29 results on '"Mudumba, Vijayasaradhi"'
Search Results
2. 3T MRI-SWI based volumetric analysis of the subthalamic and red nuclei in advanced Parkinson's disease.
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SHAH, Varshesh, ALUGOLU, Rajesh, ARORA, Abhishek, KANDADAI, Rukmini M., MUDUMBA, Vijayasaradhi, and BORGOHAIN, Rupam
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- 2023
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3. Orbital Chordoid Meningioma
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Alugol, Rajesh, primary, Jadhav, NithinKumar, additional, Mudumba, Vijayasaradhi, additional, and Uppin, Megha, additional
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- 2022
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4. Saradhi's single stage, anterior sequential reduction utilizing C3 for type III hangman's fracture: A novel technique
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Alugolu, Rajesh, primary, Mudumba, VijayaSaradhi, additional, and Pavan, S, additional
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- 2022
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5. Does the extent of soft tissue dissection and location of screws in anterior cervical discectomy and fusion impact the development of the adjacent segment degeneration? A prospective short term radiological analysis
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Kode Sashanka, Mudumba Vijayasaradhi, and Rajesh Alugolu
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Soft tissue ,Anterior cervical discectomy and fusion ,Degeneration (medical) ,Dissection (medical) ,medicine.disease ,Surgery ,Degenerative disc disease ,law.invention ,Randomized controlled trial ,law ,Radiological weapon ,medicine ,Neurology (clinical) ,business ,Reduction (orthopedic surgery) - Abstract
Background Cervical degenerative disc disease is a common condition in neurosurgical practice. Elimination of a motion segment through fusion causes the load shift to the adjacent levels leading to disc degeneration. Our hypothesis is that by avoiding excessive dissection of the prevertebral soft tissue and placing anchoring screws away the adjacent endplate, we can reduce the load bearing and degeneration rate. Methods This is a prospective randomized control study .The study included 30 consecutive cases requiring single level ACDF, 15 each in conservative and minimal dissection group. MRI evidence of disc degeneration was assessed according to Matsumoto MRI grading system. Results No significant role of age on ASD was noted (P-0.26). ASD was worse in females than males especially at the inferior level(P- 0.035). ASD was noted to be higher when the patients were operated at C5-6 level (P-0.026). The reduction in VAS was 5.933 in the minimal dissection group which was significantly better than the conventional surgery group(5.14) (P-0.023). The increase in degeneration score was 0.97 & 0.6 at superior and inferior levels respectively in the conventional group and 0.13 & 0.34 in Minimal dissection group. Conclusions The minimal soft tissue dissection for single level ACDF with PEEK cage placement appears to have reducing rate of ASD compared to conventional ACDF. Minimal soft tissue dissection has better Postoperative VAS scores.
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- 2021
6. Prospective analysis of gross and fine motor manifestations following STN- DBS and their correlation with electrode position
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ALUGOLU, Rajesh, primary, KOLPAKWAR, Swapnil, additional, MUDUMBA, Vijayasaradhi, additional, ARORA, Abhishek, additional, KANDADAI, Rukmini, additional, and BORGOHAIN, Rupam, additional
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- 2021
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7. A prospective analysis of morphometry, electrode position in STN-DBS, and its motor outcomes in advanced Parkinson's disease -- An institutional study.
