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  In this Article
   Koekkoek JA, Dir...
   CADISS trial inv...
   Choi KC, Lee JH,...
   Alfaro A, Bernab...
   Smorgick Y, Bake...
   Tan LA, Straus D...
   Mavridis IN. Ste...
   Ogilvy CS, Chua ...
   Panebianco M, Sr...
   Berlowitz DJ, Ta...
   Ota N, Tanikawa ...
   Sugano H, Arai H...
   Kronvall E, Vald...

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Table of Contents    
Year : 2015  |  Volume : 63  |  Issue : 3  |  Page : 426-429

A summary of some of the recently published, seminal papers in Neuroscience

Director, Institute of Neurosciences and Spinal Disorders, Global Health City, Perumbakkam, Chennai - 600 100, Tamil Nadu, India

Date of Web Publication5-Jun-2015

Correspondence Address:
K Sridhar
Director, Institute of Neurosciences and Spinal Disorders, Global Health City, Perumbakkam, Chennai - 600 100, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.158235

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How to cite this article:
Sridhar K. A summary of some of the recently published, seminal papers in Neuroscience. Neurol India 2015;63:426-9

How to cite this URL:
Sridhar K. A summary of some of the recently published, seminal papers in Neuroscience. Neurol India [serial online] 2015 [cited 2020 Feb 21];63:426-9. Available from:

  Kronvall E, Valdemarsson S, Säveland H, Nilsson OG. High prevalence of pituitary dysfunction after aneurysmal subarachnoid hemorrhage: A long-term prospective study using dynamic endocrine testing. World Neurosurg 2015;83:574-82. Top

The impaired systemic hormonal activity caused by hypothalamic and pituitary injury may contribute to neuropsychological disturbances and a poor quality of life after aneurysmal subarachnoid hemorrhage (SAH). The long-term clinical outcome and pituitary dysfunction after SAH were evaluated using dynamic tests for adrencorticotropic and somatotropic secretory capacity. It revealed a high frequency of long-term hypothalamic-pituitary dysfunction after aneurysmal SAH.

Contributed by Dr. Kumar Ashish, Department of Neurosurgery, SGPGI, Lucknow.

  Ota N, Tanikawa R, Miyazaki T, Miyata S, Oda J, Noda K, et al. Surgical microanatomy of the anterior clinoid process for paraclinoid aneurysm surgery and efficient modification of extradural anterior clinoidectomy. World Neurosurg 2015;83:635-43. Top

Anterior clinoidectomy is one of the most common procedures performed in any intracranial basal approach. Using a multidetector-row computed tomography, the authors preoperatively studied 144 sides in 72 patients with a paraclinoid aneurysm treated by an extradural anterior clinoidectomy. The incidence of the caroticoclinoid foramen (CCF), interclinoid osseous bridge, and pneumatization of the anterior clinoid process (ACP) discovered during an extradural anterior clinoidectomy, and the problems and technical issues encountered during surgery were described. A CCF, an interclinoid osseous bridge, and pneumatization of the ACP were observed in 16.6%, 2.77%, and 27.7% of cases, respectively. The authors conclude that CCF and interclinoid osseous bridge represent obstacles encountered during the extradural removal of the ACP. A CCF warrants a careful removal in order to facilitate the opening of the distal dural ring. Awareness of the degree of pneumatization of the ACP would reduce the risk of tear in the paranasal mucosa.

Contributed by Dr. Kumar Ashish, Department of Neurosurgery, SGPGI, Lucknow.

