Atormac
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 6597  
 Home | Reader Login
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
   Navigate here  
     Search
     Current Issue
     Submit Article 
     My Preferences 

Follow us on:

Twitter Icon Linkedin Icon Instagram Icon Facebook Icon

 


Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
  Access statistics : Table of Contents
   2009| March-April  | Volume 57 | Issue 2  
    Online since May 13, 2009

 
 
  Archives   Previous Issue   Next Issue   Most popular articles   Most cited articles
 
Hide all abstracts  Show selected abstracts  Export selected to
  Viewed PDF Cited
REVIEW ARTICLES
Transverse myelitis spectrum disorders
Lekha Pandit
March-April 2009, 57(2):126-133
DOI:10.4103/0028-3886.51278  PMID:19439840
Acute transverse myelitis (ATM) is an inflammatory demyelinating disorder that affects the spinal cord focally resulting in motor sensory and autonomic dysfunction. Establishing the diagnosis of ATM is not as difficult as determining the possible etiology. There is a difference in the perception of ATM seen in the West as compared to developing countries. In the West multiple sclerosis (MS) is the most common inflammatory disorder of the central nervous system. An attack of ATM may be the beginning of MS. However, this may not be the case in developing countries where MS is uncommon. Most often transverse myelitis is monophasic and at best represents a site-restricted form of acute disseminated encephalomyelitis (ADEM). Traditionally the combination of optic neuritis and ATM, occurring as a monophasic illness would have been called as neuromyelitis optica (NMO). Changing concepts in the definition of NMO and the discovery of a biomarker, neuromyelitis optica immunoglobulin (NMO_IgG), has changed the way relapsing autoimmune disorders are being perceived currently. A variety of idiopathic inflammatory disorders such as Japanese form of optic spinal MS, recurrent myelitis, and recurrent optic neuritis have been brought under the umbrella of neuromyelitis spectrum disorders because of the association with NMO-IgG. Complete transverse myelitis accompanied by longitudinally extensive transverse myelitis which is seronegative for this biomarker has also been reported from several countries including Japan, Australia, and India. Thus, ATM is a heterogeneous disorder with a varied clinical spectrum, etiology, and outcome.
  16,853 2,014 18
ORIGINAL ARTICLE
Neurological complications of Chikungunya virus infection
Nitin H Chandak, Rajpal S Kashyap, Dinesh Kabra, Poornima Karandikar, Sonali S Saha, Shweta H Morey, Hemant J Purohit, Girdhar M Taori, Hatim F Daginawala
March-April 2009, 57(2):177-180
DOI:10.4103/0028-3886.51289  PMID:19439849
Background: In May 2006, there was a large Chikungunya virus infection (CHIKV) outbreak in the Nagpur district of Maharashtra, a province in western India. Usually, CHIKV is a self-limiting febrile illness. However, neurological complications have been described infrequently. Aim: To study the clinical characteristics of various neurological complications associated with CHIKV infections. Materials and Methods: Patients with neurological complications following CHIKV infection during the outbreak were the subjects of the study. On the basis of clinical features and investigative findings, patients were grouped into various neurological syndromes: Encephalitis, myelopathy, peripheral neuropathy, myeloneuropathy, and myopathy. Cerebrospinal fluid (CSF) samples were also collected for biochemical and serological studies. Results: Of the 300 patients with CHIKV infection seen during the study period, June-December 2006, 49 (16.3%) [M : F: 42:7] had neurological complications. The neurological complications included: Encephalitis (27, 55%), myelopathy (7, 14% ), peripheral neuropathy (7, 14%), myeloneuropathy (7, 14%), and myopathy (1, 2%). Reverse Transcriptase polymerase chain reaction (RT-PCR) and real-time PCR was positive in the CSF in 16% and 18%, respectively. Conclusion: Recent CHIKV infection was associated with various neurological complications, suggesting neurotropic nature of the virus. The outcome of the neurological complications is likely to be good.
