Search

Byline: Jitin. Bajaj, Sarat. Chandra, Bhargavi. Ramanujam, Heri. Subianto, Shabari. Girishan, Ramesh. Doddamani, Mohit. Agrawal, Raghu. Samala, Rekha. Dwivedi, Kapil. Chaudhary, Ajay. Garg, Madhavi. Tripathi, C. Bal, Ashima. Nehra, Mehar. [...]

Post-decompressive craniectomy syndrome (PDCS) is a complication following decompressive craniectomy (DC). PDCS or also known as trephine or sunken skin flap syndrome has an indirect relationship with traumatic brain injury (TBI). The mechanism of PDCS is not yet fully understood and the clinical manifestations are diverse, causing PDCS to often be underdiagnosed. In this study, the authors aim to create a systematic review of PDCS following TBI including a discussion of incidence, clinical and radiological manifestations, management and outcome. This systematic review is conducted based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline. The literature search included electronic databases PubMed, Cochrane, JNS and EMBASE. All studies included were available in English and full-text format. In this research, 42 case reports were obtained. The population was predominantly male (72%) with a mean population age of 44.7 ± 17.3 years. The mean interval for onset and cranioplasty procedure was 80.17 ± 77.34 days and 92.05 ± 77.06, respectively. The most common clinical manifestations were sunken skin flap in the defect area (74%) and decreased consciousness (64%). Paradoxical herniation (74%) was the most common radiological manifestation. There was no connection between the occurrence of PDCS and the size of the defect. Cranioplasty remains the mainstay of management with clinical improvement in 96% of cases. PDCS should be suspected in every patient with symptoms of new neurological deficits after DC. Early management must be carried out to prevent further deterioration. [ABSTRACT FROM AUTHOR]

Byline: Ramesh. Doddamani, Heri. Subianto, Jitin. Bajaj, Shabari. Girishan, Raghu. Samala, Mohit. Agrawal, Bhargavi. Ramanujam, Manjari. Tripathi, Poodipedi. Chandra Background: Patients with temporal lobe epilepsy are subjected to standard temporal [...]

Byline: Ramesh. Doddamani, Raghu. Samala, Heri. Subianto, Bhargavi. Ramanujam, Manjari. Tripathi, Poodipedi. Chandra Background: Stereoelectroencephalography (SEEG) has become an integral part of epilepsy surgery, often used in the localization of [...]

Management of hypothalamic hamartoma (HH) with intractable gelastic epilepsy remains challenging. We performed robotic (ROSA) guided radiofrequency ablation for the treatment of HH with intractable gelastic epilepsy in a child of 6 months age. During the surgery, intracranial depth electrode implanted to the hamartoma to identify the ictal onset. Planning for surgery was performed under ROSA assistance with MRI guided targeting and radiofrequency ablation of the hypothalamic hamartoma was performed to achieve disconnection effects. No intraoperative complications occurred. The present study was primarily aimed at verifying the feasibility of using robotic guided radiofrequency disconnection technique in terms of safety, short surgical duration in younger patients to prevent further secondary epileptogenesis from hypothalamic hamartomas. [ABSTRACT FROM AUTHOR]

Aim: To prove that VIM line technique created by using a mathematical model, can be used to identify the location of the ventral intermediate nucleus of the thalamus (VIM) MATERIAL and METHODS: Eleven patients with Parkinson?s disease (PD) were assessed. To determine the VIM location, 3-T magnetic resonance imaging and stereotactic protocol 128-slice computed tomography were used. The VIM line technique was performed by drawing a line from the end-point of the right external globus pallidus to that of the left external globus pallidus in the intercommissural plane. PD severity was measured using the Unified Parkinson?s Disease Rating Scale (UPDRS)., Results: A mathematical model was constructed to describe the VIM line technique for determining the VIM location. UPDRS scores before and after thalamotomy showed a significant decreasing trend (p=0.003)., Conclusion: The VIM line technique using the mathematical model can be considered a referential method to determine the VIM location. Its effectiveness was demonstrated by decreased UPDRS scores in patients after VIM thalamotomy.