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Kolpakwar, Swapnil, Alugolu, Rajesh, Mudumba, Vijayasaradhi, Arora, Abhishek, Kandadai, Rukmini, and Borgohain, Rupam
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PARKINSON'S disease diagnosis ,ELECTRODES ,ENTACAPONE - Abstract
Introduction: Parkinson's disease (PD), a progressive neurologic disorder that affects more than 1% of the population over age 65 years, is characterized by varying intensities of tremor, rigidity, and bradykinesia.[1,2] PD is primarily treated medically, especially in the early stages of disease treatment. Carlsson and Cotzias introduced oral levodopa/carbidopa as the "gold standard" medical therapy in 1968.[3] Surgical treatment of PD began in the 1940s with resection of premotor and motor cortices with the hope of alleviating parkinsonian tremor.[4] The resultant improvement was weighed against significant iatrogenic motor deficits, while no effect was seen on either rigidity or bradykinesia.[4] In 1990, Bergman et al. demonstrated in the nonhuman primate model that the induction of parkinsonism was associated with excessive and abnormally patterned discharges in the subthalamic nucleus (STN) and ablation of the nucleus alleviated all symptoms.[5] Based on this work, Benabid et al. implanted the first chronic subthalamic stimulator for PD in the early 1990s and subsequently documented alleviation of all cardinal motor signs of PD in a case series in 1998.[6,7] Deep brain stimulation (DBS) involves placement of electrodes deep in basal nuclei and delivering electrical current to the target. STN-DBS alleviates most of the parkinsonian symptoms. DBS has been shown to be safe and cost effective, conferring up to 40%--70% clinical improvement at 5 years and significantly improving quality of life compared to other treatment modalities.[1,2,8,9--16] DBS is associated with several advantages over other ablative procedures, with the most striking one being reversibility and adjustments in stimulation programs.[17,18] Precise targeting of the subthalamic nucleus has been identified as one of the major factors for the successful outcome of DBS surgery.[19] Hence, knowledge of the anatomical variation of the nucleus carries an important role in the treatment of PD. With the availability of directional leads and multiple programming options including white matter stimulation, there might be a paradigm shift in the near future in this concept of lead position. However, till such time, the final electrode position remains a significant factor determining the outcomes of STN-DBS. The present study aims to investigate the volume of STN and red nucleus (RN) on 3 T magnetic resonance imaging (MRI) susceptibility weighted imaging (SWI) sequences and its possible correlation with disease progression in patients with advanced PD. This study also aims to measure the accuracy of electrode targeting in a three-dimensional plane and motor outcomes of STN stimulation. Aims: 1. To study the 3D morphometry of STN and RN 2. To study the electrode position in patients of advanced PD undergoing DBS 3. To correlate the active electrode position with effect on motor symptoms of PD Materials and Methods This prospective study included all consecutive patients surgically treated for STN-DBS at the Department of Neurology and Neurosurgery at Nizam's Institute of Medical Sciences, Hyderabad, from January 2019 to March 2020. The study was approved by the institutional ethics committee. Final follow-up was done at 6 months. Inclusion criteria All idiopathic PD cases found eligible by Core assessment program for surgical interventional therapies in Parkinson's disease (CAPSIT-PD) protocol 17 with advanced stages of the disease and severe motor manifestations, who underwent DBS at our center were included in this study. Exclusion criteria Patients who required removal of implants or died within 6 months of surgery and could not complete the final follow-up at 6 months were not included in the analysis. Preoperative evaluation Preoperative evaluation included detailed history and examination to assess disease, comorbidities, and ongoing medications. The quantum of gross motor symptoms of disease was assessed by measuring the Unified Parkinson's Disease Rating Scale Part III (UPDRS III) by a qualified UPDRS III specialist in "OFF" phase after depriving the patient of his anti-parkinsonian drugs for at least 12 h. UPDRS III in "ON" phase was measured once the patient achieved best clinical response following administration of 200 mg levodopa + 50 mg carbidopa. Quantification of dopaminergic treatment was done using levodopa equivalent daily dose (LEDD) score with an appropriate levodopa equivalent dose conversion factor for each drug[18] (conversion factor: immediate release levodopa dose- 1, controlled release levodopa dose- 0.75, entacapone- 0.33, tolcapone- 0.5, pramipexole- 100, amantadine- 1). For example, patient with intake of levodopa 125 mg twice daily, controlled release levodopa 250 mg once daily, and tab pramipexole 1 mg once daily had a LEDD score of 450 ([100 x 2 x 1] + [200 x 0.75] + [1 x 100] = 450). All patients were assessed for dysgraphia by analysis of handwriting in ON phase by a single investigator on bedside testing (once the patient achieved the best clinical response following administration of 200 mg levodopa + 50 mg carbidopa orally). Handedness of patient was noted and hemicorporal UPDRS III of that side was derived. Patients were asked to write their names and places of stay on a paper. Clinical