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  Citation statistics : Table of Contents
   2015| May-June  | Volume 63 | Issue 3  
    Online since June 5, 2015

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Risk stratification of vertebral artery vulnerability during surgery for congenital atlanto-axial dislocation with or without an occipitalized atlas
Jayesh Sardhara, Sanjay Behari, B Madan Mohan, Awadhesh K Jaiswal, Rabi N Sahu, Arun Srivastava, Anant Mehrotra, Hira Lal
May-June 2015, 63(3):382-391
DOI:10.4103/0028-3886.158218  PMID:26053811
Context: Variability in dimensions and course of vertebral artery (VA) makes it vulnerable to injury during surgery for congenital atlanto-axial dislocation (AAD) with or without an occipitalized atlas. Aims: This prospective study attempts to define anatomical variations that render VA at the craniovertebral junction (CVJ) vulnerable to injury during transoral decompression and posterior stabilization procedures; and, to propose a classification that helps in preoperative risk stratification. Settings and Design: A prospective study. Materials and Methods: 104 patients (65 with AAD; 39 controls) underwent a three-dimensional multiplanar computed tomographic angiogram to study anatomical variations in VA size, course, and anomalous medial deviation as well as in the type of axial isthmus and rotational deformity/tilt at the CVJ. The VA/foramen transversarium diameter; "stretched loop" sign of VA; and C1-2 facet joint angle were also assessed. Statistical Analysis Used: A medial VA deviation that brought it in close proximity to the trajectory of the surgical approach was evaluated (P ≤ 0.05 significant). Results: An increased predisposition to VA injury was present in 23 (35.4%) patients (persistent first intersegmental artery [n = 20; 30%]; fenestrated VA [n = 1; 1.53%], and low-lying posterior inferior cerebellar artery [n = 2; 3.0%]) where VA crossed the C1-2 facet joint; 8 (12%) with an anomalous medial deviation; 12 (18%) with a high-riding VA at C2 and a narrow axial isthmus; and 13 (20%) with rotation/tilt at the CVJ. A normal score of 5 was obtained in 21 patients; and a score of 6-9 (that progressively indicated an increased vulnerability of VA to iatrogenic injury) in 44 patients. The "AAD with an occipitalized atlas" group was associated with a significant medial deviation of VA (right: P = 0.00 and left: P = 0.001). Conclusions: A preoperative detailed risk assessment of anatomical variations in the size and course of VA at the CVJ significantly reduces chances of its iatrogenic injury.
  10 4,113 250
Cavernous sinus syndrome due to skull base metastasis: A rare presentation of hepatocellular carcinoma
Ronald A. B. Carey, SD Nathaniel, Sohini Das, Sniya Sudhakar
May-June 2015, 63(3):437-439
DOI:10.4103/0028-3886.158247  PMID:26053823
  3 1,960 60
"Owl eye sign": Anterior spinal artery syndrome
Alok Kumar Udiya, Gurucharan S Shetty, Vivek Singh, Rajendra V Phadke
May-June 2015, 63(3):459-459
DOI:10.4103/0028-3886.158286  PMID:26053834
  3 2,503 116
Magnetic nanoparticle tagged stem cell transplantation in spinal cord injury: A promising approach for targeted homing of cells at the lesion site
Sandeep Kumar Vishwakarma, Avinash Bardia, Syed Ameer Basha Paspala, Aleem Ahmed Khan
May-June 2015, 63(3):460-461
DOI:10.4103/0028-3886.158294  PMID:26053835
  2 2,037 57
P53 stratification reveals the prognostic utility of matrix metalloproteinase-9 protein expression in glioblastoma
Arun H Shastry, Balaram Thota, Arivazhagan Arimappamagan, Vani Santosh
May-June 2015, 63(3):399-404
DOI:10.4103/0028-3886.158227  PMID:26053814