  Koekkoek JA, Dirven L, Heimans JJ, Postma TJ, Vos MJ, Reijneveld JC, et al. Seizure reduction in a low-grade glioma: More than a beneficial side effect of temozolomide. J Neurol Neurosurg Psychiatry 2015;86:366-73. Top

Seizures are a common symptom of low-grade gliomas (LGG). The authors studied the effect of temozolomide (TMZ) chemotherapy on seizure frequency, to identify factors associated with posttreatment seizure reduction, and to analyze the prognostic value of seizure reduction in assessing survival. In a retrospective study, they analyzed the records of 104 patients with LGG, who had seizures, and who also received temozolamide. A greater than or equal to (>) 50% reduction in seizure frequency after 6 months occurred in 29 of 66 (43.9%) patients. Seizure reduction was an independent prognostic factor in the assessment of the progression-free survival and the overall survival. The authors felt that TMZ may contribute to a significant reduction in seizure frequency in patients with LGG; and, that seizure reduction following TMZ treatment has prognostic significance and may serve as an important clinical outcome measure in patients with LGG.

Contributed by Dr. Kumar Ashish, Department of Neurosurgery, SGPGI, Lucknow.

  CADISS trial investigators, Markus HS, Hayter E, Levi C, Feldman A, Venables G, et al. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): A randomized trial. Lancet Neurol 2015;14:361-7. Top

Antiplatelet and anticoagulant drugs are both used to reduce the risk of stroke in the presence of extracranial carotid and vertebral artery dissection, but whether one treatment strategy is more effective than the other is unknown. The Cervical Artery Dissection in Stroke Study compared the efficacy of these drugs, with the additional aim of establishing the true risk of recurrent stroke. A randomized trial was performed in hospitals with specialized neurology or stroke units. A total of 250 participants were enrolled in the study. The authors found no difference in the efficacy of antiplatelet and anticoagulant drugs in preventing stroke and death in patients with symptomatic carotid and vertebral artery dissection. The incidence of stroke was, however, rare in both the groups, and much rarer than reported in some observational studies. The diagnosis of dissection was not confirmed after a review in many cases, suggesting that strict radiographic criteria are not always correctly applied in routine clinical practice.

Contributed by Dr. Kumar Ashish, Department of Neurosurgery, SGPGI, Lucknow.

  Choi KC, Lee JH, Kim JS, Sabal LA, Lee S, Kim H, et al. Unsuccessful percutaneous endoscopic lumbar discectomy: A single-center experience of 10,228 cases. Neurosurgery 2015;76:372-80. Top

Percutaneous endoscopic lumbar discectomy has significantly evolved with excellent results. Choi et al. looked at the failures of PELD in 10,228 cases performed between January 2001 and December 2012. Unsuccessful PELD was defined as a case requiring reoperation within 6 weeks after primary surgery. All unsuccessful PELD cases were classified according to the type of herniated disc (HD), location of the herniation, extruded disc migration, working channel position, and intraoperative and postoperative findings. Of the 10,228 patients who had undergone PELD, 436 (4.3%) cases were unsuccessful. Inappropriate positioning of the working channel in 95 cases caused incomplete removal of the HD. Other problems included incomplete removal of HDs in 283 patients (2.8%), recurrence in 78 (0.8%), persistent pain even after complete HD removal in 41 (0.4%), and approach-related pain in 21 (0.2%). The authors concluded that proper surgical indications and a good working channel position were important for a successful PELD. The surgical techniques should be designed for each case depending on the pattern of disk herniation.

Contributed by Dr. Kumar Ashish, Department of Neurosurgery, SGPGI, Lucknow.

0[TAG:2]Alfaro A, Bernabeu Α, Agulló C, Parra J, Fernández E. Hearing colors: An example of brain plasticity. Front Syst Neurosci 2015;9:56.[/TAG:2]

Sensory substitution devices (SSDs) are providing new ways for improving or replacing sensory abilities that have been lost due to disease or injury, and at the same time offer unprecedented opportunities to address how the nervous system could lead to an augmentation of its capacities. The authors have evaluated a new visual-to-auditory SSD device called "Eyeborg," that allows colors to be perceived as sounds. They used a combination of neuroimaging techniques including functional magnetic resonance imaging, diffusion tensor imaging, and proton magnetic resonance spectroscopy to study potential brain plasticity. Their results suggest that after 8 years of continuous use of this device there could be significant adaptive and compensatory changes within the brain.

Contributed by Dr. Namita Mohindra, Department of Radiology, SGPGI, Lucknow.

