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  Citation statistics : Table of Contents
   2003| January-March  | Volume 51 | Issue 1  
 
 
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ORIGINAL ARTICLE
Free radical toxicity and antioxidants in Parkinson’s disease
K Sudha, A Rao, S Rao, A Rao
January-March 2003, 51(1):60-62
PMID:12865518
Erythrocyte lipid peroxidation, oxidative hemolysis, erythrocyte antioxidant enzymes, viz. superoxide dismutase, glutathione reductase, glutathione peroxidase, catalase and plasma antioxidants, viz. vitamin A, vitamin E, vitamin C and ceruloplasmin have been determined by spectrophotometric methods in 15 patients with Parkinson’s disease (PD) and in 50 controls. Lipid peroxidation, oxidative hemolysis and plasma ceruloplasmin were significantly higher in PD patients as compared to normals. Erythrocyte antioxidants in PD patients were not significantly different from the controls. However, plasma vitamin C in PD patients was significantly lower than the controls. It is concluded that these patients are under oxidative stress which points to a possible involvement of free radicals in PD.
  34 15,510 552
Clinical, radiological and neurophysiological spectrum of JEV encephalitis and other non-specific encephalitis during post-monsoon period in India
UK Misra, J Kalita, D Goel, A Mathur
January-March 2003, 51(1):55-59
PMID:12865517
Aims: To study the spectrum of encephalitis during the post-monsoon period in a tertiary care centre of India. Methods: Clinical, neurophysiological and radiological features of patients with encephalitis are reported in this communication. The patients were subjected to clinical examination, CT or MRI scan, EEG, motor and somatosensory evoked potentials in both upper and lower limbs bilaterally and concentric needle electromyography. The laboratory studies for Japanese encephalitis (JE) comprised virus isolated, IgM capture ELISA, mercaptoethanol test and hemagglutination inhibition titre in paired sera against JE virus. Patients were classified into JEV encephalitis and non-specific encephalitis. On the basis of radiological features, they were classified into group I (thalamic or basal ganglia involvement), group II (brainstem involvement only) and group III (normal MRI). The outcome was defined into poor (bedridden), partial (dependent for daily activities) and complete (independent) recovery at the end of 3 months. Results: Out of 26 patients (Age 7-70 years, mean 24.8 years), laboratory evidences of JEV infection was present in 14 patients and one patient had herpes simplex encephalitis. The patients with JEV encephalitis had more severe illness as evidenced by lower GCS score, higher frequency of anterior horn cell involvement, movement disorders and more extensive MRI changes. The EEG and MEP changes were also more frequently abnormal in the JEV group. On radiology, 15 patients had thalamic or basal ganglia involvement (group I), 3 isolated midbrain involvement (group II) and 8 had normal MRI (group III). Laboratory evidence consistent with JE were present in 11 out of 12 patients in group I and 3 out of 8 in group III, however, there was no laboratory evidence of JE virus infection in patients with isolated brainstem involvement. There was overlap in the neurologic and systemic manifestations in all the 3 radiological groups as well as in the groups with and without laboratory evidences of JEV infection. Conclusion: The observed overlap in neurological and systemic involvement in different subgroups of encephalitis may be due to JE or JE-like viral infection. The possibility of strain variation, change in virulence of organism or immunity of host needs further studies.
  20 8,096 511
CASE REPORT
Primary spinal extradural hydatid cyst
NK Sharma, N Chitkara, N Bakshi, P Gupta
January-March 2003, 51(1):89-90
PMID:12865531
We report a rare case of spinal cord compression caused by primary multiple extradural hydatid cysts.
  18 5,652 210
ORIGINAL ARTICLE
Endoscopic third ventriculostomy in obstructed hydrocephalus
D Singh, V Gupta, A Goyal, H Singh, S Sinha, A Singh, S Kumar
January-March 2003, 51(1):39-42
PMID:12865513
Forty-three ETV were performed in 46 patients of obstructive hydrocephalus. Study was divided into two groups. Group 1 was with 29 children of less than two years age. Group 2 had seventeen patients of more than 2 years, adolescent and adults. Group 1 had 70% clinical and 63% radiological improvement whereas Group 2 showed 100% clinical and 73% radiological improvement. ETV failed in relieving the symptoms of hydrocephalus in eight patients. They were eventually benefited with VP Shunt. There was one postoperative death, which was not related to the procedure. ETV is an important alternative to VP Shunt in relieving hydrocephalus due to obstruction in CSF pathway.