Background: Despite the conventional acceptance of the matrix metalloproteinases (MMP)-2 and MMP-9, as markers of invasion in glioblastoma (GBM), there is no large body of evidence supporting their role as prognostic markers. Since the co-expression of MMPs with p53 was noted to be prognostic in other cancers, we evaluated the protein expression of MMP-2 and MMP-9 in GBM and explored their prognostic relevance with respect to p53 expression. Materials and Methods: Tumor tissues from a uniformly treated cohort of 132 GBM patients were examined for MMP-2, MMP-9, and p53 protein expression by immunohistochemistry (IHC). Survival analyses were performed by Cox-regression and Kaplan-Meier (KM) survival analysis. P53 IHC-based stratification of all GBM cases was performed, and subgroup-specific expression of MMP-2 and MMP-9 was correlated with survival. Results: MMP-2 and MMP-9 were expressed in p53 positive as well as p53 negative GBM tumors. MMP-2 and MMP-9 protein expressions had no correlation with prognosis. MMP-9 expression, however, emerged as a strong independent predictor of poor survival in p53 positive GBMs on both Cox-regression analysis (P = 0.036) and KM survival analysis (P = 0.008). Further, even on multivariate analysis, MMP-9 remained strongly associated with poor prognosis (P = 0.010). Conclusions: MMP-9 expression strongly associates with poor prognosis in p53 positive GBMs, but the absence of such correlation in p53 negative GBMs, skews the overall relation of this molecule with prognosis. The study highlights that the dual positivity of MMP-9 and p53 is of prognostic relevance in GBM.
  2 2,292 57
Adverse effects of antiepileptic drugs and quality of life in pediatric epilepsy
Marina Jovanovic, Bosanka Jocic-Jakubi, Dejan Stevanovic
May-June 2015, 63(3):353-359
DOI:10.4103/0028-3886.158203  PMID:26053807
Background: In pediatric epilepsy, health-related quality of life (HRQOL) may be affected across the physical, psychological, social, and school domains. Studies have shown that antiepileptic drugs (AEDs) could have a significant negative impact on HRQOL, but these findings are scarce and inconsistent. Aim : To evaluate the influence that the adverse effects of AEDs have on HRQOL in pediatric epilepsy. Materials and Methods: A total of 75 children with epilepsy and at least one parent participated in this study. The Pediatric Quality of Life Inventory (PedsQL) was utilized to assess the HRQOL, while the Adverse Event Profile (AEP) was used to assess the presence and severity of the adverse effects of AEDs. Results: Assessing the children's ratings, the AEP score significantly influenced the PedsQL based psychosocial functioning score (P < 0.02; partial ç2 = 0.07); and, assessing the parents' ratings, the AEP score significantly influenced both the PedsQL based physical functioning score (P < 0.02; partial ç2 = 0.07) as well as the PedsQL psychosocial functioning score (P < 0.001, partial ç2 = 0.30). Conclusion: The frequency and severity of AED-related adverse effects could significantly predict the lowered levels of HRQOL among children with epilepsy, in particular having a large impact on their psychosocial functioning.
  2 3,404 175
Cerebral venous thrombosis: An Indian perspective
Deepa Dash, Kameshwar Prasad, Leve Joseph
May-June 2015, 63(3):318-328
DOI:10.4103/0028-3886.158191  PMID:26053803
Cerebral venous thrombosis (CVT) is an uncommon cause of stroke with extremely varied clinical presentations, predisposing factors, imaging findings, and outcomes, and thus can be extremely challenging to diagnose. Accurate and prompt diagnosis of CVT is crucial because timely and appropriate therapy can reverse the disease process and significantly reduce the risk of acute complications and long-term squel. In this article, we have reviewed the epidemiology, causative factors, clinical features, diagnosis and treatment of CVT from an Indian perspective. Over the last decade, a change in trends in the causative factors has been noted from India.
  2 11,760 967
First reported case of Charcot Marie Tooth disease type 4C in a child from India with SH3TC2 mutation but absent spinal deformities
Umesh Dinkar Kalane, Chaitanya Datar, Anita Mahadevan
May-June 2015, 63(3):395-398
DOI:10.4103/0028-3886.158222  PMID:26053813
Charcot Marie Tooth (CMT) disease is a group of hereditary motor sensory neuropathies with significant genetic heterogeneity. This disorder has been scarcely reported in the Indian literature. Here, we report a case of the rare but relatively more severe autosomal recessive CMT type 4C disease with a few features that are distinct from its regular presentation. Our patient was proven to have one of the common mutations in the SH3TC2 gene, which has so far not been described in Indian patients.
