Search

Pathogenesis Primary brain stem injury is the result of the direct effect of the trauma which results in its distortion and displacement. Kalyanaraman and Ramamurthi (1969) reported 42 cases of brain stem injury among 1100 cases of head injury patients admitted to their head injury unit in 18 months.[[1]] As late at 2007, Shukla et al. stated, "Several autopsy studies of head injury are available, but pathology of brain stem and hypothalamus injury are addressed in very few of them. "In many general surgical works today the diagnosis of primary brain stem injury amounts to pronouncement of death sentence" (Kalyanaraman and Ramamurthi 1969) It is interesting that around the same time as the above statement on ominous saying in some centers in Delhi acquired a similar predicament, "Yeh to brain stem ho gaya ab iska kuch nahi ho sakta" (He has become brain stem, now nothing can be done about it). While brain stem hemorrhage is more common in the secondary group of brain stem lesions, these are not uncommon in the primary injury especially in the lateral part of the mid-brain, the superior cerebellar peduncle, and rostral pons. [Extracted from the article]

This is a personal account of evolution of knowledge about the etio-pathogenesis, diagnosis and treatment of over three decades as a student and later a professional neurosurgeon. This reflects an historical perspective on the subject not withstanding the tremendous advances that have taken place in the field. It is regrettable that a successful management of hydrocephalus leave aside its cure, still eludes us. [ABSTRACT FROM AUTHOR]

I deem it a privilege to have been asked by Prof. P. Sarat Chandra, Editor, to write a Commentary on the paper mentioned above by Prof. Dastur et al., published half a century ago. Neurol India 2018;66:301-3. 3 Dastur DK, Lalitha VS, Udani PM, Parekh U. The brain and meninges in tuberculous meningitis-Gross pathology in 100 cases and pathogenesis. New Delhi: Indian Academy of Medical Sciences; 1973. p. 269-75. 66 Tandon PN, Pande A. (a) Tuberculosis of the central nervous system, (b) Tuberculous meningitis. [Extracted from the article]

Historical Vignette Sir Graham Teasdale, an old friend of mine, whose name as a neurotraumatologist has been immortalized by his epoch making study universally associated with the Glasgow Coma Scale (GCS).[[1]] He is credited with the establishment of the European Brain Injury Consortium and the International Neurotrauma Society, apart from his major contribution to the field of neurotraumatology.[[2]] Even 40 years later, the evidence showcases the GCS has stood the test of time.[[3]] My own interest in the field of neurotraumatology dates back to the days with Prof. Kristiansen, my mentor, who was deeply concerned regarding the challenges faced as early as 1949.[[4]] However, in spite of all the efforts and recent advances, some of the basic issues regarding the management of severe head injuries (SHI) remain unsolved. "Despite claims to the contrary, no clear decrease in traumatic brain injuries (TBI)-related mortality, or an improvement in the overall outcome has been observed over the past two decades.[[29]] Reviewing progress in the management of severe head injury between 1960 and 1995, I came to the conclusion that, "In spite of the innumerable clinical, pathological and experimental studies the ideal management of TBI remains an elusive goal." To the best of the authors' knowledge so far, no reliable information is available on the beneficial role of therapy based on this knowledge.[[42]],[[43]] Vascular Changes Following Head Injury There has been enough pathological and clinical evidence to indicate the high incidence of cerebral circulatory abnormalities associated with a severe head injury. G. Longterm ICP monitoring in comatose patients suffering from head injury. [Extracted from the article]

The article presents the biography of S. Sriramachari, founder neuropathologist. It mentions that he obtained his degrees from Andhra University. In 1954, he was deputed for training in neuropathology at the Armed Forces Institute of Pathology (AFIP) at Washington, DC. It mentions that he did under-graduation at Andhra Medical College.

The article presents the author's views regarding the contribution of neuroscientist Acharya Jagdish Chandra Bose. Topics mention including the study about electromagnetic waves and their effect on the inorganic matter, publication of scientific papers and monographs and measuring the action potentials in 1970.

The article offers information on Professor B. Ramamurthi, who was an Indian neurosurgeon. It presents an information that B. Ramamurthi, was an elected Fellow of all the three science academies in India in addition to the National Academy of Medical Sciences. It also mentions information on efforts of B. Ramamurthi, to establish the Neurosciences Centre at All India Institute of Medical Sciences (AIIMS) and the research institute National Brain Research Centre in India.

The author reflects on his life after retiring as a neurosurgeon in India. He says that he was offered one of the most prestigious Fellowship--the Bhatnagar Fellowship of the Council of Scientific and Industrial Research (CSIR)--just before his retirement. It helped it supplement his pension to take care of the family needs.

In this article, the author presents the brief profile of Professor Baldev Singh and Professor Jacob Chandy. It mentions that Singh worked as a teacher in Biology in the Dayanand Anglo Vaidik Mahavidyalaya (DAV) College in Lahore, Pakistan. It also mentions that Chandy was the founding father of Neurosciences in India and worked with the Mission Hospital.