  16 16,547 309
CASE REPORT
Gluteal abscess: A manifestation of Pott’s spine
R Kumar, A Chandra
January-March 2003, 51(1):87-88
PMID:12865530
A 3-year-old girl presented with features suggestive of compression of cauda equina. In addition, she had soft, fluctuant gluteal swelling, which on aspiration yielded pus, positive for acid-fast bacilli on staining and culture. She showed significant clinicoradiological improvement following aspiration of pus and antitubercular treatment. Rare manifestations of cold abscess in the spine are discussed.
  14 12,553 240
ORIGINAL ARTICLE
Bilateral subthalamic nucleus stimulation for Parkinson’s disease
PK Doshi, NA Chhaya, MH Bhatt
January-March 2003, 51(1):43-48
PMID:12865514
High frequency stimulation of the subthalamic nucleus (STN) is known to ameliorate the signs and symptoms of advanced Parkinson’s disease. Aim: We studied the effect of high frequency STN stimulation in 23 patients. Method: Twenty-three patients suffering from severe Parkinson’s disease (Stages III-V on Hoehn and Yahr scale) and, particularly bradykinesia, rigidity, and levodopa-induced dyskinesias underwent bilateral implantation of electrodes in the STN. Preoperative and postoperative assessments of these patients at 1, 3, 6 and 12 months follow-up, in “on” and “off” drug conditions, was carried out using Unified Parkinson’s Disease Rating Scale, Hoehn and Yahr staging, England activities of daily living score and video recordings. Results: After one year of electrical stimulation of the STN, the patients’ scores for activities of daily living and motor examination scores (Unified Parkinson’s Disease Rating Scale parts II and III) off medication improved by 62% and 61% respectively (p<0.0005). The subscores for the akinesia, rigidity, tremor and gait also improved. (p<0.0005). The average levodopa dose decreased from 813 mg to 359 mg. The cognitive functions remained unchanged. Two patients developed device-related complications and two patients experienced abnormal weight gain. Conclusion: Bilateral subthalamic nucleus stimulation is an effective treatment for advanced Parkinson’s disease. It reduces the severity of “off” phase symptoms, improves the axial symptoms and reduces levodopa requirements. The reduction in the levodopa dose is useful in controlling drug-induced dyskinesias.
  14 6,799 210
Incidence of intracranial aneurysms in north­west Indian population
K Kapoor, VK Kak
January-March 2003, 51(1):22-26
PMID:12865510
One thousand human brains of both sexes were examined. Aneurysms were found in 10 specimens (1%). The incidence of aneurysms was 1.6% in females and 0.8% in males. All the aneurysms were saccular. The aneurysms varied in size. In 5 specimens the aneurysms were minute bulbous dilatations. In the rest of the cases it varied from 0.2 to 2.5 cm. In 7 specimens the aneurysms were present at the junction of anterior cerebral artery with the anterior communicating artery, in 2 on the anterior communicating artery and in one specimen it was seen at the origin of posterior communicating artery. The youngest subject with saccular aneurysm was an 18-years-old male and the oldest was a 55-years-old male. No aneurysm was found in the brains of 94 children (1-17 years).
  14 5,686 198
Detection of heat stable mycobacterial antigen in cerebrospinal fluid by Dot-Immunobinding assay
A Mathai, VV Radhakrishnan, C Sarada, SM George
January-March 2003, 51(1):52-54
PMID:12865516
Background: Isolation of Mycobacterium tuberculosis in cerebrospinal fluid (CSF) specimen in patients with tuberculous meningitis (TBM) is infrequent and carries low sensitivity. Thus development of an alternative laboratory diagnostic test is essential for the early diagnosis and treatment of TBM. Objective: A simple, rapid Dot immunobinding assay (Dot-Iba), for the laboratory diagnosis of TBM is devised. This method minimizes the risk of handling infectious material in the laboratory. Method: The Dot-Iba was standardized with heat-inactivated M tuberculosis antigen (PPD). The heat-inactivated CSF from TBM and non-TBM patients was similarly assayed and it can detect antigen upto 1ng/ml in CSF. Result: A positive result was obtained in all the five culture positive patients with TBM and in 20/25 probable TBM. A negative result was obtained in 38/40 CSF from disease control group. The overall sensitivity and specificity of Dot-Iba was 83.3% and 95% respectively. Conclusion: Dot-Iba can be used as an adjunct for the laboratory diagnosis of TBM, particularly in culture negative TBM patients and also in those clinical situations where no laboratory tests are available to distinguish between TBM and partially treated pyogenic meningitis.