  1 3,271 112
Vigabatrin-induced reversible changes on magnetic resonance imaging of the brain
Charul Goyal, Tejas H Kapadia, Pradnya Gadgil, Darshana Sanghvi
May-June 2015, 63(3):430-431
DOI:10.4103/0028-3886.158237  PMID:26053819
  1 1,877 68
Multiple glioblastoma: A diagnostic challenge and controversies in management
Ankur Kapoor, Sandeep Mohindra, Navneet Singla, Harsimrat Bir Singh Sodhi, Debjyoti Chatterjee, Sunil K Gupta
May-June 2015, 63(3):449-452
DOI:10.4103/0028-3886.158267  PMID:26053830
  1 1,835 58
Bilateral isolated basal ganglia bleed: An atypical presentation of Japanese encephalitis
Rohan Mahale, Anish Mehta, Srinivasa Rangasetty
May-June 2015, 63(3):456-457
DOI:10.4103/0028-3886.158269  PMID:26053832
  1 2,013 53
Endoscopic endonasal transplanum transtuberculum approach for retrochiasmatic craniopharyngiomas: Operative nuances
Suresh K Sankhla, Narayan Jayashankar, Ghulam M Khan
May-June 2015, 63(3):405-413
DOI:10.4103/0028-3886.158228  PMID:26053815
The surgical treatment of craniopharyngiomas is challenging. An optimal surgical approach is extremely important to achieve complete removal of the tumor, which is often the goal of treatment. Conventionally, the endoscopic transsphenoidal approach is used for resection of craniopharyngiomas that are essentially confined to the sellar cavity, or have smaller suprasellar extension. However, the tumors located in the retrochiasmatic space are difficult to remove surgically due to a poor access. Traditionally, various transcranial microsurgical routes have been employed with limited success for resection of retrochiasmatic craniopharyngiomas. The transcranial approaches generally do not provide adequate exposure of the tumors originating in the space under the optic chiasm and nerves. Recently, the extended endonasal endoscopic surgical route, obtained by removal of the tuberculum sellae and planum sphenoidale, has been used with great success in the surgical management of tumors lying ventral to the optic chiasm, including craniopharyngiomas. It offers a direct midline access to the retrochiasmatic space and provides excellent visualization of the undersurface of the optic chiasm. It also allows extracapsular dissection using binostril-bimanual technique and facilitates complete removal of these formidable tumors. In this report, we describe step-by-step, the technical details of the endonasal endoscopic transplanum transtuberculum approach with emphasis on the operative nuances for removal of retrochiasmatic craniopharyngiomas.
  1 2,819 82
Publication performance and research output of Neurology and Neurosurgery training institutes in India: A 5-year analysis
Venkatesh S Madhugiri
May-June 2015, 63(3):338-346
DOI:10.4103/0028-3886.158200  PMID:26053805
Context: Scientific publications are a reflection of the quality of the clinical and academic work being carried out in an institute. Training in the process of research and scientific writing are important components of the residency curriculum. Aims: The publication performance and research output of institutes training residents in neurology and neurosurgery were evaluated. Setting and Design: Internet-based study. Methods: This study was based on the data available on the websites of the Medical Council of India and the National Board of Examinations. The PubMed search interface was used to determine the publication output of institutes over the past 5 years (2010-2014). Google Scholar was used to determine the citation performance of each paper. The publication parameters were normalized to the number of faculty members in each institute as listed on the institutional web page. The normalized publication performance for an institute was computed by comparing the figures for that institute with the national average. Results: Institutes could be ranked on several criteria. There was a high degree of clustering of output from the top 5% of the institutes. About 13% of the neurology intake and 30.9% of neurosurgery intake over the past 5 years has been into the institutes that have not published a single paper during this period. Conclusions: This evaluation of the publication performance and research output of neurology and neurosurgery training institutes would serve as a baseline data for future evaluations and comparisons. The absence of any publication and research output from several training institutes is a matter of concern.