details regarding the quantum of disease and other features were not revealed to the reviewer who was appointed for analysis of handwriting. Subjective clinical analysis of patient's handwriting was done by the reviewer. Handwriting that was small in vertical and horizontal axes was considered as vertical and horizontal micrographia, respectively. Writing that fatigued and decreased in size as it progressed was considered as progressive micrographia. Different features of micrographia, that is, (a) vertical, (b) horizontal, and (c) progressive, were noted in ON phase in the preoperative period. In cases of disparity, patients were asked by the investigator if they had noted any change in handwriting. For quantification of change in micrographia, vertical length of the first letter and width of the word written were calculated. An analysis of improvement in legibility of handwriting was also done for all patients using Fahn--Tolosa--Marin Tremor Rating Scale (FTMTRS). Preoperative image acquisition All subjects were scanned with a uniform protocol involving T1W, T2W, T1W-contrast, GRE, and SWI sequences in 3 T MR (SIEMENS 3T Skyra) with 0.5-mm cuts and zero spacing for planning and targeting selection. MR scanner, image acquisition protocol, and methodology were uniform and done in ON phase without any need for general anesthesia. Volumetric analysis of STN and RN was done using SWI sequences. Data acquisition SWI acquisition Gradient echo sequences, using the following parameters: 80 slices, Field of view (FoV) = 240 mm, FoV phase 88%, Time to repetition(TR)/Time to echo (TE) = 28/20 ms, flip angle of 15°, with fat suppression and flow compensation, resolution matrix of 352 x 248 with slice thickness of 0.6 mm, Anterior-posterior (AP) and Right-left (RL) phase encoding directions for axial and coronal orientation, respectively, were used for the acquisition. Acquisition time was 7 min and 14 s for acquiring each SWI dataset. The volumes of STN and RN were measured on SWI coronal images by tracing the borders of STN and RN manually on each slice and then interpolating them. Use of axial sections and axial minimum intensity projection (min IP) images was made in cases where margins of the nuclei were not clearly delineated on coronal images. Target selection and surgery Target localization, based on the borders of the RN, was planned on a fused contrast MRI using Stealth Station software. For the frame coordinates, a preoperative MRI with frame was performed and fused. Cosman-Roberts-Wells (CRW) frame was used for all cases. The left STN was targeted first in all cases, followed by the right side. The surgical procedure included five-channel microelectrode recording for probable superior surface of STN and macrostimulation at low and high currents for response and side effects, respectively. The tract with the best response and the least side effects was chosen. Lead 3389 (Medtronic Inc., Minneapolis, MN, USA) was placed based on the depth obtained in the microelectrode recordings, with the help of rigid lead guide tube, keeping one in contact with the zona incerta and two in contact with the STN under fluoroscopic guidance by a single neurosurgeon. Postoperative 3 T MRI in T1 and T2W images was obtained before connecting the electrodes with the battery. Center of C1 contact (left) and C9 contact (right) of the electrode was taken as the final position. Cartesian coordinates of the final electrode position were compared to Cartesian coordinates of the proposed target, and final deviation was calculated. Any deviation more than 2 mm from the planned target was noted and considered significant. Electrodes within 2 mm epicenter of the proposed target coordinates were considered as being in optimum position. In electrodes with deviation more than 2 mm, final active contact position was labeled as medial or lateral and anterior or posterior, based on the individual deviation in final x and y coordinates, respectively. Follow-up The UPDRS III, LEDD scores were recorded at 6 months postsurgery. All values obtained postoperatively were compared with baseline scores, and outcomes were correlated with the final electrode position. Changes in speech, gait, and bradykinesia were evaluated by giving subscores individually. Improvement in hemicorporal UPDRS III score was correlated with contralateral electrode position. Postoperative analysis of handwriting was done in drug OFF phase after depriving the patient of his anti-parkinsonian drugs for at least 12 h, with the internal pulse generator (IPG) in ON state. Patients were asked to write the same set of words in the OFF phase that were written by the patient in preoperative ON period, and various features of micrographia, such as vertical, horizontal, and progressive components, were noted by the reviewer. For quantification of change in micrographia, vertical length of the first letter and width of the word written were calculated and compared with preoperative dimensions. Statistical analysis Data entry was done in into Microsoft Excel 2007, and statistical analysis was done using IBM Statistical Package for the Social Sciences (SPSS) trial version. One-way analysis of variance (ANOVA), t-test, and chi-square test were applied to test for significance. P value less than 0.05 was considered significant. Results: There were totally 64 patients who underwent surgery in the defined period. All the 128 implanted leads were analyzed till the end of the study period. Demographic parameters Age distribution The mean and median age of patients was 57.23 ± 9.70 and 57. 