  13 5,822 194
CASE REPORT
False aneurysm of cavernous carotid artery and carotid cavernous fistula: Complications following transsphenoidal surgery
R Kachhara, G Menon, RN Bhattacharya, S Nair, AK Gupta, S Gadhinglajkar, RC Rathod
January-March 2003, 51(1):81-83
PMID:12865528
We present two cases of carotid injury during transsphenoidal surgery for pituitary adenoma. While in one of the cases it resulted in the formation of a false aneurysm of cavernous carotid artery, in the other patient, a carotid cavernous fistula (CCF) formed. The false aneurysm was managed by surgical trapping and the patient had an uneventful recovery. The CCF was initially managed with balloon embolization. The balloon got deflated and resulted in a false aneurysm with persistent CCF. This was occluded with Guglielmi Detachable Coils (GDC). The management options are discussed and relevant literature is reviewed. We emphasize the importance of an early cerebral angiography to know the status of the injured carotid artery and formation of false aneurysm / fistula.
  10 10,166 263
Ocular myasthenia gravis coincident with thyroid ophthalmopathy
A Yaman, H Yaman
January-March 2003, 51(1):100-101
PMID:12865535
Graves’ disease and myasthenia gravis are both auto-immune diseases and the coexistence of these two diseases is well recognized. Myasthenia gravis is more frequent in patients with thyroid disease. Here we present a case of thyroid ophthalmopathy and ocular myasthenia.
  10 16,237 268
ORIGINAL ARTICLE
A comparative study of classical vs. desmoplastic medulloblastomas
P Pramanik, MC Sharma, P Mukhopadhyay, VP Singh, C Sarkar
January-March 2003, 51(1):27-34
PMID:12865511
Classical and desmoplastic medulloblastomas (MBs) have been suspected to be biologically different, though comparative studies on markers of biological aggressiveness in these two variants are sparse in the literature. 87 classical and 43 desmoplastic variants of MB were studied with respect to clinical and histological characteristics, MIB-1 labeling index (MIB-1 LI), apoptotic index (AI), ratio of AI to MIB-1 LI, expression of p53 and Bcl-2 protein and 3-year progression-free survival. The only differences documented between the variants were with regard to age distribution and location. Thus, classical histology cases occurred predominantly in children and 80% were midline in location. In contrast, lateral location was seen more frequently with tumors of desmoplastic histology, which occurred in an almost equal distribution between children (56%) and adults (44%). No difference was noted between the variants with regard to proliferation index, apoptotic index, their ratio on or their molecular controls (p53 and Bcl-2). This was reflected in the clinical outcome wherein no significant difference was observed in the 3-year progression-free survival between the variants. It is concluded that the two histological variants of medulloblastoma are not different with regard to biological parameters of aggressiveness. The growth rate and clinical outcome in medulloblastomas have no correlation with the histological variant.
  10 10,610 253
SHORT REPORTS
Stroke: A rare presentation of cardiac hydatidosis
NP Singh, SK Arora, A Gupta, S Anuradha, G Sridhara, SK Agarwal, P Gulati
January-March 2003, 51(1):120-121
PMID:12865545
A 13-year-old boy presented with acute stroke leading to right-sided hemiparesis. A contrast CT scan of the brain showed a hemorrhagic infarct in the left basal ganglia region with surrounding edema. Echocardiography showed a hydatid cyst in the right atrial chamber extending into the left atrium. A single hepatic hydatid was also seen.
  10 4,895 107
CASE REPORT
Three cases of recurrent epileptic seizures caused by Endosulfan
S Kutluhan, G Akhan, F Gultekin, E Kurdoglu
January-March 2003, 51(1):102-103
PMID:12865536
To commit suicide, three young adults swallowed a relatively small amount of a widely used insecticide containing endosulfan. They developed recurrent epileptic seizures. After hospitalization they were treated and recovered without any sequel. These seizures were classified as acute symptomatic or provoked seizures. We suggest that if one faces acute repetitive seizures, especially in the rural areas, an intoxication such as endosulfan intoxication should be considered when the etiology is uncertain even in the absence of any signs of intoxication.