  1 4,759 285
Rehabilitation interventions to improve locomotor outcome in chronic stroke survivors: A prospective, repeated-measure study
Abhishek Srivastava, Arun B Taly, Anupam Gupta, Thyloth Murali
May-June 2015, 63(3):347-352
DOI:10.4103/0028-3886.158202  PMID:26053806
Objective: To ascertain whether rehabilitation interventions improve locomotion beyond 6 months post stroke. Site: The Neurological Rehabilitation Department of a university tertiary research hospital. Study Design: Prospective, repeated-measure study. Patients: Patients with first episode of supra-tentorial stroke of more than 6 months duration. Intervention: Twenty sessions of task-specific interventions consisting of lower limb resistive exercises and treadmill gait training to locomotor abilities (90 min/day, 5 days/week for 4 weeks). Evaluations were performed at the beginning and end of training and at a follow-up of 3 months. Outcome Measures: Stroke severity (Scandinavian Stroke Scale - SSS), balance (Berg Balance scale - BBS), ambulation (Functional Ambulation Category), walking ability (speed 10-m walk test - WS) and functional ability (Barthel Index - BI). Results: Forty patients (32 men and eight women; age range: 22-65 years; mean post-stroke duration of 18.90 ± 12.76 months) were included in the study. Thirty-two (80.0%) patients completed their training and 28 (70.0%) patients reported at a follow up of 3-months. At the beginning, the end of training and at follow-up, the mean SSS scores were 41.71, 44.09, and 43.96; the BBS scores were 36.28, 46.75 and 46.82; the WS scores were 0.41, 0.53 and 0.51; and the BI scores were 77.34, 89.06 and 92.32, respectively. All outcome measures showed statistically significant improvement (P < 0.001) at the end of training and at follow-up. Conclusion: Rehabilitation interventions significantly improve locomotor outcome even in the chronic phase following a stroke.
  1 3,810 137
Clinical profile and outcome of patients with acromegaly according to the 2014 consensus guidelines: Impact of a multi-disciplinary team
Pinaki Dutta, Abhishek Hajela, Ashish Pathak, Anil Bhansali, Bishan Das Radotra, Rakesh Kumar Vashishta, Márta Korbonits, Niranjan Khandelwal, Rama Walia, Naresh Sachdeva, Paramjeet Singh, Rajagopalan Murlidharan, Jagtar Singh Devgun, Kanchan Kumar Mukherjee
May-June 2015, 63(3):360-368
DOI:10.4103/0028-3886.158210  PMID:26053808
Aim: The diagnosis and treatment of acromegaly, a rare and possibly curable disease, has undergone a paradigm shift in the past few decades. Our aim was to study the changing trends in clinical presentation, management and outcome of the disease in the last fifteen years. Methodology: 271 consecutive patients with acromegaly treated at the Departments of Endocrinology and Neurosurgery, PGIMER, Chandigarh, between 2000 and 2014, were included in the study. Clinical and hormonal profiles, comorbidities, treatment modalities, outcome and mortality data were evaluated. The cure rate was assessed according to the present consensus criteria. Results: The gender distribution was equal with the mean age (±SD) of 37.1 ± 12.3 years at diagnosis. The average lag period to diagnosis was 4.7 ± 4.2 years. The most common presenting manifestations were acral enlargement and headache followed by visual deficits. The overall mortality rate was 5%, with the perioperative mortality being 1.5%. The most prevalent comorbidities in our series were hypertension (17.7%), diabetes mellitus (16.2%), arthropathy (11.8%) and obstructive sleep apnea (10.3%). Overall, 2 patients in our series suffered from extra-pituitary neoplasms and 12 patients had apoplexy as the presenting manifestation. As per the present consensus criteria, cure rate in our series was 28.5%. The cure rate was only 7.9% when many surgeons were operating. It increased to 25.5% when surgeries were being performed by one surgeon exclusively; and, when a sub-specialty clinic exclusively for pituitary diseases was set up, the cure rates improved upto 56%. Conclusion: Acromegaly has wide-ranging manifestations from acral enlargement to altered sensorium; incidental diagnosis was not prevalent in our series. Majority of the cases were due to the presence of a pituitary macroadenoma. Better cure rate can be achieved only when a dedicated group of multi-disciplinary team is involved.