5 years, respectively (range 36--83 years). Maximum number of patients were in the age group of 60--70 years (n = 28, 43.75%), followed by the age group 50--60 years (n = 20, 31.25%). There were 10 patients (15.63%) in the age group of 40--50 years. Only one patient had age more than 80 years. Gender distribution There were 47 (73.44%) males and 17 (26.56%) females in the study cohort. Age of onset Mean age of onset in the present study was 49.23 + 10.49 years. There were 31 (48.44%) patients who had disease onset before 50 years of age, qualifying them for early-onset PD (EOPD) group, and 33 (51.56%) patients who had disease onset after 50 years of age, qualifying them for late-onset PD (LOPD) group. Disease duration Average duration of disease in the present cohort was 7.96 ± 4.68 years. There were 14 (21.88%) patients who presented to us within 5 years of onset of disease. There were 33 patients (51.56%) who had disease duration of 6--10 years, while 17 (26.56%) patients presented to us with disease duration of more than 10 years. Clinical parameters UPDRS III, hemicorporal UPDRS III, and LEDD Mean UPDRS III in the preoperative period was 55.64 ± 10.75. There were 21 patients (32.81%) who had UPDRS III in the range of 50--60. About 17 patients (26.56%) had UPDRS III in the range of 40--50 and 60--70. Only one patient had UPDRS III more than 80. Mean baseline right and left hemicorporal UPDRS III were 19.01 ± 4.35 and 18.98 ± 4.48, respectively. Mean preoperative LEDD was 699.21 ± 293.62 mg. Maximum number of patients (n = 12, 18.75%) had preoperative LEDD in the range of 600--700 and 700--800. Ten patients (15.63%) had LEDD in the range of 400--500. Two patients (3.13%) had LEDD of more than 1500. Volumetric analysis Volumetric analysis of STN was done for 52 patients. Volumes of right and left STN and RN were calculated from SWI sequences. None of the patients required any form of anesthesia for image acquisition. Average of volumes of nucleus from both sides was calculated. STN volume Mean volume of STN was 103.46 ± 21.17 mm3. Right STN volumes ranged from 60 to 120 mm3, with a mean of 106.15 ± 23.60 mm3, whereas left STN volumes ranged from 70 to 160 mm3, with a mean of 100.76 ± 21.76 mm3. RN volume Mean volume of RN was 321.73 ± 67.66 mm3. Right RN volumes ranged from 190 to 460 mm3, with a mean of 321.73 ± 65.16 mm3, whereas left RN volumes ranged from 130 to 500 mm3, with a mean of 321.73 ± 73.39 mm3. Correlation of STN and RN volumes with demographic and disease parameters Volumetric analysis of STN was done for 52 patients. Among them, 14 (37.84%) patients presented to us within 5 years of onset of disease. There were 20 patients (54.05%) who had disease duration of 6--10 years. Only three (8.11%) patients presented with the onset of disease duration more than 10 years. Disease onset before 50 years of age was seen in 24 (46.15%) patients, qualifying them for EOPD group, and 28 (53.85%) patients had disease onset after 50 years of age, integrating them into LOPD group. Parameters acquired through volumetric analysis were compared with demographic and clinical features. Hemicorporal UPDRS III was compared with contralateral STN and RN volumes. Subthalamic nucleus Disease duration was found to be positively correlated with STN volume, but statistical significance was not achieved. Overall, no difference related to gender was noticed, except in cases with disease duration of less than 5 years. Males had significantly lesser STN volume than females (P = 0.046). STN volume did not differ in EOPD and LOPD groups. No statistical significance was noted between UPDRS III in OFF state and STN volumes. On multivariate analysis as well, age of onset, disease duration, and UPDRS III scores were not found to be associated with any changes in STN volumes. Red nucleus Mean right and left RN volumes were 321.73 ± 65.16 and 321.73 ± 73.39 mm3, respectively. Average RN was 321.73 ± 67.66 mm3. Age was not found to be related to any volumetric change in RN. Weak positive trend was noted between volume of RN and disease duration (Pearson correlation 0.204, P = 0.14). Among patients with disease duration of 5--10 years, the average RN volume was significantly more in males (P = 0.018); however, no overall gender-related differences were noted. Patients with EOPD had significantly more volume of RN compared to patients in the LOPD group (P = 0.014). UPDRS III scores in OFF period did not correlate with nuclei volumes. On multivariate analysis between age of onset, disease duration, and UPDRS III score, only disease duration was associated with increased relative risk; however, significance was not reached (odds ratio [OR] 2.076, P = 0.40) Clinical outcomes post-STN-DBS Patients were followed at 6 months for analysis of outcomes. UPDRS III and LEDD scores of patients were noted. Mean reduction in overall UPDRS III, right and left hemicorporal UPDRS III scores was 32.20% ± 20.12%, 38.03% ± 21.37%, and 36.13% ± 21.01%, respectively. Difference in preoperative and postoperative UPDRS III scores was found to be statistically significant (P = 0.0001). Mean postoperative LEDD was 562.92 ± 277.22, compared to preoperative LEDD of 699.21 ± 293.62. Difference in preoperative and postoperative LEDD scores was statistically significant (P = 0.0079). Correlation of motor outcomes with demographic features Demographic parameters were analyzed for correlation with postoperative outcomes. Males and females had no difference in reduction in postoperative UPDRS III scores (P = 0.84) and LEDD (P = 0.70). No statistical difference in outcomes was noted in EOPD and LOPD groups. However, it was found that patients who were less than 65 years of age at the time of surgery had more significant reduction in UPDRS III, compared to more elderly patients (P = 0.02). More than 30% reduction in LEDD was noted in patients with age less than 65 years (P = 0.01). Disease duration and postoperative reduction in UPDRS III and LEDD scores had no relation with period. Correlation of electrode position with gross motor outcomes Deviation in active contact Mean deviation in all the frame coordinates was less than 2 mm. Least deviation in the final position was seen in the left x coordinate (1.5234 ± 1.2146) [Table 13]. Correlation of deviation in x coordinate and motor outcomes Negative correlation was found between reduction in UPDRS III scores and deviation from the proposed target in both right x (Pearson correlation - 0.16, P = 0.18) and left x coordinates (Pearson correlation - 0.21, P = 0.08) [Figures 23 and 24]. Cases with mediolateral deviation of left x less than 3 mm had significant reduction in UPDRS III (P = 0.05) and speech subscore (P = 0.05). Deviation less than 2 mm in left x was significantly associated with more than 50% reduction in gait subscores (P = 0.04). All the three patients with left x deviation more than 3 mm had deterioration in gait subscore. None of the patients with right x deviation more than 4 mm had any reduction in gait subscore. Correlation of deviation in y coordinate and motor outcomes Optimal placement of right y electrode was significantly associated with >30% reduction in UPDRS III in the postoperative period (P = 0.02). Cut-off of more than 30% was taken as better response for LEDD reduction. It was found that anterior deviation of right y electrode was associated with significantly lesser reduction in LEDD (P = 0.02). Negative correlation was found between deviation from the proposed target in left y and reduction in UPDRS III scores (Pearson correlation - 0.10, P = 0.40), right hemicorporal UPDRS III scores (Pearson correlation - 0.13, P = 0.28), gait subscores (Pearson correlation - 0.18, P = 0.13), and bradykinesia subscores (Pearson correlation - 0.02, P = 0.87). Analysis and correlation of fine motor symptoms with the electrode position Different features of handwriting in preoperative and postoperative periods were analyzed for 51 patients. Preoperatively, 28 (54.90%) patients had vertical micrographia, 14 (27.45%) patients had horizontal micrographia, and 24 (47.06%) patients had progressive micrographia. Postoperatively, maximum improvement was noted in vertical micrographia and minimum improvement in horizontal micrographia. After surgery, only 14 (27.45%) patients had vertical micrographia, while 11 (21.15%) patients had horizontal micrographia and 15 (29.41%) patients had progressive micrographia [Table 14]. The prevalence of micrographia was reduced in the postoperative period, but the difference was not statistically significant. The tremor component of handwriting was assessed by FTMTRS grading. There were 8, 15, and 28 patients in grades 1, 2, and 3 respectively, with none in grade 0, in the preoperative period. Postoperatively, only 10 (19.61%) patients had FTMTRS grade 3 handwriting. Postoperatively, four patients (7.84%) had deterioration in FTMTRS grades. Maximum number of patients (n = 22, 43.14%) showed improvement in FTMTRS grades by 1 [Table 14]. Mean preoperative FTMTRS Part B in ON phase was 2.38 ± 0.74 [Figure 26]. Mean post-DBS FTMTRS grade in OFF phase was 1.61 ± 1.03. Difference in pre- and postsurgery scores was found to be statistically significant (P = 0.0001). Increasing age was found to be negatively correlated with reduction in FTMTRS grades (Pearson correlation -0.10, P = 0.46). Patients with age more than 65 years had less improvement in FTMTRS grades (P = 0.03). Weak positive correlation was noted between changes in FTMTRS scores and hemicorporal UPDRS III scores (Pearson correlation 0.12, P = 0.40). A significant positive correlation was found between postoperative LEDD and FTMTRS scores (Pearson correlation 0.29, P = 0.03). Metric parameters of words written were compared in 51 cases. Mean vertical upstroke was 5.19 ± 2.01 and 5.65 ± 2.42 mm in preoperative and postoperative periods, respectively. Mean horizontal width of words was 3.31 ± 1.61 and 3.88 ± 1.58 cm in preoperative and postoperative periods, respectively. The differences in these parameters were not statistically significant. Moderate positive correlation was noted between improvement in FTMTRS grade and increase in horizontal width of words written (Pearson correlation 0.23, P = 0.10) Conclusions: Volume of STN stays consistent as the disease progresses. However, disease duration and early age of onset in PD can be associated with increased RN volume. Therapeutically, STN-DBS results in significantly improved functional outcome, particularly in patients with age less than 65 years. Accurate final electrode position in relation to the proposed target is associated with maximum clinical benefit and improvement in dysgraphia. Area of Research: Clinical aspects [ABSTRACT FROM AUTHOR]
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- 2022
8. A 270-Degree Decompression of Optic Nerve in Refractory Idiopathic Intracranial Hypertension Using an Ultrasonic Aspirator - A Prospective Institutional Study
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Alugolu, Rajesh, primary, Wadikhaye, Rohit, additional, and Mudumba, VijayaSaradhi, additional
