Comparison of postoperative delirium in patients anesthetized with isoflurane versus desflurane during spinal surgery: A prospective randomized controlled trial.

Background: Following spine surgery, different types of inhalational anesthetic agents can result in postoperative delirium (POD) that can increase perioperative/postoperative morbidity. Here, we compared the incidence of POD in adults undergoing spine surgery anesthetized with isoflurane versus desflurane.

Methods: A prospective randomized double-blind clinical trial for patients undergoing spinal surgery was performed in 60 adults (aged 18-65 years); they were randomized to receive isoflurane or desflurane.

Factors predicting long-term outcome after short-segment posterior fixation for traumatic thoracolumbar fractures.

Background: The "gold standard" for instrumentation of unstable thoracolumbar fracture-dislocations is pedicle screw and rod fixation. Although traditional treatment supports long-segment posterior fixation (LSPF), more recent studies show short-segment posterior fixation (SSPF) may be effective, but incur higher failure rates. Here, we evaluated the effectiveness of SSPF in the management of unstable thoracolumbar injuries and analyzed the factors impacting long-term outcomes.

Comparative evaluation of H&H and WFNS grading scales with modified H&H (sans systemic disease): A study on 1000 patients with subarachnoid hemorrhage.

The comparative studies on grading in subarachnoid hemorrhage (SAH) had several limitations such as the unclear grading of Glasgow Coma Scale 15 with neurological deficits in World Federation of Neurosurgical Societies (WFNS), and the inclusion of systemic disease in Hunt and Hess (H&H) scales. Their differential incremental impacts and optimum cut-off values for unfavourable outcome are unsettled. This is a prospective comparison of prognostic impacts of grading schemes to address these issues.

Temporal aneurysmal bone cyst: cost-effective method to achieve gross total resection.

Aneurysmal bone cyst (ABC) is a vascular benign bony expansile lesion. The treatment is gross total resection. Surgery for a skull base aneurysmal bone cyst poses a significant challenge because of its vascularity and the adjacent neurovascular structures.

Are C2 pars-pedicle screws alone for type II Hangman's fracture overrated?

Background/object: The recent trend for treatment of certain cases of type II Hangman's fracture has been towards motion preserving surgery. This is claimed to be achieved with placement of pedicle screws across the fracture fragments. However, the long term outcome in clinical scenario is not yet clear, neither are the factors determining suitability of such a technique.

Centrifugal opening of dura for total extirpation of large convexity meningiomas: modifying the "classic" technique to prevent injury to the adjacent brain and veins.

Background: Traditionally, the dura is opened along the margin of a convexity meningioma, jeopardizing the adjacent herniating brain and compressed veins in case of large meningioma. In this work, we describe a technique to open the dura centrifugally over convexity meningiomas.

Methods: Fifteen cases of large convexity meningiomas were operated on using the new technique.

Posterior clinoid meningioma: A case report with discussion on terminology and surgical approach.

Background: Posterior clinoid process (PCP) meningiomas are rare lesions. In close proximity to these lesions are the perforators from internal carotid artery and the oculomotor nerve, which need to be considered while deciding the appropriate surgical approach.

Case Description: We describe a basal frontotemporo-orbito-zygomatic approach with splitting of the sylvian fissure to resect an eccentrically placed PCP meningioma.

The clinical profile, management, and overall outcome of aneurysmal subarachnoid hemorrhage at the neurosurgical unit of a tertiary care center in India.

Background And Purpose: Several studies report good outcomes in selected patients of aneurysmal subarachnoid hemorrhage (aSAH). The purpose of our study is to project the clinical characteristics, management, and overall outcome of patients with aSAH presenting to a tertiary care center in India.

Materials And Methods: A prospective study was conducted over a period of 10 months and all patients presenting with aSAH were studied.

Optic nerve hypoplasia.

Optic nerve hypoplasia (ONH) is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology.

Is ligation and division of anterior third of superior sagittal sinus really safe?

Background/object: Ligation and division of anterior third (AT) of superior sagittal sinus (SSS) is presumed to be safe and is commonly used for approaching anterior skull base tumors and distal anterior cerebral artery aneurysms (DACA). Contrary to this belief we found complications secondary to this procedure more often than described and we have described them along with probable etiology.

Materials And Methods: A total of 62 patients who underwent bifrontal or extended bifrontal craniotomies with ligation and division of the proximal end of SSS were studied retrospectively.

Congenital atlantoaxial dislocation: a dynamic process and role of facets in irreducibility.

Object: Patient age at presentation with congenital atlantoaxial dislocation (CAAD) is variable. In addition, the factors determining irreducibility or reducibility in these patients remain unclear. The facets appear to contribute to the stability of the joint, albeit to an unknown extent.