  Sugano H, Arai H. Epilepsy surgery for pediatric epilepsy: Optimal timing of surgical intervention. Neurol Med Chir (Tokyo) 2015;55:399-406. Top

The authors look at the recent evidence related to pediatric epilepsy surgery and try to establish the optimal surgical timing for patients with intractable epilepsy. Appropriate surgical timing depends on the etiology and natural history of epilepsy to be treated. The most common etiology of pediatric intractable epilepsy patients is malformation of cortical development, and early surgery is recommended for them. Patients operated on earlier than 12 months of age tended to improve their psychomotor development compared to those operated on later. Recent progress in neuroimaging and electrophysiological studies provide the possibility of very early diagnosis and comprehensive surgical management even at an age before 12 months.

Contributed by Dr. Namita Mohindra, Department of Radiology, SGPGI, Lucknow.

0[TAG:2]Miwa T, Hayashi N, Endo S, Ohira T. Neuroendoscopic biopsy and the treatment of tumor-associated hydrocephalus of the ventricular and paraventricular region in pediatric patients: A nationwide study in Japan. Neurosurg Rev 2015. DOI 10.1007/s10143-015-0629-z[/TAG:2]

The authors have conducted a nationwide investigation of the current status of neuroendoscopic biopsy for intra- and para-ventricular tumors in children, as well as the treatment of tumor-associated hydrocephalus, in pediatric patients. They looked at the patient's age and sex, location of the tumor, pathological diagnosis, complications, treatment and efficacy of treatment of the tumor-associated hydrocephalus, and the dissemination during the postoperative course in 221 pediatric patients from 67 institutions. Endoscopic tumor biopsies were performed in 206 patients (93.2%), and a histopathological diagnosis could be confirmed in 195 of these 206 patients (94.7%). The efficacy rate of the endoscopic third ventriculostomy in the perioperative period was 99.0%, and the long-term response rate was 90.1%. Perioperative complications other than fever were found in 24 patients (10.9%). The authors concluded that neuroendoscopic procedures involving pediatric intra- and para-ventricular tumors were very useful, with a low incidence of complication and were safe to use.

Contributed by Dr. Namita Mohindra, Department of Radiology, SGPGI, Lucknow.

[TAG:2]Souter MJ, Blissitt PA, Blosser S, Bonomo J, Greer D, Jichici D, et al. Recommendations for the critical care management of devastating brain injury: Prognostication, psychosocial, and ethical management: A position statement for healthcare professionals from the neurocritical care society. Neurocrit Care 2015. DOI10.1007/s12028-015-0137-6[/TAG:2]

Devastating brain injuries (DBIs) profoundly damage cerebral function and frequently cause death. DBI survivors admitted to critical care will suffer both intracranial and extracranial effects from their brain injury. The indicators of quality care in DBI are not completely defined, and despite best efforts, many patients will not survive, although others may have better outcomes than originally anticipated. Inaccuracies in prognostication can result in premature termination of life support, thereby biasing outcomes research and creating a self-fulfilling cycle where the predicted course is almost invariably dismal. The Neurocritical Care Society organized a panel of expert clinicians from neurocritical care, neuroanesthesia, neurology, neurosurgery, emergency medicine, nursing, and pharmacy to develop an evidence-based guideline with practice recommendations, intended for use by healthcare professionals especially in the first 72 h of the insult. The recommendations include prognostication, psychosocial issues, and ethical considerations.

Contributed by Dr. V. Ponniah, Department of Neuroanesthesiology and Neuro Critical Care, Global Health City, Chennai.

  Smorgick Y, Baker KC, Herkowitz H, Montgomery D, Badve SA, Bachison C, et al. Predisposing factors for dural tear in patients undergoing lumbar spine surgery. J Neurosurg Spine 2015;22:483-6. Top

The authors identify risk factors for incidental durotomies in lumbar spine surgery. The authors prospectively evaluated 523 patients who underwent lumbar and thoracolumbar spine surgery. Data from patients in whom a dural tear occurred were compared with data from patients who did not experience a durotomy. The authors concluded that in patients who underwent lumbar and thoracolumbar spine surgery for degenerative problems, previous surgery, and older age were found to be predisposing factors for dural tear.