  15,563 843 84
ORIGINAL ARTICLES
Improvement of balance in progressive degenerative cerebellar ataxias after Ayurvedic therapy: A preliminary report
SJ Sriranjini, Pramod Kumar Pal, KV Devidas, Selva Ganpathy
March-April 2009, 57(2):166-171
DOI:10.4103/0028-3886.51286  PMID:19439847
Background: The treatment options for improving the balance in degenerative cerebellar ataxias are very few. Ayurvedic texts have described diverse treatment regimens for this disease. Aims: To determine the change in balance indices, if any, by dynamic posturography (Biodex Balance System, USA) in progressive cerebellar ataxia following Ayurvedic treatment. Materials and Methods: We performed a preliminary open labelled study on ten patients diagnosed with progressive cerebellar ataxia. The patients were treated over a period of one month. Treatment consisted of Shirobasti (therapeutic retention of medicament over the scalp) in male patients and Shirodhara (pouring of a steady stream of medicament on the forehead) in female patients with Dhanvantaram tailam (medicated oil) for 45 minutes daily, followed by Abhyanga (methodical massage) with Dhanvantaram tailam and Bhashpa sweda (steam bath), for 14 days. In addition, the treatment also consisted Abhyantara aushadha (oral medicines) of Maharasnadi kashayam 15ml thrice daily, Dhanvantaram capsules 101 two capsules thrice daily, and Ashwagandha tablet 500 mg one tablet thrice daily, for one month. The patients were assessed on the Biodex balance system before and after the treatment. Results were analyzed using paired samples 't' test. Results: All patients tolerated the treatment well without any adverse events and reported subjective improvement in walking. There was a statistically significant improvement in the overall and anteroposterior balance indices of dynamic stability. Conclusions: Over the short period of the present study, Ayurvedic therapy was found to be safe and, showed improvement in the balance in patients with progressive degenerative cerebellar ataxia. Further randomized placebo-control double-blind studies are needed to validate the results.
  15,604 728 6
INDIAN PERSPECTIVE
Neurology of acute organophosphate poisoning
Gagandeep Singh, Dheeraj Khurana
March-April 2009, 57(2):119-125
DOI:10.4103/0028-3886.51277  PMID:19439839
Acute organophosphate (OP) poisoning is one of the most common poisonings in emergency medicine and toxicological practice in some of the less-developed nations in South Asia. Traditionally, OP poisoning comes under the domain of emergency physicians, internists, intensivists, and toxicologists. However, some of the complications following OP poisoning are neurological and involve neurologists. The pathophysiological basis for the clinical manifestations of OP poisoning is inactivation of the enzyme, acetylcholinesterase at the peripheral nicotinic and muscarinic and central nervous system (CNS) nerve terminals and junctions. Nicotinic manifestations occur in severe cases and late in the course; these comprise of fasciculations and neuromuscular paralysis. There is a good correlation between the electrophysiological abnormalities and the severity of the clinical manifestations. Neurophysiological abnormalities characteristic of nicotinic junctions (mainly neuromuscular junction) dysfunction include: (1) single, supramaximal electrical-stimulus-induced repetitive response/s, (2) decrement-increment response to high frequency (30 Hz) repetitive nerve stimulation (RNS), and (3) decremental response to high frequency (30 Hz) RNS. Atropine ameliorates muscarinic manifestations. Therapeutic agents that can ameliorate nicotinic manifestations, mainly neuromuscular, are oximes. However, the evidence for this effect is inconclusive. This may be due to the fact that there are several factors that determine the therapeutic effect of oximes. These factors include: The OP compound responsible for poisoning, duration of poisoning, severity of poisoning, and route of exposure. There is also a need to study the effect of oximes on the neurophysiological abnormalities.
