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Atypical teratoid/rhabdoid tumor (AT/RT) is a biologically aggressive tumor of the central nervous system, usually occurring in the posterior fossa in infants and young children. Supratentorial location is relatively rare, especially tumors arising primarily within the lateral ventricles. Prognosis remains poor, despite multiple treatment modalities consisting of surgical excision, radiotherapy, and chemotherapy. We present the case of a 3-year-old girl with an AT/RT of the lateral ventricle with diffuse leptomeningeal and spinal metastasis on magnetic resonance imaging. She underwent a left frontoparietal craniotomy and near-total excision of the tumor. Immunohistochemistry confirmed the diagnosis and the child died within 3 months of surgery. There are isolated case reports in the literature regarding primary lateral ventricular AT/RTs, although secondary involvement of the ventricle from an adjacent tumor is commoner. Ours is the first case that demonstrates AT/RT arising within the body of the lateral ventricle causing extensive metastasis, both within the brain and spine. Given the dismal prognosis, the choice between further adjuvant treatment and palliative care is a matter of debate that necessitates a truthful and meaningful discussion with the parents. Keywords: Atypical teratoid/rhabdoid tumor, histopathology, lateral ventricle, pediatric brain tumors, Author(s): Gopalakrishnan C. Viswanathan [1]; Akhil Mohan [1]; Sourav Chowdhury [1]; Dilip Panikar [2]; Biji K. Aravind [1] The malignant rhabdoid tumor was originally described as a renal neoplasm in [...]

Byline: Shejoy. Joshua, S. Sundar, Vineeth. Viswam, Dilip. Panikar Background: Rathke's cleft cysts (RCCs) are benign epithelial lesions arising from the Rathke's pouch remnants that fail to regress during embryogenesis. [...]

Byline: Boby. Maramattom, Ananth. Ram, Prashant. Narayanan, T. Jithendra, Dilip. Panikar Sir, Leptomeningeal metastases (LMMs) are devastating complications of malignancies. A combination of large volume cerebrospinal fluid (CSF) examination, ventricular [...]

Byline: Boby. Maramattom, Vijay. Jayakrishnan, Dilip. Panikar, S. Sundar Sir, False localizing signs (FLS) are potentially misleading clinical signs that occur at a distance from the predicted site of anatomic [...]

Byline: Dilip. Panikar The area around the medial sphenoid wing, the anterior clinoid, the orbit and the cavernous sinus represents one of the most complex anatomical regions of the skull [...]

We report a case of vascularised fibula osteocutaneous flap used for composite cervical spinal and posterior pharyngeal wall reconstruction, in a patient with recurrent skull base chordoma, resected by an anterior approach via median labio-mandibular glossotomy approach. Bone stability and pharyngeal wall integrity were simultaneously restored

Pediatric tumefactive demyelination (TD) is a very rare pathology. There are no previous case reports of histopathologically proven solitary cerebellar TD in children. We report the case of a 7-year-old girl who presented with headache, vomiting, and imbalance. Magnetic resonance imaging (MRI) of the brain showed an irregular enhancing lesion in the left cerebellar paravermian region with perilesional edema. On a preoperative diagnosis of high-grade tumor, she underwent complete excision with an intraoperative frozen section suggestive of a glial neoplasm. Histopathology revealed a diagnosis of TD. Solitary TDs of the cerebellum in children are extremely rare. This is the first report of a histologically proven isolated cerebellar TD in a child. We discuss the diagnostic difficulty and surgical dilemma in the management of this case. [ABSTRACT FROM AUTHOR]

Byline: Boby. Maramattom, Dilip. Panikar A trapped fourth ventricle often requires fourth ventriculoperitoneal shunting (4VP). Complications of this procedure include shunt blockage, infection, shunt migration, and overdrainage. Cranial nerve palsies [...]

Byline: Boby. Maramattom, Shyam. Sundar, Dalvin. Thomas, Dilip. Panikar Postoperative visual loss (POVL) is an unpredictable complication of nonocular surgeries. Posterior ischemic optic neuropathy (PION) is particularly feared in spinal [...]

Abstract Introduction Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature. Case presentation We report two cases of people (a 23-year-old man and a 41-year-old man) with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma. Conclusion It is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.

Byline: Boby. Maramattom, Dilip. Panikar Sir, Peri-ictal pseudo-progression [PIPG] is a rare delayed sequela of cranial irradiation after brain tumors. It is a newly described phenomenon and less than 19 [...]

Byline: Venkidesh. Krishnamoorthy, Chirag. Parmar, Dilip. Panikar Rosai Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a benign histiocytic proliferative disorder mainly affecting the lymph nodes. [...]

Byline: Ramesh. Teegala, S. Menon, Dilip. Panikar Sir, Intracranial foreign bodies are a rare entity. These may be secondary to traumatic brain injuries, mainly warfare or civilian injuries,[1] surgical procedures [...]