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- 2021
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9. Acute neuroendocrine profile in predicting outcomes in severe traumatic brain injury: A study from a tertiary care center in South India
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Anne, Beatrice, primary, Vishwa Kumar, KS, additional, Mudumba, VijayaSaradhi, additional, and Alugolu, Rajesh, additional
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- 2021
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10. Role of PET CT Brain A Tool for Cause Detection in Pachymeningitis than Current Available Method
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Manure, Vikram, primary and Mudumba, Vijayasaradhi, additional
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- 2020
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11. Prospective analysis of motor manifestations following STN-DBS and their correlation with electrode position
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Rupam Borgohain, Mudumba Vijayasaradhi, Rajesh Alugolu, Rukmini Mridula Kandadai, and Swapnil Kolpakwar
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medicine.medical_specialty ,Prospective analysis ,Position (obstetrics) ,Physical medicine and rehabilitation ,Neurology ,business.industry ,Electrode ,medicine ,Neurology (clinical) ,Motor Manifestations ,business - Published
- 2021
12. 3T MRI-SWI based volumetric analysis of the subthalamic and red nuclei in advanced Parkinson's disease
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SHAH, Varshesh, primary, ALUGOLU, Rajesh, additional, ARORA, Abhishek, additional, KANDADAI, Rukmini M., additional, MUDUMBA, Vijayasaradhi, additional, and BORGOHAIN, Rupam, additional
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- 2020
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13. Moyamoya disease presenting as bilateral acute subdural hematomas without deficits
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Vangala Bramha Prasad and Mudumba Vijayasaradhi
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medicine.medical_specialty ,Subarachnoid hemorrhage ,business.industry ,subarachnoid hemorrhage ,Case Report ,General Medicine ,medicine.disease ,Subdural Hematomas ,Bilateral acute subdural hemorrhage ,medicine ,Moyamoya disease ,Radiology ,cardiovascular diseases ,Presentation (obstetrics) ,business ,moyamoya disease - Abstract
We report a patient presenting with imageological features of bilateral acute subdural hematomas and subarachnoid hemorrhage, who was subsequently diagnosed as a case of moyamoya disease. Imageological features, source of hemorrhage, literature review, and management are discussed. We report this case in view of its rarity in presentation with these imageological features.
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- 2017
14. Orbital Chordoid Meningioma.
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Jadhav, Nithin Kumar, Alugol, Rajesh, Mudumba, Vijayasaradhi, and Uppin, Megha
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Chordoid meningioma, classified as WHO grade II, are rare tumors comprising only 0.5% of all meningiomas. Chordoid meningioma is an aggressive tumor with high local recurrence. Orbital chordoid meningioma is a much rare entity with very few cases reported in the literature. We report a case of a 77-year-old male who presented with a painless progressive swelling over the right lateral orbital wall. [ABSTRACT FROM AUTHOR]
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- 2022
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15. A series of biopsy-proven patients with immunoglobulin G4-related neurological disease
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Kanikannan, MeenaAngamuthu, primary, Sireesha, Yareeda, additional, Uppin, MeghaS, additional, Ganti, Shridhar, additional, Alugolu, Rajesh, additional, Mudumba, VijayaSaradhi, additional, Bhattacharjee, Suchanda, additional, Neeharika, MathukumalliL, additional, and Bastia, Jogendra, additional
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- 2019
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16. Ossification of posterior longitudinal ligament and fluorosis
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Mudumba, VijayaSaradhi, primary, Shivanand Reddy, KV, additional, Tokala, IndraM, additional, and Reddy, DRaja, additional
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- 2018
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17. Focal Ligamentum Flavum Hypertrophy with Ochronotic Deposits: An Unusual Cause for Neurogenic Claudication in Alkaptonuria
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Debabrat Biswal, Mudumba Vijayasaradhi, and Rajesh Reddy
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musculoskeletal diseases ,medicine.medical_specialty ,Pathology ,Spinal stenosis ,business.industry ,Neurogenic claudication ,Case Report ,medicine.disease ,musculoskeletal system ,Alkaptonuria ,Surgery ,Muscle hypertrophy ,Pathogenesis ,medicine ,Ligamentum flavum ,Orthopedics and Sports Medicine ,Lumbar spine ,medicine.symptom ,business ,Focal hypertrophy - Abstract
Neurogenic claudication resulting from focal hypertrophy of the ligamentum flavum in the lumbar spine due to ochronotic deposits has not been reported till date. The authors discuss one such case highlighting the pathogenesis, histological and radiological features. Salient features of management are also emphasized upon.