  10,798 1,030 17
REVIEW ARTICLES
Microvascular decompression as a surgical management for trigeminal neuralgia: A critical review of the literature
Serdar Kabatas, S Baki Albayrak, Tufan Cansever, Kemal T Hepgul
March-April 2009, 57(2):134-138
DOI:10.4103/0028-3886.51279  PMID:19439841
Trigeminal neuralgia (TN) is a common pain syndrome and is characterized by recurrent episodes of intense lancinating pain in one or more divisions of the trigeminal nerve. Neurovascular compression (NVC) has been considered as the main cause of TN in the root entry zone (REZ) of the trigeminal nerve in the cerebellopontine angle cistern. Microvascular decompression (MVD) is the surgical procedure of choice for the treatment of medically refractory TN. MVD has also been shown to provide pain relief even in patients without visible neurovascular compression. Additionally, it has been accepted that MVD can provide the highest rate of long-term patient satisfaction with the lowest rate of pain recurrence. We did, systematic review of the subject and also our own experiences.
  10,452 746 22
CASE REPORTS
Life-threatening cardiotoxicity due to chronic oral phenytoin overdose
Chih-Min Su, Chia-Te Kung, Yu-Chin Wang, Cheng-Hsien Lu
March-April 2009, 57(2):200-202
DOI:10.4103/0028-3886.51296  PMID:19439856
Severe cardiac adverse effects are often related to intravenous phenytoin overdose. However, there is no reported cardiotoxicity resulting from oral overdose of phenytoin. We report a patient with post-traumatic epilepsy who received oral phenytoin for five months and developed life-threatening junctional bradycardia, with his serum phenytoin level reaching up to 91g/mL. The patient was successfully treated with temporary transvenous pacemaker implantation for his severe bradycardia and hypotension. To our knowledge, our patient had the most serious cardiovascular toxicity ever reported with chronic oral phenytoin overdose. From emergency department (ED) physician's perspective, when a patient with dysrhythmias and cardiovascular collapse is presented to the ED, severe phenytoin overdose should be considered in patients on oral phenytoin with hyperbilirubinemia, hypoalbuminemia, and severe electrolyte imbalance.
  8,146 408 4
Ondine's curse after brainstem infarction
Jose Luiz Pedroso, Robson Fantinato Baiense, Ana Paula Scalzaretto, Pedro Braga Neto, Aecio Flavio Teixeira de Gois, Maria Elisabeth Ferraz
March-April 2009, 57(2):206-207
DOI:10.4103/0028-3886.51298  PMID:19439858
This report describes a rare case of acquired Ondine's curse. The patient developed central sleep apnea syndrome named Ondine's curse after a brainstem infarction. Lesions involving the descending medullocervical pathways that subserve automatic breathing can result in this syndrome.
  5,872 415 13
ORIGINAL ARTICLES
Clinical and magnetic resonance imaging features of 'diamond on quadriceps' sign in dysferlinopathy
Sunil Pradhan
March-April 2009, 57(2):172-175
DOI:10.4103/0028-3886.51287  PMID:19439848
Background: There is very little by way of clinical examination that helps in the diagnosis of subtypes of limb-girdle muscular dystrophy (LGMD). Materials and Methods: A small observation led to this study on a clinical sign in a group of 31 patients with dysferlinopathy that included 13 with LGMD-2B and 18 with Miyoshi myopathy (MM). The patients were asked to stand with knees slightly bent so that the quadriceps muscles were in moderate action. Those who could not stand in this posture due to muscle weakness were observed during sitting-down and standing-up in slow motion keeping hands away from thighs. Upper half of the anterolateral aspect of thighs was observed for any abnormal bulge. Results: Twenty one (eight with LGMD-2B and 13 with MM) were found to have diamond-shaped bulge in this region with wasting of muscles above and below. This bulge was not apparent in standing or sitting position when quadriceps muscle was not in action. T1-weighted MRI of the thighs revealed focal bulge-out of muscle fibers during contraction. Among the patients with other types of muscular dystrophy, who served as controls, one with clinical diagnosis of sarcoglycanopathy had multiple mild bulges visible over the quadriceps muscle but none showed diamond-shaped or little elongated single bulge as was seen in dysferlinopathy. Conclusion: We infer that nearly two-thirds of the patients with dysferlinopathy demonstrate 'diamond on quadriceps' sign. Further studies are needed to look for its specificity among patients with muscular dystrophy.