The positive outcomes of the transplantation of fetal neural tissue in adult rat models of a variety of neurological disorders, particularly Parkinson's disease, in the 1970s, and its translation to humans in the 1980s, raised great hopes for patients suffering from these incurable disorders. This resulted in a frantic research globally to find more suitable, reliable, and ethically acceptable alternatives. The discovery of adult stem cells, embryonic stem cells, and more recently, the induced pluripotent cells further raised our expectations. The useful functional recovery in animal models using these cell transplantation techniques coupled with the desperate needs of such patients prompted many surgeons to "jump from the rat-to-man" without scientifically establishing a proof of their utility. Each new development claimed to overcome the limitations, shortcomings, safety, and other technical problems associated with the earlier technique, yet newer difficulties prevented evidence-based acceptance of their clinical use. However, thousands of patients across the globe have received these therapies without a scientifically acceptable proof of their reliability. The present review is an attempt to summarize the current status of cell therapy for neurological disorders. [ABSTRACT FROM AUTHOR]

Unlike most other hospitals, all patients with acute head injury were admitted directly into the neurosurgical unit of the Osmania General Hospital. The primary concern, no doubt the mortality of severe head injury (currently accepted as Glasgow Coma Scale <8) cannot be assessed from the data provided. Unfortunately, until today, we do not have statistically reliable data to permit developing a "consensus regime" to be adopted generally for the treatment of severe head injury patients.[[5]],[[6]],[[7]],[[8]],[[9]],[[10]],[[11]],[[12]],[[13]],[[14]],[[15]] I have recently summarized the current status on the outcome of the severe head injury (Tandon 2020 in press). [Extracted from the article]

The article provides information on Krishna Prasad Bhargava, a professor who is considered as founder of Indian Neurosciences. Topics discussed include his childhood and education in Alwar, India and graduation from King George's Medical College; establishment of Indian Council of Medical Research (ICMR); and his research on cardiovascular functions.

The article features Professors Autar Singh Paintal and Darab Kersasp Dastur, founders of Indian Neurosciences. Paintal was born in Mogok, Burma on September 24, 1925 and died on December 21, 2004. His major contribution to science is said to be the development of a single-fiber technique for recording afferent impulses from individual sensory receptors. Professor Dastur was born in Bombay, India on February 6, 1924 and died on February 16, 2010. His awards and honours are listed.

The article talks about Bimal Kumar Bachhawat, Indian neurochemist and glycobiologist, known for his discovery of HMG-CoA lyase, which is an intermediate in mevalonate and ketogenesis pathway, and for elucidation of molecular cause of Metachromatic leukodystrophy, a hereditary disease of the brain. Professor Bal Krishan Anand, Indian Physiologist and Pharmacologistis credited for the discovery of feeding center in Hypothalamus in 1951.

The article offers information on neuroinflammation along with its presence in different developmental disorders such as autism. Topics discussed include manifestation of neuroinflammation process through microglia along astrocytes presence; association of microglia with proinflammatory cytokines along with analysis of several factors such as prostaglandin (PGE); and regulation of an inflammation conditions through neural cell adhesion molecule (NCAM).

The nearly absent ability of the neurons to regenerate or multiply has prompted neuroscientists to search for the mean to replace damaged or dead cells. The failed attempts using adult tissue, initiated nearly a century ago, ultimately brought rays of hope when developing fetal neurons were used for transplantation in 1970s. The initial excitement was tempered by limited success and ethical issues. But these efforts unequivocally established the feasibility of successful neural transplantation provided appropriate tissue was available. The ability to derive embryonic stem cells with their totipotent potential by Thomson in 1998 rekindled the interest in their use for replacement therapy for damaged brain tissue. The present review surveys the current status of this promising field of stem cell research especially in respect to their therapeutic potentials for purposes of neural transplantation. A brief account is provided of the ongoing Indian efforts in this direction. [ABSTRACT FROM AUTHOR]

The article discusses the function of the neural stem cells, astrocytes and microglia in physiological and pathological states of the nervous system. It reveals that adults have neural stem cells in some parts of the brain which can help replace damaged brain cells in mammals. It has been claimed that the microglia play an important role in neuroinflammation associated with neurodegeneration. In addition, astrocytes are needed for normal synaptogenesis and synaptic stability.

Little was known about the human prefrontal cortex till recently . It was thus labeled as the "silent area," "uncommitted cortex." It not only constitutes the largest component of the human brain but is the latest evolutionary addition to the mammalian brain. It endows the human beings with qualities that differentiate humans from all other animals. During the last couple of decades the advent of modern electrophysiological and imaging (functional magnetic resonance imaging, proton emission tomography, SPECT) techniques have provided a wealth of insight into its role in memory, thought, emotions, moral judgment, social behavior, evaluating rewards, and assessing its fairness or otherwise and above all self-awareness. This brief review summarize the recent significant observations on its functions and connectivity which would interest the cognitive scientists and clinicians alike. [ABSTRACT FROM AUTHOR]

A response from the author of the article "Cell Therapy for Neurological Disorders; the elusive goal. Neurology India" is presented.

An obituary for Noshir Hormusjee Wadia, a professor and first department head of Neurology of All India Institute of Medical Sciences (AIIMS) in Delhi, India is presented.