. Kandregula, Bharat. Guthikonda [INLINE:1] The conventional open TLIF was first described in 1982 by Harms and Rolinger. Minimally invasive TLIF progressed in these years rapidly. Minimally TLIF was [...]

Byline: Sandeep. Kandregula, Bharat. Guthikonda Posterior Inferior cerebellar artery (PICA) aneurysms are the second most common posterior circulation aneurysms after basilar apex aneurysms. Although the PICA aneurysm can be treated [...]

Background The literature suggests that minority racial and ethnic groups have lower treatment rates for unruptured intracranial aneurysms (UIA). It is uncertain how these disparities have changed over time. Methods A cross-sectional study using the National Inpatient Sample database covering 97% of the USA population was carried out. Results A total of 213 350 treated patients with UIA were included in the final analysis and compared with 173 375 treated patients with aneurysmal subarachnoid hemorrhage (aSAH) over the years 2000-2019. The mean (SD) age of the UIA and aSAH groups was 56.8 (12.6) years and 54.3 (14.1) years, respectively. In the UIA group, 60.7% were white patients, 10.2% were black patients, 8.6% were Hispanic, 2% were Asian or Pacific Islander, 0.5% were Native Americans, and 2.8% were others. The aSAH group comprised 48.5% white patients, 13.6% black patients, 11.2% Hispanics, 3.6% Asian or Pacific Islanders, 0.4% Native Americans, and 3.7% others. After adjusting for covariates, black patients (OR 0.637, 95% CI 0.625 to 0.648) and Hispanic patients (OR 0.654, 95% CI 0.641 to 0.667) had lower odds of treatment compared with white patients. Medicare patients had higher odds of treatment than private patients, while Medicaid and uninsured patients had lower odds. Interaction analysis showed that non-white/Hispanic patients with any insurance/no insurance had lower treatment odds than white patients. Multivariable regression analysis showed that the treatment odds of black patients has improved slightly over time, while the odds for Hispanic patients and other minorities have remained the same over time. Conclusion This study from 2000 to 2019 shows that disparities in the treatment of UIA have persisted but have slightly improved over time for black patients while remaining constant for Hispanic patients and other minority groups. [ABSTRACT FROM AUTHOR]

Byline: Sandeep. Kandregula, Bharat. Guthikonda Stereotactic electroencephalography (SEEG) is a minimally invasive surgical and electrophysiological technique to identify the epileptic zone (EZ) in pharmacoresistant epilepsy. The application of robotic technology [...]

/Summary. A 39-year-old female with a notable medical history of smoking and a familial predisposition to unruptured aneurysms presented with clinical symptoms of intermittent right-sided headaches, flashes of light, and pulsatile tinnitus in the right ear. Diagnostic evaluations, including advanced angiographic techniques, identified a right occipital arteriovenous malformation (AVM). The angiogram revealed significant venous flow voids, emphasizing the need for a comprehensive treatment approach. The Spetzler-Martin grading system classified the AVM as Grade 2, indicating a moderate risk profile. A strategic decision was made to undergo partial embolization of two primary arterial feeders from the right posterior cerebral artery (PCA). Subsequent post-embolization angiograms confirmed a marked reduction in arteriovenous shunting, validating the efficacy of the intervention. The surgical approach encompassed an occipital craniotomy, meticulous subarachnoid dissection, and intraoperative angiography to ensure complete resection. Post-operative assessments showcased a successful and complete AVM resection. The patient experienced a brief, transient headache post-surgery, which resolved on its own. She was discharged on the third post-operative day and has since reintegrated into her professional life. However, she reported a minor visual field deficit, which, while noticeable, did not impede her daily activities. This case underscores the importance of a holistic, patient-centric approach in managing AVMs [1–3]. It challenges the conventional wisdom from the ARUBA trial, advocating for a more nuanced, individualized treatment paradigm, especially for young patients with low-grade AVMs [4]. [ABSTRACT FROM AUTHOR]

Byline: Sandeep. Kandregula, Bharat. Guthikonda [INLINE:1] Course of the vertebral artery varies slightly with an incidence of 2-3% in normal population. These variations are more commonly seen in craniovertebral junction [...]

Byline: Sandeep. Kandregula, Bharat. Guthikonda [INLINE:1] Endoscopic third ventriculostomy(ETV) refers to a surgical approach creating an alternate pathway for CSF circulation bypassing the aqueduct of Sylvius through the perforation of [...]

Byline: Sandeep. Kandregula, Bharat. Guthikonda Supra-cerebellar Infratentorial (SCIT) approach (also known as Krause's approach) dates back to 1926 when Krause published a report of three patients with pineal region tumors. [...]