  5,773 478 5
CASE REPORTS
Subependymomas of the lateral ventricle: Tumor recurrence correlated with increased Ki-67 labeling index
Maria Koutourousiou, N Georgakoulias, G Kontogeorgos, A Seretis
March-April 2009, 57(2):191-193
DOI:10.4103/0028-3886.51293  PMID:19439853
Subependymomas of the lateral ventricles are rare tumors. We present two patients with subependymomas of the lateral ventricle, who underwent gross total resection of the tumor via transcallosal approach. The patient, with increased Ki-67 labeling index had recurrence of tumor two years after the initial operation. We emphasize at the risk of recurrence which is probably correlated with Ki-67 labeling index.
  5,717 241 5
EDITORIALS
Chikungunya virus: The neurology
JMK Murthy
March-April 2009, 57(2):113-115
DOI:10.4103/0028-3886.51275  PMID:19439837
  4,988 746 7
LETTERS TO EDITOR
Unusual cutaneous reaction with sodium valproate
S Roy, Deepak Goel
March-April 2009, 57(2):216-217
DOI:10.4103/0028-3886.51302  PMID:19439862
  5,259 276 4
ORIGINAL ARTICLES
Hyperdense middle cerebral artery sign in multidetector computed tomography: Definition, occurrence, and reliability analysis
Kasim Abul-Kasim, Eufrozina Selariu, Marco Brizzi, Jesper Petersson
March-April 2009, 57(2):143-150
DOI:10.4103/0028-3886.51282  PMID:19439843
Background: The hyperdense middle cerebral artery sign (HMCAS) is one of the early changes seen on the computed tomography in acute ischemic stroke of MCA territory. Aims: To evaluate the reliability of subjective evaluation of HMCAS on CT performed at multidetector CT (MDCT) and evaluated in the Picture Archiving Communication Systems, to define objective criteria for HMCAS and to find out if there are any predictors for the occurrence of HMCAS. Materials and Methods: CTs of 121 consecutive patients (mean age of 70 years) treated with thrombolytic therapy were retrospectively evaluated by two neuroradiologists both subjectively and objectively with respect to HMCAS. Results: HMCAS was subjectively found in 32% of study population. The interobserver and intraobserver agreement were substantial (K value of 0.69 and 0.80, respectively) and increased to almost perfect (Kvalue of 0.86) when the reader provided with clinical information. The HMCAS was found twice as often in male patients. Patients with HMCAS were three years younger than those whose baseline CT did not show HMCAS. A 100% sensitivity achieved when objective criteria were defined as combination of MCA attenuation ≥ 46HU and MCA ratio > 1.2 (using oval ROIs) and MCA attenuation ≥ 50 HU and MCA ratio of > 1.4 (using pixel sized ROIs). Conclusion: Performing CT examinations on MDCT and assessment of the images in PACS might have contributed to improvement of the reliability of evaluating HMCAS on CT by enabling an objective evaluation of this sign with measurements of attenuation value in the course of MCA using oval or pixel sized ROIs as well as estimation of MCA ratio .
  5,196 317 12
Anterior subaxial cervical spine fixation using a plate with single screw per vertebral body: A simple and efficient construct - Clinical series and a cadaver study
Prasad SSV Vannemreddy, Alan Ogden, Debi Mukherjee
March-April 2009, 57(2):151-156
DOI:10.4103/0028-3886.51283  PMID:19439844
Objective: To report our experience with a novel construct for traumatic and nontraumatic cervical spine lesions that was validated by biomechanical studies of cadaver cervical spine. Study Design: Consecutive cases of anterior cervical spine fixation performed over six years reviewed for stability offered by a construct comprising of a plate fixed by a single screw to each vertebral body. Setting: A university hospital and a biomechanical lab. Materials and Methods: Data were coded and entered into a statistical worksheet for multivariate analysis. Cadaver spine models applied for biomechanical study of stability. Results: Total of 103 cases reviewed; 86 with single-level disease; traumatic in 66 (64%) cases and degenerative in 33 (32%) cases, including hard disks, OPLL, and spondylitis (4% with other causes). Fixation was with diskectomy in 59 and with corpectomy in 40. A bone graft was utilized for fusion in 87 and a bone-filled titanium spacer in 13. A single screw was placed in each vertebral body with a locking plate (having linear arrangement of holes). This construct remained strong in 95% of cases at the end of 6-24 months. Five cases failed requiring reoperation. Five patients with cervical spinal cord injury (SCI) died. On statistical analysis, construct was stronger with diskectomy compared with corpectomy. Construct used on cadavers confirmed the biomechanical stability in short segment fixation (C5-6). Conclusion: A conservative construct utilizing a single screw per vertebral body and a one-holed plate system appears to be strong enough to afford stability in both traumatic and nontraumatic lesions of subaxial cervical spine, comparable to others.
