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Byline: Sandeep. Mishra, Akshay. Kumar, Kanwaljeet. Garg, Manoj. Phalak, Manjul. Tripathi, Deepak. Agrawal, Manmohan. Singh, Shashank. Kale Context: Cavernous sinus haemangiomas (CSHs) are rare vascular malformations arising from the micro-circulation [...]

Byline: Manoj. Phalak, Neiwete. Lomi, Akshay. Ganeshkumar, Simranjeet. Singh, Kanwaljeet. Garg, Gopishankar. Natanasabhapathi, Manmohan. Singh, Rajinder. Kumar, Shashank. Kale Background: Various therapies ranging from plaque brachytherapy to enucleation have been [...]

Background: In neurosurgical practice, continuous care after discharge and the ability to detect subtle indicators of clinical deterioration are mandatory to prevent the progression of a disease. The care of 'unknown' patients discharged to rehabilitation homes may not have this privilege, especially in resource-poor countries such as India. Objective: We have attempted to study the causes and outcomes of re-admissions of 'unknown' patients with previous traumatic brain injury (TBI) to estimate the quality of nursing care in our rehabilitation centers. Material and Methods: The electronic hospital records of all consecutive 'unknown' TBI patients with unplanned re-admissions at our institute from January 2014 to December 2018 were retrospectively reviewed and analyzed for the factors determining the risk and outcomes of re-admission. Results: Out of 245 patients sent to rehabilitation homes at discharge, 47 patients (19.18%) were re-admitted. A total of 33 patients (70%) were re-admitted between 1 month and 1 year. Out of these, 38 patients (80.9%) were re-admitted because of preventable causes. Fifteen patients (31.9%) died during the hospital stay. The rest of the 32 (68%) patients were discharged after the management of the concerned condition with an average hospital stay of 9 ± 11.1 days. The average Glasgow coma scale (GCS) at re-admission of the patients who died was 6 (range 3-11). Two patients were brought in the brain dead status, whereas 20 patients (42.6%) had a GCS of 5 or below at the time of re-admission. The risk of mortality among patients with non-preventable causes was 88.9% (8/9) compared to preventable causes 18.4% (7/38). However, preventable causes for re-admission are much more common, resulting in nearly a similar overall contribution to mortality. Conclusions: There is a high rate of mortality and morbidity in 'unknown' patients with TBI because of poor post-discharge care in developing countries. Because preventable causes are the major contributor to re-admissions, the re-admission rate is a good indicator of a lack of adequate rehabilitative services. The need for improving the post-discharge management of 'unknown' patients with TBI in resource-poor countries cannot be over-emphasized. [ABSTRACT FROM AUTHOR]

Byline: Ankur. Khandelwal, Suman. Sokhal, Surya. Dube, Keshav. Goyal, Akanksha. Singh, Vivek. Tandon, Manoj. Phalak, Arvind. Chaturvedi, Shashank. Kale Chin-on- chest deformity is not uncommon sequelae of ankylosing spondylitis. Apart [...]

Byline: Raghavendra. Sharma, Ravi. Sharma, Vivek. Tandon, Manoj. Phalak, Kanwaljeet. Garg, Manmohan. Singh, Deepak. Gupta, Deepak. Agrawal, Sarat. Chandra, Shashank. Kale, V. Sreenivas Background: Posttraumatic hydrocephalus (PTH) adds to the [...]

Byline: Venkat. Koyalmantham, Shashank. Kale, Leve. Devarajan, Manoj. Phalak, P. Chandra, Ashish. Suri, Rajender. Kumar, Vivek. Tandon Background: Spinal dural arteriovenous fistula (SDAVF) is a known cause of progressive myelopathy [...]