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- 2012
18. Acanthamoeba meningoencephalitis in an immunocompetent patient: An autopsy case report
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Afshan Jabeen, Megha S Uppin, Sundaram Challa, Rajesh Reddy, Mudumba Vijayasaradhi, and Rupam Borghain
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Pathology ,medicine.medical_specialty ,Tuberculosis ,biology ,business.industry ,Autopsy ,General Medicine ,Autopsy case ,Acanthamoeba Meningoencephalitis ,medicine.disease ,biology.organism_classification ,Pathology and Forensic Medicine ,Acanthamoeba ,CNS TUBERCULOSIS ,medicine ,Neurology (clinical) ,Differential diagnosis ,Granulomatous amoebic encephalitis ,business - Abstract
Chronic granulomatous CNS infections may be caused by tuberculosis, fungi and rarely by free-living amoeba, especially in immunocompromised individuals. We report a rare, fatal case of granulomatous amoebic encephalitis in an immunocompetent patient mimicking CNS tuberculosis, and review the imageological features and diagnostic tests.
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- 2011
19. A rare case of extradural neurenteric cyst with supratentorial and infratentorial extension
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Mudumba Vijayasaradhi, Megha S Uppin, Rajesh Reddy, and Sundaram Challa
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Fossa ,biology ,Colloid cyst ,business.industry ,Anatomy ,medicine.disease ,biology.organism_classification ,Tentorium ,Intracranial neurenteric cyst ,medicine.anatomical_structure ,Clivus ,Medicine ,Surgery ,Cyst ,Neurology (clinical) ,Neurenteric cyst ,business ,Sinus (anatomy) - Abstract
Dear Editor, Neurenteric cysts are rare benign endodermal lesions of the central nervous system like the Rathke cleft and colloid cysts. Intracranial neurenteric cysts are rare, with less than 100 cases reported in literature, most of which are found in the posterior fossa. We discuss a rare case of an extradural neurenteric cyst with supratentorial and infratentorial extension, and review the embryogenesis and differential diagnosis based on imaging and histopathological features. A 20-year male presented with suboccipital headache and painless, progressive diminution of vision of both eyes of 2 months’ duration. He was counting fingers close to face, and bilateral papilledema was noted. Evaluation with CT scan and MRI of the brain revealed an extradural lesion in the left posterior fossa with extension into the temporal region across the tentorium (Fig. 1a). He underwent a left retromastoid suboccipital craniectomy which was extended into the temporal region. The cyst was completely extradural in location, easily separable from the overlying bone and underlying duramater, except in the region over the transverse sinus where it was adherent to the duramater. Near total excision of the cyst wall was performed, leaving behind a part of the wall which was not separable from the duramater overlying the transverse sinus. The cyst contained thick, yellowish fluid (Fig. 1b), which was sterile on pyogenic culture with no cholesterol crystals or macrophages on microscopic examination. The patient had an uneventful post operative recovery period. At 6 months follow-up, his vision in the right eye improved to finger counting at 2 m, while that in the left eye remained unchanged. On fundoscopy, bilateral optic atrophy was noted. CT scan performed at 6 months showed no evidence of recurrence of the lesion (Fig. 1d). Histopathology sections showed a cystic lesion lined by a single layer of ciliated tall columnar epithelium (Fig. 1e). There was focal squamous metaplasia. Other connective tissue or glial elements were not identified. Immunohistochemistry with cytokeratin showed intense cytoplasmic positivity (Fig. 1f) in lining cells, whereas glial fibrillary acidic protein was negative (Fig. 1g). The precise embryological origin of the intracranial neurenteric cyst is not known. Since the endoderm does not extend cranially farther than the clivus, the possible explanation for an intracranial neurenteric cyst is displacement of the endoderm from its normal location (nasopharyngeal, respiratory tract, or intestinal tract) to an ectopic position in the embryo. Harris et al. has attributed the occurrence of posterior fossa neurenteric cyst to disturbance in early gastrulation after the onset of primitive streak regression [3]. Graziani et al. proposed that neurenteric cyst, colloid cyst, and Rathke cleft cyst originate from Seessel’s pouch, an endoderm diverticulum found behind esophageal membrane that usually regresses and disappears [2]. The evidence in support of this theory is that intracranial neurenteric cysts are not associated with other developmental malformations unlike spinal neurenteric cysts that are associated with occult spinal dysraphisms. The authors declare that this case report has not been presented at any conference or accepted for publication in any journal before. R. S. Reddy (*) :M. Vijayasaradhi Department of Neurosurgery, Nizam’s Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India 500082 e-mail: rajesh_jipmer@rediffmail.com
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- 2010
20. Frontal intradiploic angioleiomyoma
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Mudumba Vijayasaradhi, Shantiveer Uppin, Manas Panigrahi, Vuyyuri Sreedhar, and Challa Sundaram
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Frontal bone ,Smooth muscle ,business.industry ,Angioleiomyoma ,medicine ,Rare Lesion ,General Medicine ,Anatomy ,Differential diagnosis ,medicine.disease ,business ,Benign tumor - Abstract
A left frontal intradiploic angioleiomyoma in a 10-year-old girl is presented with a review of the literature. The pathological and differential diagnosis and management of this rare lesion is discussed.