  4,835 287 1
CASE REPORTS
Adult medulloblastoma mimicking Lhermitte-Duclos disease: Can diffusion weighted imaging help?
Puneet Mittal, Kamini Gupta, Kavita Saggar, Supreet Kaur
March-April 2009, 57(2):203-205
DOI:10.4103/0028-3886.51297  PMID:19439857
Lhermitte-Duclos disease, also known as dysplastic cerebellar gangliocytoma, is a rare cerebellar benign tumor with characteristic appearance of thickened cerebellar folia giving a laminated or striated appearance, quite diagnostic of the condition. We had seen a patient with medulloblastoma with imaging findings suspicious for thickened cerebellar folia reminiscent of Lhermitte-Duclos disease. However, it showed patchy contrast enhancement and restricted diffusion on diffusion-weighted imaging, which are not typically associated with Lhermitte-Duclos disease. Presence of restricted diffusion proved to be a useful diagnostic feature for differentiation between the two lesions. This patient highlights the importance of obtaining all the MR imaging sequences in suspected Lhermitte-Duclos disease and histological diagnosis if there is doubt.
  4,440 308 5
Pure cortical supratentorial extraventricular ependymoma
Yad Ram Yadav, Neha , SK Chandrakar
March-April 2009, 57(2):213-215
DOI:10.4103/0028-3886.51301  PMID:19439861
Majority of ependymomas are infratentorial and intraventricular. Supratentorial and purely cortical extraventricular ependymomas are extremely rare and only five cases were reported. We report a 15-year-old male with left frontal cortical ependymoma. He had gross total excision of the lesion and was not given radioptherapy.
  4,388 264 14
LETTERS TO EDITOR
Spontaneous thoracic spinal cord herniation presenting as tethered cord syndrome
Narayanam A Sai Kiran, Sandeep Vaishya, Manish K Kasliwal, Shashank S Kale, Bhavani S Sharma
March-April 2009, 57(2):221-222
DOI:10.4103/0028-3886.51306  PMID:19439866
  4,184 231 4
Sudden death in a case of lateral medullary syndrome
Dhananjay Duberkar, Dheeraj Khurana, Vivek Gupta, Sudesh Prabhakar
March-April 2009, 57(2):225-225
DOI:10.4103/0028-3886.51309  PMID:19439870
  3,831 242 2
BRIEF REPORT
Spectrum of magnetic resonance imaging findings in a family with giant axonal neuropathy confirmed by genetic studies
S Ravishankar, Gaurav Goel, Chandrajit Prasad Bernd Rautenstrauss, Atchayaram Nalini
March-April 2009, 57(2):181-184
DOI:10.4103/0028-3886.51290  PMID:19439850
Giant axonal neuropathy is a disorder that affects both the peripheral and central nervous system with clinical and genetic heterogeneity. We describe the spectrum of magnetic resonance imaging (MRI), MR-spectroscopy (MRS), and diffusion changess in two siblings from India. In addition to the described MRI findings two unreported findings, hyperintensity signals of both the globus pallidus on T1-weighted images and involvement of bilateral thalamus, were observed. MRS showed elevated choline peaks and reduced N-acetylaspartate peaks as well as presence of lactate peaks. Diffusion weighted images showed restricted diffusion.