  Tan LA, Straus DC, Traynelis VC. Cervical interfacet spacers and maintenance of cervical lordosis. J Neurosurg Spine 2015;22:466-9. Top

The cervical interfacet spacer is a relatively new technology that can increase foraminal height and area by facetal distraction. These offer the potential to provide an indirect neuroforaminal decompression while simultaneously enhancing the fusion potential due to the presence of a relatively large osteoconductive surface area and the compressive forces exerted on the grafts. One concern with the use of interfacetal spacers is the theoretical risk of inducing iatrogenic kyphosis. The authors studied at 64 patients in whom a total of 154 levels were fused using the spacer. The authors found no evidence of significant loss of cervical lordosis. They were of the opinion that the impact of these spacers on fusion and clinical outcome needs further evaluation.

  Mavridis IN. Stereotactic microanatomy of the nucleus accumbens stimulation for obsessive-compulsive disorder: Reported coordinates and mavridis' area. Neurosurgery 2015. DOI: 10.1227/NEU.0000000000000794 Top

In this letter to the Editor, Mavridis' brings into focus the targets used in deep brain stimulation (DBS) for Obsessive Compulsive Neurosis. He looks at the neuroanatomy and correlates the same with the hardware used for the DBS surgery. This is an extremely important paper in the realm of functional neurosurgery.

  Ogilvy CS, Chua MH, Fusco MR, Griessenauer CJ, Harrigan MR, Sonig A, et al. Validation of a system to predict recanalization after endovascular treatment of intracranial aneurysms. Neurosurgery 2015. DOI: 10.1227/NEU.0000000000000744 Top

The authors have previously reported the Aneurysm Recanalization Stratification Scale, which uses accessible predictors including aneurysm-specific factors (size, rupture, and intraluminal thrombosis) and treatment-related features (treatment modality and immediate angiographic result) to predict the retreatment risk after endovascular therapy. External validity was assessed in independent cohorts from 4 centers in the United States and Canada where endovascular and open neurovascular procedures are performed, and in a multicenter cohort of 1543 patients. The probability of retreatment stratified by risk score was derived for each center and the combined multicenter cohort. They concluded that the Aneurysm Recanalization Stratification Scale is a valid prognostic index and is the first comprehensive model that has been developed to predict quantitatively the retreatment risk following endovascular therapy.

  Panebianco M, Sridharan K, Ramaratnam S. Yoga for epilepsy. Cochrane Database of Systematic Reviews 2015, Issue 5. Art. No.: CD001524. DOI: 10.1002/14651858.CD001524.pub2 Top

In adult patients with refractory epilepsy, a review of two unblinded randomized controlled trials was conducted. All patients were continued on antiepileptic medication. The control group received no intervention while the study group received interventions like yoga-mimicking exercises or Acceptance and Commitment Therapy. The percentage of people rendered seizure free; seizure frequency and duration; and, quality of life were evaluated.

Results of the overall efficacy analysis show that yoga treatment was better when compared with no intervention or interventions other than yoga. The main benefit in the yoga group was related to a significant improvement in their quality of life according to the Satisfaction With Life Scale. However, the effectiveness of yoga as a treatment of epilepsy remained undetermined.

  Berlowitz DJ, Tamplin J. Respiratory muscle training for cervical spinal cord injury. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No.: CD008507. DOI: 10.1002/14651858.CD008507.pub2 Top

Cervical spinal cord injury (SCI) has the potential to cause severe impairment of the respiratory muscles. The literature was reviewed to assess the efficacy of respiratory muscle training (RMT) in improve respiratory function following a cervical SCI. It was determined that the vital capacity as well as the maximal inspiratory and expiratory pressure improved while the forced expiratory volume in one second or dyspnea showed no change.


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