  9 7,733 241
LETTER TO EDITOR
Aseptic cerebral venous thrombosis associated with abdominal tuberculosis
N Kakkar, AK Banerjee, RK Vasishta, N Marwaha, SD Deodhar
January-March 2003, 51(1):128-129
PMID:12865551
  9 5,600 149
ORIGINAL ARTICLE
Morbidity predictors in ischemic stroke
JN Panicker, M Thomas, K Pavithran, D Nair, PS Sarma
January-March 2003, 51(1):49-51
PMID:12865515
Background: Although ischemic CVA is one of the leading causes for death and disability, parameters for predicting long-term outcome in such patients have not been clearly delineated, especially in the Indian context. Methods: A prospective hospital-based study of 105 patients of ischemic stroke, focal neurological deficits and functional score was assessed and the C-reactive protein level (CRP) was measured. A follow-up was done at 5 days and at 6 months and outcome variable was the functional status at 6 months using Barthel Index of Activities of Daily Living. Accordingly, patients were grouped into 3 – Barthel Index < 41: Severely disabled, Barthel Index 41-60: Moderately disabled and Barthel Index > 60: Mildly disabled. Results: At admission, if upper limb power was less than Medical Research Council (MRC) grade 4, or aphasia was present or CRP assay was positive, then at 6 months, these patients most likely belonged to the severely disabled group. If upper limb or lower limb power was greater than MRC grade 3 or there was no aphasia or conjugate gaze deviation or CRP assay was negative, these patients most likely belonged to the mildly disabled group at 6 months. Follow-up rate was 86%. Conclusion: Patients can be stratified according to the predicted prognosis. The treatment and rehabilitation can be properly planned and strictly adhered to in patients predicted to have worse prognosis.
  8 7,470 337
SHORT REPORTS
Recurrent intramedullary cervical ependymal cyst
R Chhabra, S Bansal, BD Radotra, SN Mathuriya
January-March 2003, 51(1):111-113
PMID:12865539
We report a rare case of high cervical intramedullary ependymal cyst in a young boy. This was associated with atlantoaxial dislocation. After partial removal and marsupialization, the cyst recurred and needed radical total resection.
  8 5,754 117
CASE REPORT
Interhemispheric subdural hematoma: An uncommon sequel of trauma
A Shankar, M Joseph, MJ Chandy
January-March 2003, 51(1):63-64
PMID:12865519
Interhemispheric subdural hematomas are relatively uncommon and usually seen in patients with bleeding disorders. They may present with signs of the falx syndrome or seizures. The management options range from craniotomy and evacuation to conservative management. We report such a case in a patient with normal bleeding parameters, which was managed with a twist drill craniostomy and drainage of the hematoma.
  7 15,212 205
Secondary holocord syringomyelia with spinal hemangioblastoma: A report of two cases
SB Pai, KN Krishna
January-March 2003, 51(1):67-68
PMID:12865521
Intramedullary spinal hemangioblastoma is well known to be accompanied by syringomyelia. However, holocord secondary syringomyelia is uncommon. We present 2 cases of spinal hemangioblastoma, one in the conus medullaris and the other in midthoracic region, accompanied by holocord syrinx. In both the cases the secondary syrinx resolved following successful total tumor excision with good neurological recovery.
  7 6,916 188
SHORT REPORTS
Craniofacial surgery and optic canal decompression in adult fibrous dysplasia
AK Mahapatra, PK Gupta, RR Ravi
January-March 2003, 51(1):123-124
PMID:12865547
A 29-year-old female had a 3-year history of bony swelling over the right frontal area. For 3 months she noticed proptosis of her right eye. Investigations revealed fibrous dysplasia involving the right half of the frontal bone and the right greater and lesser wings of the sphenoid bone. Visual evoked potentials (VEP) showed delayed latencies on the involved side. A craniofacial surgery with optic canal decompression was performed. Follow-up after 2 years revealed normalization of VEP.
  7 8,320 196
LETTER TO EDITOR
Oligodendroglioma causing calvarial erosion
DP Muzumdar, A Goel, CK Pakhmode
January-March 2003, 51(1):129-130
PMID:12865552
  6 3,356 75
SHORT REPORTS
Spontaneous subdural hematoma in a young adult with hemophilia
D Agrawal, AK Mahapatra
January-March 2003, 51(1):114-115
PMID:12865541
We report a case of spontaneous acute subdural hematoma in a 30-year-old man, who was diagnosed with hemophilia during his hospital stay. He developed an extradural hematoma following evacuation of the acute SDH, which was also evacuated. He had a good outcome. Management of such a patient is discussed.