  3,687 335 8
EDITORIALS
Managing cerebral and cranial hydatid disease
D Raja Reddy
March-April 2009, 57(2):116-118
DOI:10.4103/0028-3886.51276  PMID:19439838
  3,613 407 7
LETTERS TO EDITOR
Recurrent atypical meningioma seeding to surgical scar
Muhammad Z Tahir, Muhammad S Shamim, Khalid N Chishti
March-April 2009, 57(2):222-224
DOI:10.4103/0028-3886.51307  PMID:19439867
  3,478 244 3
CASE REPORTS
Usefulness of gamma knife pituitary surgery to control thalamic pain after treatment of thalamic malignant lymphoma and report of pathology of gamma knife lesions
Satoshi Utsuki, Hidehiro Oka, Yoshiteru Miyajima, Kiyotaka Fujii
March-April 2009, 57(2):185-187
DOI:10.4103/0028-3886.51291  PMID:19439851
Here, we describe the first reported autopsy findings following gamma knife surgery for thalamic pain. A 62-year-old man presented with thalamic pain after treatment for thalamic malignant lymphoma. He was treated with narcotic drugs, but his pain was uncontrollable. Treatment using gamma knife surgery on the pituitary gland using a maximum dose of 180 Gy, led to the control of his intractable pain with lower doses of drugs. His death was pain-free and was caused by a recurrence of the tumor, six months after gamma knife surgery. An autopsy was performed and necrosis was present in the area of the pituitary gland where it borders the pituitary stalk. Half of the adenohypophysis was not necrotic, and necrosis was not found in the pituitary stalk.
  3,461 222 1
ORIGINAL ARTICLES
Surgical treatment options for cerebral alveolar echinococcosis: Experience in six patients
Junyi Wang, Bowen Cai, Chao You
March-April 2009, 57(2):157-161
DOI:10.4103/0028-3886.51284  PMID:19439845
Background: Cerebral alveolar echinococcosis (AE) is a rare but lethal parasitic disease. Its pathogenesis remains poorly understood. Currently there is no widely accepted methods for its surgical treatment. Aims: To discuss the surgical treatment options. Settings and Design: Hospital-based observational study. Materials and Methods: Patients who had surgery for cerebral AE during 2001 and 2007 were the subjects of the study. According to the lesion location and volume, patients have been allocated to either massive resection group or radical piecemeal resection group. Postoperatively, all patients received long-term aldendazole therapy in view of the associated hepatic involvement and were follow-up in the clinic. Results: Of the six patients with cerebral AE who were operated during the study period, four had massive resection and two had radical piece meal resection. None of the patients had postoperative neurological worsening and there was improvement in the neurological status in all the patients except for the patient with blindness. Of the 4 patients in massive resection group, two patients died during the follow-up, one because of liver failure and the other due to hydrocephalus. The remaining four patients were back to their normal activities and none had recurrence of the disease during the follow-up. Conclusions: Although radical massive resection is generally regarded as the surgical method treatment for cerebral AE, radical piecemeal resection can be a reasonable, effective alternative management option, especially when massive resection might result in unavoidable morbidity and mortality.
  3,295 230 5
CASE REPORTS
Cerebellar liponeurocytoma: An updated follow-up of a case presenting histopathological and clinically aggressive features
Gallina Pasquale, Buccoliero Anna Maria, Pirillo Vania, Pansini Gastone, Di Lorenzo Nicola
March-April 2009, 57(2):194-196
DOI:10.4103/0028-3886.51294  PMID:19439854
Cerebellar liponeurocytoma is a rare tumor recently included by World Health Organization in the classification of brain tumors as a separate clinicopathological entity separate from medulloblastoma. However, because of the rarity of the tumor, the natural history of the tumor is still not yet been defined. We report a patient with cerebellar liponeurocytoma with unusual clinical and pathological aggressive features. This patient suggests the possible existence of different histological grades of liponeurocytoma and its possible progression to a malignant grade.
