Craniotomy with Ridges: A Time and Cost-Efficient Technique for Unwavering Fixation of Bone Flap.

After advent of the power driven tools, the ease of surgeons and pace of surgery has been enhanced. Nowadays, most of the neurosurgeons are tend to use the motorized drills for elevating a bone flap to make a craniotomy. The bone cutting by the craniotome is wide and nonbeveled, which mandates the fixation of bone flap at closure, either by wiring, miniplates, or other fixation techniques.

Age estimation of living Indian individuals based on aspartic acid racemization from tooth biopsy specimen.

Background: Age estimation in living individuals is imperative to amicably settle civil and criminal disputes. A biochemical method based on amino acid racemization was evaluated for age estimation of living Indian individuals.

Design: Caries-free maxillary/mandibular premolar teeth ( = 90) were collected from participants with age proof documents and divided into predefined nine age groups.

The transparaspinal approach: A novel technique for one-step removal of dumb-bell-shaped spinal tumors.

Complex dumb-bell spinal tumors are challenging surgical lesions. Combined antero-posterior exposures have traditionally been used in their management. This combined exposure has the disadvantage of a two-stage operation with transthoracic or retroperitoneal dissection.

Unilateral hydrocephalus: atypical presentation of intracranial tuberculoma.

A 43-year-old male presented with 3-month history of low-grade fever and headache. Radiological investigations revealed unilateral hydrocephalus. Unilateral obstruction of the foramen of Monro due to chronic tubercular ependymal inflammation was suspected and endoscopic septostomy was planned.

Intraoperative ventriculo-stomographic evaluation of endoscopic cerebrospinal fluid diversion and flow restoration procedures.

Purpose: This prospective study was designed for intra-operative demonstration of cerebrospinal fluid (CSF) flow in ventricles and cisternal spaces before and after neuroendoscopic procedure. The aim of this study was to evaluate site of obstruction of CSF flow and subsequent stomal or aqueductal patency after endoscopic third ventriculostomy (ETV) or aqueductoplasty in patients with hydrocephalus of diverse aetiology.

Method: Seventeen patients with hydrocephalus due to diverse aetiology underwent ETV (n = 15) and aqueductoplasty (n = 2) or cysto-ventrticulostomy (n = 1) or transaqueductal removal of neurocysticercus cyst (NCC) (n = 1).

Central pontine myelinolysis in a pediatric head injury patient.

Central pontine myelinolysis occurs inconsistently as a complication of severe and prolonged hyponatremia, particularly when corrected too rapidly. It is a concentrated, frequently symmetric, noninflammatory demyelination within the central basis pontis. We describe a head injury patient who suffered this clinical entity as a consequence of rapidly corrected hyponatremia.

Surgical outcome of tuberculous meningitis hydrocephalus treated by endoscopic third ventriculostomy: prognostic factors and postoperative neuroimaging for functional assessment of ventriculostomy.

Object: Endoscopic third ventriculostomy (ETV) is increasingly being used as an alternative treatment for post-tuberculous meningitis (TBM) hydrocephalus. The aim of this study was to affirm the role of ETV in patients with TBM hydrocephalus and also to study the usefulness of cine phase-contrast MR imaging (cine MR imaging) for functional assessment of the ETV stoma. An additional goal was to identify factors that influence the outcome of ETV, so as to define patients with TBM hydrocephalus in whom ETV is warranted.

Combined trans-sphenoidal and simultaneous trans-ventricular-endoscopic decompression of a giant pituitary adenoma: case report.

Objective: This is the first report of the simultaneous combined use of trans-sphenoidal and trans-ventricular-endoscopic route for decompression of a giant pituitary adenoma.

Method: A 38 year old man presented to us with symptoms of raised intracranial pressure along with visual and hypothalamic disturbances. The CT scan revealed destruction of the sella by a large (5 x 3.

Role of endoscopic third ventriculostomy in patients with communicating hydrocephalus: an evaluation by MR ventriculography.

Post-tubercular meningitic hydrocephalus (TBMH) and post-traumatic hydrocephalus (PTH) is often considered a contraindication for endoscopic third ventriculostomy (ETV), as it is mostly of communicating type in these cases. The aim of the present study was to define the role of ETV in patients with communicating hydrocephalus. Ten consecutive patients of TBMH, PTH and postneurocysticercus (NCC) hydrocephalus were formed the study group.

Relative cerebral blood volume is a measure of angiogenesis in brain tuberculoma.

Objective: The aim of this study was to correlate the perfusion indices with magnetic resonance imaging-derived cellular and necrotic fraction of the tuberculoma and angiogenesis metrics on histopathology.

Methods: We performed dynamic contrast-enhanced magnetic resonance imaging in 13 excised brain tuberculoma patients. Microvascular density and vascular endothelial growth factor (VEGF)-expressing cells were quantified from the excised tuberculoma.

Endoscopic transaqueductal removal of fourth ventricular neurocysticercosis with an angiographic catheter.

Objective: Fourth ventricular neurocysticercosis (FVNCC) usually presents with obstructive hydrocephalus. Available treatment options are medical, external cerebrospinal fluid diversion, microsurgical, or endoscopic removal alone or in combination. We present our experience of transaqueductal removal of FVNCC by angiographic catheter with endoscopic third ventriculostomy with a rigid endoscope.

Endoscopic transoral surgery for craniovertebral junction anomalies. Technical note.

Craniovertebral junction (CVJ) anomalies continue to be challenging for neurosurgeons because of the complex anatomy of this region. To date, microsurgical decompression via a transoral route is the standard treatment for anteriorly located compressive lesions of the cervicomedullary junction (CMJ). The results obtained by minimizing surgical trauma are fewer complications, shorter hospital stays, and reduced overall psychological burden.

The role of diffusion-weighted imaging in the differential diagnosis of intracranial cystic mass lesions: a report of 147 lesions.

Background: The objective of this study is to evaluate the sensitivity and specificity of DWI in differentiating brain abscesses from other intracranial cystic lesions.

Methods: One hundred fifteen patients with 147 cystic lesions (mean age, 26.4 year) were prospectively studied with DWI on a 1.

Aventriculi associated with holoprosencephaly.

We describe an 18-month-old male child presenting with delayed milestones. MRI revealed absent lateral and third ventricles associated with fusion of the posterior cerebral hemispheres.

Angiographic catheter: unique tool for neuroendoscopic surgery.

Background: Neuroendoscopic removal of intraventricular and juxtaventricular space-occupying lesions (SOL) requires long and thin instruments that can be maneuvered through the compromised working channels. Currently, various rigid and flexible forceps and scissors are being used for this purpose. We present our experience of using cut segment of angiographic catheters for removal of intraventricular and juxtaventricular SOL by neuroendoscopic surgery.

Endoscopic third ventriculostomy through the interfornicial space.

Endoscopic third ventriculostomy (ETV) is the most common cranial endoscopic surgery being done worldwide for a variety of conditions resulting in hydrocephalus. We report ETV in a case of congenital hydrocephalus with deficient third ventricular roof and wide interfornicial space. A 6-month-old male child presented with gradual progressive head enlargement and signs of raised intracranial pressure.

Role of neuroendoscopy in the management of patients with tuberculous meningitis hydrocephalus.

The role of neuroendoscopy in patients of tuberculous meningitis with hydrocephalus (TBMH) is not yet established. We present details of endoscopic morphology, and analyze outcome of Neuroendoscopy performed in 28 patients (15 males and 13 females, average age 23 years) of TBMH in last 2.5 years.