Publications by authors named "Ashwin Kumaria"

Article Synopsis
  • - This study examines thirteen rare cases of primary cerebellar glioblastoma (cGB) surgically treated between 2005 and 2022, highlighting the challenges in diagnosing this uncommon type of brain tumor.
  • - All patients (3 female, 10 male, median age 56) had MRI scans showing ring enhancement, with surgical treatments varying from craniectomy to biopsy, and four requiring CSF diversion.
  • - The researchers propose that cGB's rarity in the cerebellum may be linked to its distance from germinal regions and lower activity of local neural stem cells, contributing to the limited understanding of this tumor type.
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Background: Total intravenous anaesthesia (TIVA) is emerging as a preferred neuroanaesthetic agent compared with inhalational anaesthetic (IA) agents. We asked if TIVA with propofol and remifentanil was associated with shorter operative times compared to IA using sevoflurane in brain tumour surgery under GA.

Methods: We performed a retrospective analysis of all patients undergoing surgery for glioblastoma (GBM).

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There may be a role for vagus nerve stimulation as an anticancer strategy. This may include the modulation of signalling between nerves and tumour cells and epigenetic influences, in addition to reduction of oxidative stress, anti‐inflammatory and endocrine mechanisms.

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Malignant acute ischemic stroke (AIS) is characterized by acute neurological deterioration caused by progressive space-occupying brain edema, often occurring in the first hours to days after symptom onset. Without any treatment, the result is often fatal. Despite advances in treatment for AIS, up to 80% of patients with a large hemispheric stroke or cerebellar stroke are at risk of poor outcome.

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High grade gliomas carry a poor prognosis despite aggressive surgical and adjuvant approaches including chemoradiotherapy. Recent studies have demonstrated a mitogenic association between neuronal electrical activity and glioma growth involving the PI3K-mTOR pathway. As the predominant excitatory neurotransmitter of the brain, glutamate signalling in particular has been shown to promote glioma invasion and growth.

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Article Synopsis
  • In 1932, Harvey Cushing linked peptic ulcers to increased intracranial pressure due to vagal overactivity, but the current review suggests that the causes may be more complex than originally thought.
  • Clinical evidence shows only slight increases in gastric acid in head-injured patients, and increased vagal tone is not common among those with severe brain injuries.
  • The narrative proposes a new hypothesis that neurogenic peptic ulcers may stem from changes in the gut microbiome and gastrointestinal inflammation rather than just vagal mechanisms.
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Despite decades of research and the growing emergence of new treatment modalities, Glioblastoma (GBM) frustratingly remains an incurable brain cancer with largely stagnant 5-year survival outcomes of around 5%. Historically, a significant challenge has been the effective delivery of anti-cancer treatment. This review aims to summarize key innovations in the field of medical devices, developed either to improve the delivery of existing treatments, for example that of chemo-radiotherapy, or provide novel treatments using devices, such as sonodynamic therapy, thermotherapy and electric field therapy.

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Endogenous neural stem cells are thought to continue to generate new neurons throughout life in the human brain. Endogenous neurogenesis has been proposed to contribute to physiological roles in maintaining and regenerating olfaction, as well as promoting normal cognition, learning and memory. Specific impairments in these processes in COVID-19 - impaired olfaction and cognition - may implicate the SARS-CoV-2 virus in attenuating neurogenesis.

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Terson syndrome (TS) describes the presence of intraocular haemorrhage in patients with intracranial haemorrhage or traumatic brain injury. The aetiology of TS is controversial as an anatomical conduit between the vitreous humour and subarachnoid space remains contested. We herewith present a case of primary vitreous haemorrhage with secondary intracranial extension into the ventricles.

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Olfactory neuroblastoma (ONB) is a rare tumour of the skull base, typically originating from the nasal cavity and around the cribriform plate. We present the rare case of ONB originating from and limited to the sphenoid sinus in a 42-year old lady. Pre-operatively the lesion was thought to be a sinonasal polyp and underwent functional endoscopic sinus surgery (FESS) and total excision of the polypoid lesion.

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Beckwith-Wiedemann syndrome (BWS) is a rare congenital overgrowth syndrome associated with certain childhood tumours. We present the case of a 36-year-old lady with BWS who developed a left frontoinsular secondary glioblastoma. This is the first case report in the literature of glioblastoma associated with BWS.

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We present a case of syringomyelia following retrosigmoid craniectomy and resection of vestibular schwannoma complicated by Cerebrospinal fluid (CSF) leak, multiple infections and CSF diversion procedures. We believe this is the first reported case of syrinx formation after this type of surgery. Potential mechanisms by which the syrinx may have developed are discussed.

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Psychrobacter piechaudii is a recently described species of Gram-negative bacteria in the Moraxellaceae family. No cases of human infection due to this species have been described before. We report the case of an ex-premature infant girl with hydrocephalus secondary to intraventricular haemorrhage who underwent multiple cerebrospinal fluid (CSF) shunt operations.

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