  1 4,634 163
Acute ischemic stroke with tandem/terminal ICA occlusion - CT perfusion based case selection for mechanical recanalization
Rajsrinivas Parthasarathy, Gaurav Goel, Vipul Gupta, Vasudha Singhal, Jyoti Sehgal, Arun Garg, Sumit Singh
May-June 2015, 63(3):369-377
DOI:10.4103/0028-3886.158211  PMID:26053809
Background: Rapid reperfusion in a patient with a favorable penumbral pattern is crucial to achieving a good outcome in acute ischemic stroke. Recanalization rates for tandem and terminal internal carotid artery (ICA) occlusion are better with endovascular management as compared with intravenous tissue plasminogen activator (IV-tPA) alone. We hypothesize that tissue-based selection would enable the identification of the ideal patient most suited for reperfusion therapy. We present our series of patients who developed tandem or terminal ICA occlusion and were selected for endovascular management based on their computed tomography (CT) perfusion (CTP) imaging. Results: In this prospective study, 14 (29.16%) of the 48 patients treated by endovascular intervention between January 2011 and March 2014 had either tandem or terminal ICA occlusion. In the tandem group, thrombolysis in cerebral infarction (TICI) 2b/3 reperfusion and a good outcome was observed in five (71.42%, n = 7) and six patients (85.71%, n = 6), respectively. Among the terminal ICA occlusion group, TICI 2b/3 reperfusion and a good outcome was observed in three (42.8%, n = 7) and two patients (28.5%, n = 7), respectively. In patients with early reperfusion, a strong correlation with a median difference of one, in cerebral blood volume (CBV) Alberta Stroke Program Early CT Score (ASPECTS) on CBV map and post-procedure 24-h non-contrast CT, was noted. The median imaging-to-puncture and puncture-to -meaningful reperfusion time was 70 and 68.5 min, respectively, and, overall, good outcomes were seen in 57.1% of the patients. Conclusion: The cerebral blood volume (CBV) core estimation reliably predicted the final infarct volume. The key reasons for the significantly better outcomes seen in our cohort were the stringent perfusion imaging-based patient selection and the rapid reperfusion.
  1 3,830 112
Brain abscess: Heuristics, principles, pathobiology, practice
Manu Kothari, Atul Goel, Dattatraya Muzumdar
May-June 2015, 63(3):329-337
DOI:10.4103/0028-3886.158192  PMID:26053804
Brain abscess is an uncommon but a compelling reality in neurosurgical practice. Its focal, local, and systemic manifestations conceal its infective and obsessive nature. There are many a lesson that a brain abscess, as a bio-phenomenon, offers to the medical fraternity in general and the neurosurgeons, in particular. From Skt. puyati = to stink, comes the word "pus," meaning something foul, putrid, or rotten. From ab = away, and cedre = to go, comes the term "abscess" which is but nature's ingenious way of creating a fluid-filled cavity that will eventually rupture to an exterior to get rid of the non-self contents and proceed to healing. A brain abscess is special in the sense that it is, in general, more solid than fluid for reasons the human body and brain know best.
  1 3,130 168
Snakebite in India today
Romulus Whitaker
May-June 2015, 63(3):300-303
DOI:10.4103/0028-3886.158155  PMID:26053797
  1 5,394 230
Dorsal ectopic breast in a case of spinal dysraphism: A rare entity
Vipin K Gupta, Isha Kapoor, Rajpal S Punia, Ashok K Attri
May-June 2015, 63(3):392-394
DOI:10.4103/0028-3886.158220  PMID:26053812
An ectopic breast, that is present at a distance from the embryonic milk line, is an uncommon condition in the normal population. We describe a case with the presence of a breast in the dorsal region occurring in a patient with meningomyelocele and split cord malformation type I. A dorsally situated breast in a case of split cord malformation has never been reported previously in the literature. This case report highlights that an ectopic breast could be a marker of occult spinal dysraphism. This lesion should be corrected only after appropriate radiological investigations ascertain the underlying pathology.