  6 8,231 190
CASE REPORT
Paradoxical embolism through patent foramen ovale causing cerebellar infarction in a young boy
Devidayal , BR Srinivas, A Trehan, RK Marwaha
January-March 2003, 51(1):73-74
PMID:12865524
A previously healthy young boy who suffered an acute stroke involving superior cerebellar artery circulation is presented here. Echocardiography revealed a patent foramen ovale through which paradoxical embolism had probably occurred. Low dose aspirin was started and surgical closure was planned to prevent further recurrences.
  5 7,173 213
NEUROIMAGE
Dyke-Davidoff-Masson syndrome
DS Shetty, BN Lakhkar, JR John
January-March 2003, 51(1):136-136
PMID:12865560
  5 11,929 364
ORIGINAL ARTICLE
Increased cortical excitability with longer duration of Parkinson’s disease as evaluated by transcranial magnetic stimulation
M Bhatia, S Johri, M Behari
January-March 2003, 51(1):13-15
PMID:12865507
Transcranial Magnetic Stimulation (TMS) was used to evaluate the cortical excitability and central motor pathways in Parkinson’s disease (PD) and correlate with severity and duration of disease. 19 cases of PD and 13 controls were enrolled. The threshold intensity (TI), cortical latency (CL), central conduction time (CCT), motor evoked potential amplitude (MEP) obtained with TMS were correlated with Hoehn and Yahr and duration of disease. The threshold intensity (TI) was significantly lower in patients of PD than controls. The TI in patients with PD was 53.16+ 8.4% patients and 67.1+21.6% in controls (p<0.05). This strongly correlated with duration of disease, TI being lower in patients with disease duration more than 5 years. There was no difference in the other TMS parameters – CL, CCT, MEP between patients and controls.Our study revealed increased excitability in PD which was related to longer duration of disease.
  5 5,303 168
REVIEW ARTICLE
Current status of osmotherapy in intracerebral hemorrhage
J Kalita, P Ranjan, UK Misra
January-March 2003, 51(1):104-109
PMID:12865537
  5 23,933 618
SHORT REPORTS
Occipital seizures presenting with bilateral visual loss
S Hadjikoutis, IM Sawhney
January-March 2003, 51(1):115-116
PMID:12865542
Transient visual loss may occur with occipital seizures as an ictal or post-ictal phenomenon. Its duration varies from less than one minute to days, or can be permanent. We describe a 61-year-old man presenting with headache, vomiting and bilateral visual loss. EEG revealed persistent spike discharge in the occipital lobes suggesting occipital seizures. His vision improved with carbamazepine.
  5 27,751 195
CASE REPORT
Fenestration of the posterior communicating artery
M Tripathi, V Goel, MV Padma, S Jain, MC Maheshwari, S Gaikwad, V Gupta, PS Chandra, VS Mehta
January-March 2003, 51(1):75-76
PMID:12865525
A 21-year-old male presented with sudden onset of right-sided third nerve paresis. Angiogram showed a fenestrated posterior communication artery on the right side and no other vascular anomalies. There was no other lesion that could suggest a cause for the third nerve weakness. Fenestration of the posterior communicating artery has not been reported till date. The case is discussed and the literature on the subject is reviewed.
  4 7,075 158
Orthostatic tremor: Report of a case and review of the literature
KB Bhattacharyya, S Basu, AD Roy, S Bhattacharya
January-March 2003, 51(1):91-93
PMID:12865532
Orthostatic tremor is a rare movement disorder characterized by tremulousness of the lower limbs on standing that disappears on walking, sitting or on lying down and a distinctive electromyographic burst of 14 to 16 Hz. On inspection, fine ripples can sometimes be seen over the quadriceps on standing. The tremor has a tendency to reappear even in the supine posture if the lower limb muscles are put to an isometric contraction state, indicating thereby that in spite of the fact that the tremor occurs on standing, it is essentially ‘orthostasis independent’ and the central factor is the contraction of the muscles. As a matter of fact, the tremor is abolished if the subject is suspended by harness, thus relieving him of muscle contraction. Doubts are being cast whether it is a variant of essential tremor since a number of families are being reported to be suffering from this disease as well. Positron emission tomography reveals hyperactivity of cerebellum in orthostatic tremor as it shows in essential tremor, therefore lending credence to such a hypothesis. However, lack of response to alcohol, propranolol and primidone in orthostatic tremor stands out as a serious challenge to such a view. Lack of positive family history, synchrony of contracting group of muscles and negative `reseting’ of the tremor by increasing peripheral load–phenomena consistently observed in orthostatic tremor and not in essential tremor, are other features that often help to distinguish between the two conditions. We report a case of orthostatic tremor that presented with the classical clinical and eletromyographic features. Relevant literature in this regard is also being reviewed.