  3,273 229 13
Intradural extramedullary tuberculoma mimicking en plaque meningioma
Erdinc Ozek, A Celal Iplkcioglu, Mustafa Erdal
March-April 2009, 57(2):211-212
DOI:10.4103/0028-3886.51300  PMID:19439860
In this paper we report an 18 year old woman with an intradural extramedullary tuberculoma mimicking en plaque meningioma located in the thoracic region. The patient was operated via thoracic laminoplasty and tumor was totally resected. On the follow-up examination the magnetic resonance imaging demonstrated the total excision of the tumor. Here we describe a case of intradural extramedullary tuberculoma of the spinal cord as a complication of tuberculosis meningitis in a previously healthy young female.
  3,157 303 15
Cerebral sinus thrombosis in a patient with active ulcerative colitis and double heterozygosity for Factor V Leiden and prothrombin gene mutations
Fahri Yakaryilmaz, Sefa Guliter, Bulent Degertekin, Candan Tuncer, Selahattin Unal
March-April 2009, 57(2):188-190
DOI:10.4103/0028-3886.51292  PMID:19439852
Inflammatory bowel diseases are associated with increased risk for thrombotic complications, In patients with ulcerative colitis (UC) cerebral sinus venous thrombosis (CSVT) is an extremely rare complication. We report a patient with active UC and CSVT. The patient was heterozygous for Factor V Leiden and G20210A prothrombin gene mutations without other identifiable precipitating factors. This patient highlights the need for investigating the patients with UC with thrombotic complications for other thrombophilic states.
  3,142 252 5
ORIGINAL ARTICLES
Study of pyruvate kinase activity in human astrocytomas - Alanine-inhibition test revisted
VK Javalkar, KY Vinod, S Sharada, BA Chandramouli, MN Subhash, VR Kolluri
March-April 2009, 57(2):140-142
DOI:10.4103/0028-3886.51281  PMID:19439842
Background: Recent studies have confirmed that alterations in the isoenzyme of pyruvate kinase (PK) provide tumor cells with selective growth advantage. Aims: Our aim was to establish the mean activity of the enzyme PK in human astrocytomas and to look for any trends in the activity with relation to histological grade. Materials and Methods: The PK (EC 2.7.1.40) activity was measured in the tumor homogenate by spectrophotometric rate determination. ΔAbsorbance at 340 nm (A 340nm ) per minute was obtained using the maximal linear rate for both the test and the blank. Enzyme activity was estimated in the presence and absence of amino acid alanine. Results: The mean PK level in astrocytomas was 3.5 2.0 mmol/min/mg protein, which was significantly higher (24%; P < 0.001) when compared to 2.8 0.3 mmol/min/mg protein in control brain. Highest PK activity was noted in grade 2 astrocytomas. In controls there was no change in PK activity in the presence of alanine. In grade 2 astrocytomas there was 7% decrease in mean PK activity in the presence of alanine, this difference in grade 3 astrocytomas was 33% and in grade 4 astrocytomas it was 61%. As the tumors were becoming malignant there was a graded increase in the levels of PK inhibition. Conclusions: Mean PK activity was significantly higher in astrocytomas. There was a graded increase in level of PK inhibition as the tumors were becoming more malignant.
  3,028 233 2
CASE REPORTS
Endoscopic-assisted microscopic decompression of adenoid cystic carcinoma of paranasal sinus extending to the sella: A case report and review of literature
Pradipta Tripathy, Yashbir Dewan
March-April 2009, 57(2):197-199
DOI:10.4103/0028-3886.51295  PMID:19439855
Technological development in neuroendoscopy has lead to an expansion of its applications. The dimensions of a microsurgical approach to the brain can greatly be enlarged with the use of endoscope, making it possible to look behind structures and around corners. We performed an endoscopic assisted microsurgical decompression of an adenoid cystic carcinoma of paranasal sinus with intracranial sellar extension with good results.
