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Byline: Gagandeep. Attri, Suyash. Singh, G. Kumar, Jeena. Joseph, Kamlesh. Bhaisora, Arun. Srivastava, Sushila. Jaiswal, Sanjay. Behari Sir, Spinal drop metastasis is common sequelae in high-grade like glioblastoma. However drop [...]

Byline: Gagandeep. Attri, Ved. Maurya, Arun. Srivastava, Sanjay. Behari, Kamlesh. Bhaisora, Jayesh. Sardhara, Pawan. Verma, Aftab. Nazar, Sushila. Jaiswal Background: The human calvaria harbors a variety of pathology and majority [...]

The tumor was compressing the foramen of Monro, leading to dilatation of lateral ventricles [Figure 1]a, [Figure 1]b, [Figure 1]c.{Figure 1} An endoscopic transcortical-transventricular approach was planned. Histopathology report was suggestive of ganglioglioma (WHO grade I) and was confirmed via immunohistochemistry [Figure 2]a, [Figure 2]b, [Figure 2]c, [Figure 2]d, [Figure 2]e.{Figure 2}{Figure 3} This rare case of septum pellucidum ganglioglioma presenting with seizure was successfully managed with a minimally invasive approach. On computed tomography (CT) done after one hour of surgery, as per protocol, a bilateral remote frontoparietal extradural hematoma was seen with some operative site bleed [Figure 1]d, [Figure 1]e. [Extracted from the article]

Background  Among the patients of drug-resistant epilepsy, a subset which has focal impaired seizures localizes to the temporal lobe region (TLE). A majority of these cases are surgically amenable with anterior-medial temporal lobe resection or "lesionectomy." Objective  In India, there is scarcity of "specialized centers" providing "comprehensive epilepsy care" and this dearth is further worse in populous states. In this article, we share our single center, observational, and retrospective experience of TLE in background of limited resources and utmost requirement. Methodology  Our study is a retrospective analysis medically refractory epilepsy patients (2016–2019). Patients with medically refractory epilepsy were selected based upon our noninvasive protocol (clinical semiology, interictal scalp electroencephalography (EEG), long-term video EEG monitoring data, and magnetic resonance injury [MRI]). The follow-up was noted from the last out-patient visit record or through telephonic conversation (International League Against Epilepsy score). Results  Of 23 cases of TLE (n = 7, mesial temporal sclerosis; n = 16 temporal lobe like cavernomas, tumors, or arterio-venous malformations). Single photon emission computed tomography/positron emission tomography (SPECT/PET) was performed in five cases (three cases of ictal/interictal SPECT and two cases of PET scan) where there was discordance between EEG/clinical and MRI. The median follow-up was of 19 months with 18 cases being seizure free. Five cases were fully off the antiepileptic drug (AEDs) while in 15 cases, the AEDs dosages or the number were reduced. Average number of AEDs reduced from 2.9 in preoperative period to 1.2 postoperatively. Two cases had quadrantanopia and one case of cerebrospinal fluid leak. Conclusion  A multidisciplinary and holistic approach is required for best patient care. The results of our initial surgical experience are encouraging. [ABSTRACT FROM AUTHOR]

Introduction and Study Design: Spinal arachnoid cyst is an uncommon entity, presenting with radiculopathy or paraparesis. These cysts are usually found in intradural extramedullary region; and the extradural region is a rare location. The exact pathogenesis in the existence of these cysts in the extradural region is still debated. In this article, we have retrospectively analyzed the clinical profile of the rare extradural arachnoid cyst (EDAC). Methodology: In this study, 19 patients of EDAC operated at our institute between January 2006 to June 2016 are analyzed. All patients with the Oswestry disability index score of >20 were managed surgically (open laminectomy and cyst excision). The clinical outcome was assessed at using 5-point satisfaction scale and McCormick grading. Results: All 13 operated patients had EDACs with communication with the intradural compartment. In 11 (84.6%) patients, cyst wall was excised completely, in 2 (15.3%) patients underwent partial excision of cyst wall; dural communication was closed in all patients (n = 13). None of the patients had clinical deterioration or radiological recurrence till the last follow-up. Mean follow-up was 52.2 months (range 1–160); all patients were satisfied after surgery (median score was 3). Discussion: Symptomatic EDACs account <2% of all spinal tumors. The EDACs have communication with the intradural compartment. In our article, we have discussed the approach and management of EDAC, including minimally invasive percutaneous procedures. Conclusion: One should aim for preoperative or intraoperative localization of dural communication and try to disconnect the extradural cyst from the intradural connection to prevent recurrence. Surgical treatment is complete excision of the cyst. [ABSTRACT FROM AUTHOR]