  4 12,162 479
Massive falx cerebri empyema
AK Yende, S Mohanty
January-March 2003, 51(1):65-66
PMID:12865520
A rare case of otogenic massive intra-falx empyema is reported. The patient presented with headache, vomiting and left lower limb weakness of 8 months duration. C.T. scan revealed two cavities in the falx. Right fronto-parietal craniectomy and drainage of massive empyema was undertaken through interhemispheric approach with wide opening of the falx, evacuation of voluminous amount of thick pus and marsupalization of flax with dura. The patient showed complete recovery. The relevant literature is briefly reviewed.
  4 5,619 150
LETTER TO EDITOR
Intracerebral schwannoma
HS Bhatoe, K Srinivasan, AK Dubey
January-March 2003, 51(1):125-127
PMID:12865549
  4 4,108 125
ORIGINAL ARTICLE
Ho: Yag laser-assisted lumbar disc decompression: A minimally invasive procedure under local anesthesia
S Agarwal, AS Bhagwat
January-March 2003, 51(1):35-38
PMID:12865512
The morbidity associated with open procedures for lumbar intervertebral disc prolapse has led to the development of minimally invasive techniques. Ho: LADD (Laser-assisted disc decompression) is a very cost-effective minimally invasive procedure. The procedure is carried out under local anesthesia The patient can be mobilized immediately after the surgery. The study involved 36 cases treated with Ho: LADD for contained lumbar intervertebral disc prolapse. 35 cases were available for follow-up. There was a 91.5% success rate and a minimal complication rate. All cases adhered to strict inclusion and exclusion criteria and were evaluated with the modified Macnab criteria for the assessment of postoperative results.
  4 10,398 234
CASE REPORT
Lipoma in the region of the jugular foramen
AV Prasanna, DP Muzumdar, A Goel
January-March 2003, 51(1):77-78
PMID:12865526
A 22-year-old girl presented with a gradually progressive loss of hearing in the left ear and ipsilateral facial paresis. Investigations revealed a lipoma in the region of the jugular foramen. Conservative resection of the tumor resulted in improvement in facial paresis. The treatment options in such cases are discussed in this report.
  3 6,264 118
Subependymomas in children: A report of five cases including two with osseous metaplasia
MK Mallik, N Babu, N Kakkar, VK Khosla, AK Banerjee, RK Vasishta
January-March 2003, 51(1):98-99
PMID:12865534
Subependymomas are highly differentiated slow growing gliomas. They are one of the few gliomas which are biologically benign. They are extremely rare in children. However, after going through the histopathology records of our department of fourteen years (1983-1997) we found that five (20%) cases of subependymomas have been diagnosed in children out of a total of twenty-six subependymomas. Two of our cases showed the presence of osseous metaplasia, a hitherto undescribed finding.
  3 4,286 145
NEUROIMAGE
Tolosa-Hunt syndrome: MRI before and after treatment
R Koul, R Jain
January-March 2003, 51(1):137-137
PMID:12865561
  3 7,428 378
ORIGINAL ARTICLE
Prognosis in children with head injury: An analysis of 340 patients
HS Suresh, SS Praharaj, B Indira Devi, D Shukla, VR Sastry Kolluri
January-March 2003, 51(1):16-18
PMID:12865508
Background: The outcome in children with head injury is distinctive because of the different biophysical properties of the child’s skull and brain, and their reaction to injury. Methods: In this retrospective study of three hundred and forty children with head injury, managed from January 1993 to December 1998, at NIMHANS, the factors influencing outcome were analyzed. Results: On admission there were 40 children in GCS 3-5, 55 children in GCS 6-8, 96 in GCS 9-12 and 152 children in GCS 13-15. Eleven patients were under 2 years of age, 53 were between 3-5 years, 140 were between 6-10 years and 156 were between 11-15 years of age. The prognosis in various intracranial pathologies due to head injury was evaluated and outcome assessed at discharge. There were 95 children with EDH and 8.4% had poor outcome (vegetative state or death). There were 85 patients with contusion and poor outcome was noted in 18.8%. One hundred patients had diffuse cerebral oedema on CT scan and outcome was poor in 25% of these patients. The clinical features associated with poor prognosis were, absence of ocular movements (50%), abnormal pupillary size and reaction (49%) and age less than 2 years (27%).