  - 2,469 72
Surgery for acromegaly
CE Deopujari
May-June 2015, 63(3):312-314
DOI:10.4103/0028-3886.158183  PMID:26053801
  - 1,931 75
Decoding the V3 segment of the vertebral artery...
R Girish Menon, G Lakshmi Prasad
May-June 2015, 63(3):315-317
DOI:10.4103/0028-3886.158184  PMID:26053802
  - 2,359 102
Ophthalmic artery occlusion with total ophthalmoplegia following spinal surgery
Jyoti Matalia, Vimal Krishna Rajput, Geetanjali J Chillal, Bhujang K Shetty
May-June 2015, 63(3):431-434
DOI:10.4103/0028-3886.158239  PMID:26053820
  - 2,190 45
A novel minimally invasive endoscopic repair in a case of spontaneous CSF rhinorrhea with persistent craniopharyngeal canal
Satyawati Mohindra, Karan Gupta, Sandeep Mohindra
May-June 2015, 63(3):434-436
DOI:10.4103/0028-3886.158243  PMID:26053821
  - 1,826 71
Megaencephalic leukoencephalopathy with subcortical cysts in a young Bengali girl
Kalyan B Bhattacharyya, Saurabh Rai
May-June 2015, 63(3):436-437
DOI:10.4103/0028-3886.158245  PMID:26053822
  - 2,191 51
"Fungimitosis": Invasive fulminant Aspergillus brain infection mimicking gliomatosis cerebri
Alugolu Rajesh, Srikant Reddy, Malladi Venkat Surya Subbalaxmi, Megha Shantveer Uppin
May-June 2015, 63(3):439-441
DOI:10.4103/0028-3886.158250  PMID:26053824
  - 1,925 51
Quadrigeminal cistern lipoma revisited
Anu Kapoor, KR Harsha Vardhana, Mahesh D Dudhat, Phani Chakravarty Mutnuru
May-June 2015, 63(3):441-443
DOI:10.4103/0028-3886.158254  PMID:26053825
  - 2,621 59
Hemifacial spasm associated with the vertebral artery fenestration
Shunsuke Nomura, Takakazu Kawamata, Tadasuke Tominaga, Yoshikazu Okada
May-June 2015, 63(3):443-444
DOI:10.4103/0028-3886.158260  PMID:26053826
  - 1,651 44
Wall-eyed bilateral internuclear ophthalmoplegia
Abhishek Agarwal, Sony Vyas, Subodh Banzal, Rajesh Kumar Jha
May-June 2015, 63(3):444-446
DOI:10.4103/0028-3886.158263  PMID:26053827
  - 3,514 76
Hypokalemic paralysis as a primary presentation of Fanconi's syndrome and distal renal tubular acidosis in a patient with primary Sjogren's syndrome
Anita Basavaraj, Rohan Ramesh Badave, Manasi Kadam, Deelip Babasaheb Kadam
May-June 2015, 63(3):446-448
DOI:10.4103/0028-3886.158264  PMID:26053828
  - 2,020 68
A rare case of an aberrant innominate vein causing posttracheostomy haemorrhage
Vikas Naik, Biradar Basavaraj Patil, V Abhilash, Amresh Bhaganagare, S Balaji Pai, MD Patil
May-June 2015, 63(3):448-449
DOI:10.4103/0028-3886.158265  PMID:26053829
  - 1,764 42
Post ventriculo-peritoneal shunt chronic calcified hematoma or an abscess: A dilemma
Harish R Naik, Hrushikesh Umakant Kharosekar, S Jasmit, Vernon Velho
May-June 2015, 63(3):457-458
DOI:10.4103/0028-3886.158272  PMID:26053833
  - 1,407 39
Diffusion restriction in fulminant subacute sclerosing panencephalitis: Report of an unusual finding
Dhaval Shah, K Srinivasan, Tejas Sakale, S Sajith, C Kesavadas
May-June 2015, 63(3):452-456
DOI:10.4103/0028-3886.158268  PMID:26053831
  - 3,033 80
The Cover Page

May-June 2015, 63(3):297-297
DOI:10.4103/0028-3886.158146  PMID:26053795
  - 1,968 88
Neurosciences Education: From 'Gurukul' to e-Learning
Vijay Kak
May-June 2015, 63(3):298-299
DOI:10.4103/0028-3886.158149  PMID:26053796
  - 2,555 115
Department of Neurology, King George's Medical University, Lucknow: The journey continues
Praveen Kumar Sharma, Ravindra Kumar Garg, Hardeep Singh Malhotra, Rakesh Shukla, Rajesh Verma
May-June 2015, 63(3):414-418
DOI:10.4103/0028-3886.158229  PMID:26053816
King George Medical University is one of the oldest and most prestigious medical universities of India. The Department of Neurology has trained many illustrious neurologists who are offering yeoman's service to the nation. This brief review traces the history and milestones of the department and its current areas of focus.