Background: Lumbar discectomy is performed for symptomatic lumbar disc herniation and is one of the most widely performed spinal surgical procedures worldwide in a variety of ways. This survey aimed at providing an overview/perspective of different practice patterns and the impact of lumbar discectomy on axial back pain with or without sciatica. Methods: An online survey was performed using the application “Google Forms.” The link to the questionnaire was distributed to neurosurgeons through personal E‑mail and social media platforms. Results: We received 333 responses. The largest percentage of responses across five continents was from Asia (66.97%, n = 223). The mean age of the respondents was 40.08 ± 10.5 years. A total of 66 respondents (20%) had a spine practice of 7%–90%, and 28 respondents had a spine practice of 90%–100% (8.4%). The number of respondents who practiced microscopic discectomy using a tubular retractor (n = 143 respondents, 42.9%) was nearly equal to the number of respondents who practiced open discectomy (n = 142 respondents, 42.6%). An almost equal proportion of respondents believed discectomy does not help in relieving axial back pain. Only 20.4% (n = 68) of respondents recommend bed rest for a longer duration postoperatively. Conclusions: Our survey revealed that only 22.2% of spine surgeons recommended discectomy in patients with radiological disc herniation with axial back pain alone and preferred a minimally invasive method of discectomy. Almost half of them believed discectomy to be ineffective for axial low back pain and only a few recommended prolonged bed rest postoperatively. [ABSTRACT FROM AUTHOR]

Byline: Ravi. Sharma, Kanwaljeet. Garg, Manoj. Phalak, Vivek. Tandon, Kalpana. Kumari, Vaishali. Suri, Ashish. Suri, Ajay. Garg, S. Kale, A. Mahapatra Sir, Fungal infections of the central nervous system are [...]

Byline: Barkha. Bindu, Ranadhir. Mitra, Gyaninder. Singh, Manoj. Phalak Hypertension in the clinical setting of posterior fossa tumors is a known entity and occurs due to medullary compression by the [...]

Byline: Ravi. Sharma, Manoj. Phalak, Varidh. Katiyar, Sachin. Borkar, Shashank. Kale, Ashok. Mahapatra Objective: The current opinion among neurosurgeons regarding the selection between microvascular decompression (MVD) and gamma knife radiosurgery [...]

Ependymoma is a relatively rare glial tumor of the central nervous system that arise from the cells lining the ventricles and central canal of the spinal cord. Ependymosarcoma (ES) is a newly introduced tumor entity of uncertain prognosis characterized by a rare phenomenon of a malignant mesenchymal transition arising within an ependymoma. ESs are surgically challenging tumors for diagnosis and therapy with a high incidence of morbidity and mortality. Here, we report two diagnostically challenging cases of primary ES in a 25‐year‐old female and a 17‐year‐old male. Both the cases presented with progressive and sequential neurological deficits over a period of five to eight months, and histological examination revealed a biphasic gliomesenchymal architecture comprised of anaplastic ependymomatous and sarcomatous components. Molecular genetic analysis revealed the presence of type 1 C11orf95:RELA fusion transcript. To date, 22 cases of ES have been reported in the literature, and only one case harbored type 1 C11orf95:RELA fusion transcript. [ABSTRACT FROM AUTHOR]

Byline: Pankaj. Dawar, Manoj. Phalak, Sumit. Sinha, Bhawani. Sharma Sir, Ipsilateral occurrence of more than one extradural hematoma (EDH) is rare [sup][1] and calcification or ossification of EDH is further [...]

Byline: Manoj. Phalak, Vivek. Tandon, Ashok. Mahapatra A 51-year-old lady was operated for right cerebello-pontine angle (CP angle) meningioma by suboccipital retromastoid approach about 3.5 years back. She presented at [...]

Byline: Aanchal. Kakkar, Vaishali. Suri, Prerana. Jha, Arti. Srivastava, Vikas. Sharma, Pankaj. Pathak, Mehar. Sharma, Manish. Sharma, Shashank. Kale, Kunzang. Chosdol, Manoj. Phalak, Chitra. Sarkar Background: Glioblastoma multiforme (GBM) is [...]