  3 8,212 318
SHORT REPORTS
Intracranial aneurysmal bone cyst manifesting as a cerebellar mass
S Kumar, TM Retnam, T Krishnamoorthy, S Parameswaran, S Nair, RN Bhattacharya, VV Radhakrishanan
January-March 2003, 51(1):121-123
PMID:12865546
A 17-year-old boy presented with symptoms of raised intracranial pressure for a month. Investigations revealed a large extra-cerebellar mass. The lesion was radically resected. It arose from the petrous bone. Histology revealed that the lesion was an aneurysmal bone cyst [ABC].
  3 6,272 121
Phenylpropanolamine-induced intraventricular hemorrhage
A Prasad, KK Bhoi, K Bala, KS Anand, HK Pal
January-March 2003, 51(1):117-118
PMID:12865543
Intracranial hemorrhage is an uncommon complication of phenylpropanolamine. There is an increasing awareness of this complication in the West. However, to the best of our knowledge there have been no cases reported from India. Here we report a patient who developed Intraventricular hemorrhage following ingestion of Phenylpropanolamine, from which he made an uneventul recovery over the next two weeks.
  3 5,895 145
Cerebral salt wasting syndrome in a patient with a pituitary adenoma
SK Singh, AG Unnikrishnan, VS Reddy, RK Sahay, SK Bhadada, JK Agrawal
January-March 2003, 51(1):110-111
PMID:12865538
Cerebral salt wasting syndrome (CSWS) is often an unrecognized cause of hyponatremia that occurs in the setting of intracranial lesions. It is important to differentiate CSWS from the syndrome of inappropriate ADH secretion, as this would alter the management of hyponatremia. We describe a case of CSWS that occurred in association with a non­functioning pituitary adenoma.
  3 10,155 276
CASE REPORT
Sudden bilateral foot drop: An unusual presentation of lumbar disc prolapse
AK Mahapatra, PK Gupta, SJ Pawar, RR Sharma
January-March 2003, 51(1):71-72
PMID:12865523
Bilateral acute foot drop is reported in a 30-year-old healthy male. He presented with a 7-day history of sudden severe backache, radiating to both the lower limbs and 1-day history of sudden bilateral ankle weakness that progressed to bilateral foot drop within 6 hours. He also developed retention of urine. Investigations revealed a large central disc prolapse at L3-4 with significant canal stenosis at that level. Following surgery the patient had progressive improvement.
  2 26,285 346
LETTER TO EDITOR
Unusual radiological picture in eclamptic encephalopathy
G Sarma, A Kumar, AK Roy
January-March 2003, 51(1):127-128
PMID:12865550
  2 3,618 113
Brain abscess due to Streptococcus sanguis
B Dhawan, V Lyngdoh, VS Mehta, R Chaudhry
January-March 2003, 51(1):131-132
PMID:12865554
  2 6,688 130
Carbamazepine-induced immune thrombocytopenia
JS Goraya, VS Virdi
January-March 2003, 51(1):132-133
PMID:12865555
  2 4,867 192
SHORT REPORTS
Cauda-conus syndrome resulting from neurocysticercosis
NN Singh, R Verma, BK Pankaj, S Misra
January-March 2003, 51(1):118-120
PMID:12865544
A 60-year-old male, presented with insidious onset, gradually progressive, burning paresthesia over the saddle area, sphincteric disturbance, impotence and paraparesis. Investigations revealed a ring-enhancing lesion in the conus medullaris suggestive of neurocysticercosis . This was supported by quantitative enzyme-linked immunosorbant assay from purified cell fraction of taenia solium cysticerci. On treatment with steroids he showed marked improvement.
  2 9,649 168
CASE REPORT
Tuberculous osteitis of clivus
B Indira Devi, AK Tyagi, DI Bhat, V Santosh
January-March 2003, 51(1):69-70
PMID:12865522
Tuberculous osteitis of clivus is rare. Its diagnosis is difficult because of the rarity of the site and the non-specific nature of the disease. Management consists of confirmation of diagnosis by biopsy and chemotherapy with anti-tubercular drugs. Meningitis may complicate the clinical course, increase morbidity and mortality.
  1 5,227 184
Foramen magnum metastatic malignant melanoma
SB Pai, KN Krishna
January-March 2003, 51(1):79-80
PMID:12865527
The foramen magnum as a site for brain metastasis is extremely rare. We report the case of a 24-year-old male who presented with features of increased intracranial pressure and lower cranial nerve palsies. Imaging revealed a foramen magnum tumor with extension up to the cerebellar vermis superiorly and into the spinal canal inferiorly (craniospinal mass) with mild obstructive hydrocephalus. A malignant melanoma was completely excised. The patient continued to be tumor-free 24 months later.