  - 27,030 116
A summary of some of the recently published, seminal papers in Neuroscience
K Sridhar
May-June 2015, 63(3):426-429
DOI:10.4103/0028-3886.158235  PMID:26053818
  - 1,736 89
A to Z in neurointerventional surgery: A primer for residents
Sudheer Ambekar, Paritosh Pandey
May-June 2015, 63(3):419-425
DOI:10.4103/0028-3886.158233  PMID:26053817
Neurointerventional surgery has evolved rapidly over the last two-and-a-half decades. It is now the treatment of choice for many neurovascular conditions, and its techniques and indications are rapidly expanding. It is the need of the hour that residents in training programs should familiarize themselves with the basic concepts of neurointerventional surgery. There are no set guidelines regarding neuroendovascular training of residents in India. The current article provides an insight into the basic concepts of neurointerventional surgery for residents in training.
  - 4,795 259
Comparative study of electrophysiological changes in snake bites
Patwari Panduranga, SA Sangle, Abhay A Mane, Suyog Doshi, DB Kadam
May-June 2015, 63(3):378-381
DOI:10.4103/0028-3886.158214  PMID:26053810
Aims: To study and compare the electrophysiological changes in neuroparalytic or vasculotoxic snakebites. Materials and Methods: 40 patients who had a definite history of snakebite, either vasculotoxic or neuroparalytic, were selected. They were grouped as Group A, 20 patients having a neuroparalytic snakebite with definite envenomation at the time of admission, and Group B, 20 patients having a vasculotoxic snakebite with definite envenomation at the time of admission. All patients underwent a detailed clinical examination, all relevant investigations and nerve conduction studies according to protocol. Results: In this study, we noticed that the motor nerve conduction amplitude, conduction velocity and distal latency were within normal limits in both the groups. On RNS (repetitive nerve stimulation study) of facial and median nerves, a decremental response was seen in 13 (65%) patients in facial nerve and in 7 (35%) patients in median nerve in Group A; while, the same response was seen in 8 (40%) patients in facial nerve and 3 (15%) patients in median nerve in Group B. A post exercise decremental response was seen in 13 (65%) patients in median nerve and 16 (80%) patients in facial nerve in Group A; and, in 3 (15%) patients in median nerve and 8 (40%) patients in facial nerve in Group B. Conclusions: In our study, we noticed that the decremental response on RNS was not only present in neuroparalytic snake bite (post-synaptic neuromuscular blockade) but also in vasculotoxic snakebite [pre-synaptic neuromuscular blockade] (seen in Russel's viper).
  - 2,134 110
Electrophysiologic evaluation of snake bite
Aastha Takkar, Parampreet S Kharbanda
May-June 2015, 63(3):304-306
DOI:10.4103/0028-3886.158159  PMID:26053798
  - 2,244 116
Stepping to reorganize the damaged brain: Does the journey lead to a destination?
Kamal Narayan Arya, Ravindra K Garg
May-June 2015, 63(3):307-309
DOI:10.4103/0028-3886.158162  PMID:26053799
  - 1,694 55
Is it possible to facilitate neural plasticity for enhancing post chronic stroke recovery?
MV Padma Srivastava
May-June 2015, 63(3):310-311
DOI:10.4103/0028-3886.158163  PMID:26053800
  - 1,984 92
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