Disparities in casemix, acute interventions, discharge destinations and mortality of patients with traumatic brain injury between Europe and India.

Background: Traumatic brain injury (TBI) is a major global health problem that disproportionally affects low- and middle-income countries. The needs for patients with TBI therefore may differ between levels of national development. We aimed to describe differences in epidemiology and acute care provision of TBI between India and Europe.

Decompressive Hemi Craniectomy in Malignant Middle Cerebral Artery Infarction: Adding Years of Quality Life or Mere Existence?

Background: In spite of advancements in treatment options for MCA infarct, there is a definite role of decompressive hemicraniectomy. When compared with best medical management, it decreases mortality and improves functional outcome. But does surgery improve quality of life in terms of independence, cognition or it merely leads to increased survival?

Objective: Outcome of 43 consecutive patients of MMCAI who underwent DHC was studied.

The Yin and Yang of Operating on a Posterior Fossa Meningioma: The Schmahmann Syndrome.

The cerebellum is classically linked with control of motor function, such as coordination, balance, and regulation of movement. There is an increasing awareness, now, of the non-motor functions of the cerebellum, and the occurrence of behavioral anomalies with cerebellar disorders. We present the first report of Schmahmann syndrome (cerebellar cognitive affective syndrome [CCAS]) occurring secondary to posterior fossa meningioma excision.

Challenges and prospects of neurosurgical teleconsultations in a developing country: a reality check.

Objective: The adoption of telemedicine became a necessity during the COVID-19 pandemic because patients found commuting to be difficult owing to travel restrictions. Initially, audio-based teleconsultations were provided. Later, on the basis of the feedback of patients and caregivers, the authors started to provide video-based teleconsultations via WhatsApp.

Repurposing of FDA Approved Drugs Against SARS-CoV-2 Papain-Like Protease: Computational, Biochemical, and Studies.

The pandemic caused by SARS-CoV-2 (SCoV-2) has impacted the world in many ways and the virus continues to evolve and produce novel variants with the ability to cause frequent global outbreaks. Although the advent of the vaccines abated the global burden, they were not effective against all the variants of SCoV-2. This trend warrants shifting the focus on the development of small molecules targeting the crucial proteins of the viral replication machinery as effective therapeutic solutions.

Setting up a Neurosurgical Skills Laboratory and Designing Simulation Courses to Augment Resident Training Program.

Background: The surgical skill practice in neurosurgery is being compromised in the recent past owing to the duty time constraint, patient safety concerns, and medico-legal issues. Surgical practice outside the operating room is essential to enhance a resident's operative skills and to gain confidence.

Objective: To discuss the experience of establishing an 'in-house neurosurgery skills laboratory' and various training sessions conducted with cadaveric and non-cadaveric simulation modules.

Seasonal variation and Incidence of rupture of intracranial aneurysm : A prospective study and Literature review.

Objectives: Some studies have found an association of incidence of aneurysmal Sub arachnoid hemorrhage (aSAH) seasonal variations and weather patterns but others have refuted this. With conflicting reports in the literature, we tried to find out whether climatic conditions influence the incidence of aSAH.

Patients And Methods: This was a prospective single centre study involving patients with aSAH operated in a tertiary care hospital over one calendar year.

Outcome Following Surgical Revascularization in Patients of Moyamoya Disease with Focus on Graft Patency and Angiographic Changes.

Background: Surgical revascularization is the mainstay of treatment in symptomatic patients of moyamoya disease (MMD).

Objective: The present study analyzed the postoperative angio-architecture in pediatric and adult patients of moyamoya disease.

Material And Methods: Patients with MMD, both ischemic and hemorrhagic, were subjected to surgery.

Coexistent pituitary adenoma and frontal convexity meningioma with frontal sinus invasion: A rare association.

The coexistence of pituitary adenoma (PA) and meningioma in the same patient is rare, after excluding radiotherapy-induced meningiomas. Most of the literature on their coexistence describes meningiomas located in the close vicinity to PA, that is, in the sellar/parasellar region. We describe a case of a 65-year-old lady with a nonfunctioning PA and an associated frontal convexity meningioma with frontal sinus invasion.

Convergence Weakness with Intact Medial Rectus Function in Proptosis due to Orbital Tumors.

Background: The pathway underlying ocular convergence is less clear. Convergence weakness is usually a clinical sign of dorsal midbrain pathology. An orbital tumor causing such phenomenon is unknown.

Diffuse Leptomeningeal Glioneuronal Tumor: A Unique Leptomeningeal Tumor Entity.

Background: Diffuse leptomeningeal glioneuronal tumor (DLGNT) is a recent addition to the World Health Organization classification schema of brain tumors, under the heading of neuronal and mixed neuronal-glial tumors. DLGNTs have a classic imaging appearance. However, it has often been misdiagnosed owing to its rarity, its resemblance to granulomatous/leptomeningeal etiologies, and the clinical presentation.

Giant skull vault defect in a child caused by Langerhans cell histiocytosis: the "calvaria-eating disease".

Langerhans cell histiocytosis (LCH) is a rare disease of young children that can be difficult to diagnose and treat. Clinical manifestations can sometimes be quite unusual, and bony lesions can reach a large size before treatment is sought. We present a unique case of a 3-year-old male child with a painless giant calvarial defect and cystic swelling.

Supergiant Cavernous Carotid Aneurysm: Successful Management with Ligation of Internal Carotid Artery and STA-MCA Bypass.

Supergiant cerebral aneurysm (size > 6 cm) is a rare and challenging cerebrovascular disease with few documented cases in literature. We describe a simple, safe, and effective treatment option for supergiant cavernous carotid aneurysm and discuss the proposed mechanisms for a favorable outcome.

Neutrophil-to-Lymphocyte Ratio: Can It Be Used as an Adjunct Tool to Predict Histopathological Grade of Brain Tumor?

Since histopathology is available only after surgery, clinical condition and radiological characters of the tumor are important factors on which a clinician counsels the patient of brain tumor to take a decision regarding the management. Neutrophil lymphocyte ratio (NLR), a marker of inflammation can be used as a prognostic marker to predict the survival in high-grade gliomas and metastases. We evaluated the utility of NLR as an adjunct tool in predicting the histopathological grade of brain tumors.

Necessity is the mother of invention: Technical note on the use of self-designed low-cost continuous sump suction for use in microvascular anastomosis.

Background: Technical advances in microneurosurgery facilitated the continuous evolution of surgery. In many developing countries surgeons face difficulties rendering high quality services due to resource constraints. The continuous dry surgical field is essential for performing microvascular anastomosis.

Synchondral Fracture of the Posterior "Hemiarch" of Pediatric Atlas with Cerebrospinal Fluid Fistula following a Penetrating Neck Injury.

Introduction: As such, the incidence of spinal fractures in young children is less than that of adults due to an increased pliability of the immature bones. The presence of unfused synchondroses in these children predisposes them to an infrequent pattern of fractures that traverse through ossification centers. Such synchondral injuries are uncommonly reported in the C1 and C2 vertebrae.

Has Outcome of Subarachnoid Hemorrhage Changed With Improvements in Neurosurgical Services?

Background and Purpose- Though reports suggest decreasing fatality rates of subarachnoid hemorrhage with time, trends in outcome are not reported much especially from developing countries. This study was to analyze changes in outcome across 2 decades and elucidate probable factors. Methods- Prospective databases during 1996 to 2015 were reviewed for neurological outcome at 3 months in relation to demographics, Hunt and Hess grade, Fisher grade, and definitive treatment; and compared between 2 decades, contrasted by establishment of intensive care unit with continuous monitoring and other advancements.

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.