Malignant bihemispheric cerebral edema after cranioplasty - An extension of the Monro-Kellie doctrine and predictive factors.

Background: Several changes in normal pressure dynamics on the brain occur with a decompressive craniectomy and subsequent cranioplasty. Dead space volume is an important factor contributing to intracranial volume postcranioplasty. A decrease in this volume due to negative suction drain along with relative negative pressure on the brain with the loss of external atmospheric pressure may lead to fatal cerebral edema.

Dorsal vertebral body tumor and non-compressive quadriparesis - A rare case report of a phosphaturic mesenchymal tumor.

Background: Phosphaturic mesenchymal tumors cause renal phosphate wasting leading to hypophosphatemia manifesting as bone pain and fractures. About 95% of these tumors involve the extremities and the appendicular skeleton, with spinal tumors being exceedingly rare. We describe a case of non-compressive quadriparesis, caused by a thoracic vertebral body phosphaturic mesenchymal tumor (PMT).

The Honorable "Honorary system" in teaching/university public hospitals - An ideal blend of academics and prosperity for the medical professional.

The options available for a specialist in India today can be broadly divided into joining a public teaching institution in the capacity of lecturer or higher, freelancing, and taking up a full-time corporate position. Whereas public teaching institutions have an abundance of academics, skill and mastery development potential, corporate positions and freelancing offer better monetary stability. From an ideal blend of both systems, stems the honorary system.

Migrainous facial palsy (MFP): the introduction of a new concept of neurovascular conflict and its preliminary clinical evidence.

Background: Facial palsy and migraine have frequently been reported to occur in conjunction. We report a case series and propound a theory to explain the same.

Aims And Objectives: To postulate an anatomico-pathophysiological association in the causative factor of lower motor neuron type of facial palsy in cases with migraine without aura.

Transtentorial Brain Herniation After Lumbar Drainage in Patient Planned for Cranioplastic Reconstruction: Catastrophic Play Between Atmospheric and Intracranial Pressure.

Background: The sinking skin flap syndrome, also known as the syndrome of the trephined or the trephination syndrome, occurs in patients who have undergone a decompressive craniectomy. As opposed to this, persistent brain herniation also occurs in patients after a decompressive craniectomy and a cerebrospinal fluid (CSF) drainage procedure is one of the therapies used to reduce it. A continuous lumbar CSF drainage procedure can upset the pressure dynamics of the atmosphere versus intracranial pressures to a point of fatal clinical deterioration and hence needs to be closely monitored.

Bi-modal radiofrequency treatment for coexisting neuralgia and neuropathy in adjacent divisions of the trigeminal nerve.

Trigeminal neuralgia and deafferentation neuropathic pain, or trigeminal neuropathy, are different symptomatologies, rarely reported to present together. The case of a 65-year-old gentleman suffering from trigeminal neuralgia of the maxillary and mandibular division is reported. He first underwent an infraorbital neurectomy that was complicated by deafferentation neuropathic pain, whilst his mandibular neuralgia continued.

Ultra-extended euthermic pulsed radiofrequency for the treatment of ophthalmic neuralgia: A case report with elaboration of a new technique.

Background: Pulsed radiofrequency although present for many years has been used little compared to ablative procedures for pain relief. Its use in trigeminal neuralgia is sparse and unreported in the ophthalmic division, where the possibility of sensory loss can lead to high morbidity. We wished to explore the potential of this reportedly safe modality for a prolonged duration in a highly sensitive anatomic neural location, however, in a very secure, structured, and staged manner.

Vestibular schwannoma and tuberculoma occurring In collision in the posterior fossa: A case report.

Introduction: Though acoustic schwannoma is the most common primary tumour in the cerebello-pontine angle, its occurrence with tuberculoma has never been reported.

Presentation Of Case: A case of a vestibular schwannoma and tuberculoma occurring as collision tumors in the posterior fossa in a 46 years old female is reported. She presented with chronic raised intracranial pressure manifesting as headache, occasional diplopia, speech disturbance, and unsteady gait.

Plaster of Paris mould for stereotactic frame fixation.

Stereotactic procedures have been prevalent in neurosurgical practice for a prolonged time period. With the advent of new custom-made frames designed for morphologic and functional neurosurgical procedures, its extended use in the pediatric population is becoming increasingly popular. However, there is still a need for sophistication in design and instrumentation.

Giant cerebral cavernous haemangioma: a case report and review of literature.

An 18-year-old male presented with uncontrolled left focal seizures with secondary generalisation for the past 10 years. Investigations revealed a large lobulated mass in the right frontal brain. Surgical excision of a giant cavernous haemangioma was performed.

Intraventricular tuberculoma.

A 38-year-old female presented with headaches, fever, and malaise. Computed tomography showed an intraventricular peripheral ring-enhanced lesion with central necrosis. The lesion was totally excised.

Flare up of tuberculous abscess following stereotactic aspiration--case report.

A 16-year-old non-immunocompromised and otherwise healthy patient presented with a tuberculous brain abscess. The abscess was aspirated stereotactically. Following the aspiration the disease process flared up and multiple daughter abscess cavities were discovered.

Basilar invagination and Chiari malformation associated with cerebellar atrophy: report of two treated cases.

We report two patients with an unusual complex of anomalies wherein the basilar invagination and Chiari malformation was associated with marked cerebellar atrophy. Both patients presented with relatively severe lower cranial nerve deficits and showed clinical improvement following a posterior foramen magnum bony decompression. The pathogenesis of the anomalies is discussed and the rationale of treatment is analysed.

Cavernous haemangioma in the interpeduncular cistern: case report and review of literature.

A rare case of a cavernous haemangioma in the interpeduncular cistern is reported. The patient, forty-five year old male presented with excruciating left sided trigeminal neuralgia and diplopia for the past one year. Examination revealed left third and fifth nerve paresis.

Diffuse calvarial meningioma: a case report.

A rare case of a diffuse calvarial meningioma in a sixty-three year-old female is reported. The patient presented with headache, painful proptosis and chemosis of the left eye. Imaging showed that the frontoparietal calvarium on both sides and the left orbital roof were thickened.

Transnasal intracranial entry of a flying wire fragment.

A 7-year-old boy was playfully revolving a partly insulated electric wire which accidentally struck a bamboo pole in its path. He soon found that his left nostril was hit and blood trickled from the site. Unsuspected on investigation, a small fragment of the wire was found within the brain.

Pathological laughter as a presenting symptom of massive trigeminal neuromas: report of four cases.

Objective And Importance: This is a report of four cases of huge trigeminal neuromas that presented with the principle symptom of pathological laughter (PL).

Clinical Presentation: All four patients were male and were in either the third or fourth decade of life. In addition to PL, there were neurological deficits related to trigeminal nerve, brainstem, and cerebellar dysfunctions.

Midline cerebellar cystic schwannoma : a case report.

An extremely unusual case of a cystic schwannoma in the region of the inferior vermis and posterior to the fourth ventricle in a fifteen year old boy is reported. The cystic tumour caused partial obstruction to the outflow of cerebrospinal fluid from fourth ventricle and resulted in development of supratentorial hydrocephalus. On investigations, the schwannoma simulated a Dandy-Walker cyst.