  1 7,497 152
Functional MR imaging of hand motor cortex in a case of persistent mirror movement
PN Jayakumar, J Kovoor, SG Srikanth, AB Taly, V Kamat
January-March 2003, 51(1):94-97
PMID:12865533
Persistent mirror movements are unwanted movements restricted to muscles homologous to those moved intentionally on the opposite body half. It is rarely observed and the functional MRI findings in a case of persistent mirror movement are described.
  1 5,182 141
Giant vertebrobasilar junction aneurysms: Unusual cases
A Suri, VS Mehta
January-March 2003, 51(1):84-86
PMID:12865529
Giant vertebrobasilar (VB) junction aneurysms are uncommon aneurysms, especially those associated with multiple aneurysms of the posterior circulation. We report two cases, one with a small and a giant aneurysm of the VB junction which were surgically clipped; and the other with a small left anterior inferior cerebellar artery (AICA) aneurysm which resolved spontaneously. The patient, however, developed a de-novo giant VB junction aneurysm, which was detected on a follow-up angiogram. This aneurysm was treated by surgical clipping. The clinical features, angiographic considerations and surgical treatment of such rare conditions are discussed and the relevant literature reviewed.
  1 7,551 175
LETTER TO EDITOR
Visual loss with papilloedema in Guillian-Barrei- Syndrome
RK Garg
January-March 2003, 51(1):135-135
PMID:12865559
  1 4,604 127
Craniopharyngioma in an 82-year-old male
SK Jain, S Chopra, P Mathur
January-March 2003, 51(1):133-134
PMID:12865556
  1 3,660 97
Congenital exostoses of the cervical vertebrae
N Chitkara, NK Sharma, U Dhall, N Bakshi, H Kamal
January-March 2003, 51(1):130-131
PMID:12865553
  1 4,591 94
Indian references in Neurology India
PN Tandon
January-March 2003, 51(1):134-135
PMID:12865557
  - 3,015 88
Letter
KR Nair
January-March 2003, 51(1):135-135
PMID:12865559
  - 2,486 64
Congenital toxoplasmosis infection
M Popli, V Popli
January-March 2003, 51(1):125-125
PMID:12865549
  - 4,109 112
ORIGINAL ARTICLE
Hemodynamic response to skull pins application in children: Effect of lignocaine infiltration of scalp
P Bithal, HH Dash, N Vishnoi, A Chaturvedi
January-March 2003, 51(1):19-21
PMID:12865509
Background: Skull pins application following local anesthetic infiltration of scalp obtunds hemodynamic changes in adults. No such study is available in children. Methods: 30 children undergoing elective suboccipital craniectomy with skull pins fixation, were randomly allocated either to control group I, or lignocaine group II. Whereas in group I, pins were applied without any scalp infiltration. In group II, pins were applied 1 min. after scalp infiltration with 0.5% lignocaine (plain) at each pin site. Results: Mean arterial pressure and heart rate were recorded during pinning (peak increase),1,4,7 and 10 min later, and were compared with the baseline (parameters recorded approximately 20 min. after intubation). Mean arterial pressure in group I peaked from 77.0 ± 9.19 to 113.87 ± 13.7mmHg (P<0.001) and remained significantly high throughout the study period. In Group II peak increase in mean arterial pressure was from 91.64 ± 16.39 to 101.85 ± 15.87 mmHg (P<0.01) and remained high till 1 min. only. Pins placement resulted in significant increase in heart rate only during pinning (peak increase) and up to 1 min. in both the groups (P<0.01). Conclusions: In children, skull pins placement 1 min. after scalp infiltration with 0.5% lignocaine plain fails to prevent the hemodynamic changes arising during pins placement (peak change) and up to 1 min. after pins placement. However, the technique successfully blocks these changes beyond 1 min. post skull pins fixation.
  - 4,548 123
SHORT REPORTS
Carpal tunnel syndrome after 22 years of Colle’s fracture
V Goyal, M Bhatia, M Behari
January-March 2003, 51(1):113-114
PMID:12865540
Delayed carpal tunnel syndrome is rare. We describe the electrophysiological findings in a patient with Colle’s fracture, who developed carpal tunnel syndrome 22 years after a wrist injury.
  - 7,657 154
Online since 20th March '04
Published by Wolters Kluwer - Medknow