- Published
- 2008
21. Acanthamoeba meningoencephalitis in an immunocompetent patient: an autopsy case report
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Rajesh, Reddy, Mudumba, Vijayasaradhi, Megha S, Uppin, Sundaram, Challa, Afshan, Jabeen, and Rupam, Borghain
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Adult ,Diagnosis, Differential ,Male ,Fatal Outcome ,Humans ,Acanthamoeba ,Central Nervous System Protozoal Infections ,Amebiasis ,Autopsy ,Tuberculosis, Central Nervous System - Abstract
Chronic granulomatous CNS infections may be caused by tuberculosis, fungi and rarely by free-living amoeba, especially in immunocompromised individuals. We report a rare, fatal case of granulomatous amoebic encephalitis in an immunocompetent patient mimicking CNS tuberculosis, and review the imageological features and diagnostic tests.
- Published
- 2010
22. Transient brain stem ischemia following cervical spine surgery: An unusual cause of delayed recovery
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Jonnavithula, Nirmala, additional, Cherukuri, Kavya, additional, Durga, Padmaja, additional, Kulkarni, DilipKumar, additional, Mudumba, Vijayasaradhi, additional, and Ramachandran, Gopinath, additional
- Published
- 2014
- Full Text
- View/download PDF
23. Double Hangmanʼs Fracture
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Patibandla, Mohana Rao, primary, Mudumba, Vijayasaradhi, additional, and Yerramneni, Vamsi Krishna, additional
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- 2013
- Full Text
- View/download PDF
24. Can spontaneous fusion of vertebral bodies be considered as nature's solution to the growth of Ossification of posterior longitudinal ligament?
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Mudumba, Vijayasaradhi, primary and Vuddagiri, Sridhara N., additional
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- 2012
- Full Text
- View/download PDF
25. Cervical osteochondroma presenting with acute quadriplegia
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Mudumba, Vijayasaradhi, additional and Mamindla, Ravi, additional
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- 2012
- Full Text
- View/download PDF
26. Spinal canal stenosis at the level of Atlas
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Bhattacharjee, Suchanda, primary, Mudumba, Vijayasaradhi, additional, and Aniruddh, PurohitK, additional
- Published
- 2011
- Full Text
- View/download PDF
27. Ossified rathke′s cleft cyst: A rare variant
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Megha S Uppin, Vangala Bramha Prasad, Challa Sundaram, and Mudumba Vijayasaradhi
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Neurology ,Rathke's cleft cyst ,business.industry ,Medicine ,Neurology (clinical) ,Anatomy ,business - Published
- 2012
28. Spontaneous arthrodesis of atlanto-axial complex in a case of rheumatoid arthritis
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Kumar Mr and Mudumba Vijayasaradhi
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medicine.medical_specialty ,Neurology ,business.industry ,Rheumatoid arthritis ,Arthrodesis ,medicine.medical_treatment ,Medicine ,Neurology (clinical) ,business ,medicine.disease ,Surgery - Published
- 2012
29. Anteverted odontoid: A rare congenital bony anomaly of craniovertebral junction
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Mudumba Vijayasaradhi, B.L.S. Kumar, and Gurram L Phaniraj
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Neurology ,business.industry ,Medicine ,Neurology (clinical) ,Anatomy ,Anomaly (physics) ,business - Published
- 2010
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