  2,970 226 -
LETTERS TO EDITOR
Giant extra-axial posterior fossa tuberculoma in a three-year-old child
Vijay Parihar, YR Yadav, Dhananjaya Sharma
March-April 2009, 57(2):218-220
DOI:10.4103/0028-3886.51304  PMID:19439864
  2,940 252 3
Parenchymal brain cysts in Schimmelpenning-Feuerstein-Mims syndrome
Mahesh Kamate, Arun Dumale, Virupaxi Hattiholi
March-April 2009, 57(2):225-226
DOI:10.4103/0028-3886.51310  PMID:19439869
  2,868 181 1
ORIGINAL ARTICLES
Incidence and pattern of intraoperative hemodynamic response to endoscopic third ventriculostomy
P Ganjoo, S Sethi, MS Tandon, R Chawla, D Singh
March-April 2009, 57(2):162-165
DOI:10.4103/0028-3886.51285  PMID:19439846
Background: In patients undergoing endoscopic third ventriculostomy (ETV), various cardiovascular changes occur in the intraoperative period. Aim: We tried to determine a pattern in these changes and their relation to different surgical steps. Materials and Methods: A total of 260 patients were studied over a period of six years. Heart rate and mean arterial pressures were recorded before introduction of the endoscope and thereafter at various stages of the operation. Results: Tachycardia was the predominant observed abnormality in 20% of patients, occurring mostly during manipulations and irrigation in the third ventricle (TV). Bradycardia was seen in 12% of patients, more often during fenestration of the floor of the third ventricle. Conclusions: Tachycardia observed during ETV may be related to hypothalamic stimulation or a rise in intracranial pressure and bradycardia may be due to stimulation of the hypothalamus or the third cranial nerve. Anticipation of these cardiovascular changes during the relevant steps of the operation can help in taking appropriate corrective action, thus preventing potentially serious complications of ETV.
  2,788 261 7
NEUROIMAGES
Massive cerebral air embolism in a preterm with fetal alcohol syndrome
Tai-Heng Chen, Yuh-Jyh Jong, Rei-Cheng Yang, San-Nan Yang
March-April 2009, 57(2):227-228
DOI:10.4103/0028-3886.51311  PMID:19439871
  2,828 219 1
LETTERS TO EDITOR
Tuberculous brain abscess in a child with tetralogy of Fallot
Rojin Abraham, Sathish Kumar, Julius Xavier Scott, Indira Agarwal
March-April 2009, 57(2):217-218
DOI:10.4103/0028-3886.51303  PMID:19439863
  2,763 245 -
NEUROIMAGES
Extensive gliosis in the wall of cervico-dorsal syrinx masquerading intramedullary tumor
Amit Agrawal, Rajesh Dulani, Arvind Bhake, Kishore M Hiwale, Anita Mahadevan, SK Shankar
March-April 2009, 57(2):229-230
DOI:10.4103/0028-3886.51312  PMID:19439872
  2,708 215 -
CASE REPORTS
A delayed frontorbital abscess caused by a penetrating nonmissile foreign body (A bamboo stick)
Wen-ke Liu, Lu Ma, Bo-yong Mao
March-April 2009, 57(2):208-210
DOI:10.4103/0028-3886.51299  PMID:19439859
We report an interesting case of delayed frontal abscess caused by a penetrating nonmissile foreign body, a bamboo stick in a 1.5-year-old male child. A parietal craniotomy was performed, and the brain abscess was resected along with the foreign body without any damage to the surrounding brain tissue. He also received the appropriate antibiotics. The child made a good recovery.
  2,702 210 4
LETTERS TO EDITOR
High cervical cord injury after accidental pencil stab
AK Sinha, S Adhikari, SK Gupta
March-April 2009, 57(2):220-221
DOI:10.4103/0028-3886.51305  PMID:19439865
  2,628 209 2
Topiramate and rhegmatogenous retinal detachment
Sribhargava Natesh
March-April 2009, 57(2):224-225
DOI:10.4103/0028-3886.51308  PMID:19439868
  2,104 199 1
INVITED COMMENTARY
Invited Commentary
Satish Khadilkar
March-April 2009, 57(2):175-176
DOI:10.4103/0028-3886.51288  
  1,815 189 -
Invited Commentary
Belachew D Arasho, Nora Sandu, Bernhard J Schaller
March-April 2009, 57(2):138-139
DOI:10.4103/0028-3886.51280  
  1,673 167 1
Online since 20th March '04
Published by Wolters Kluwer - Medknow