The Call for Neuroendoscopy Cadaveric Workshops in Lower-Middle Income Countries.

Objective: This study aims to assess the impact of the workshops organized during Neuroendocon 23 on the perspective and confidence of neurosurgeons toward endoscopy in a lower-middle income country.

Methods: Neuroendocon 23 had cranial and spinal endoscopy cadaveric workshops with 30 delegates each. A pre and postworkshop survey was disseminated among the delegates, and statistical analysis was performed with SPSS (version 26) using P < 0.

IgG4-related hypophysitis: A monocentric experience from North India.

Background: Immunoglobulin (Ig)G4-related disease is a systemic fibroinflammatory disease characterized by dense infiltration of IgG4-positive plasma cells in the affected tissue(s) with or without elevated plasma levels of IgG4. Hypophysitis itself is a very rare disease with reported prevalence in the operative specimens are around 0.2-0.

Quality of life after surgical clipping of ruptured aneurysms from a developing country: differential independent impact of grading scales & baseline factors.

Background: Detailed Quality of Life(QOL) burden among patients with ruptured aneurysms has not been thoroughly studied, especially from developing countries. This is to evaluate the independent impact of factors influencing QOL following clipping.

Methods: Patients who underwent clipping for ruptured anterior circulation aneurysms were prospectively studied for demography, site of aneurysm, H&H, WFNS, and Fisher grades, with QOL, assessed as per WHOQOL-BREF(range 4-20 in 4 domains), and analyzed.

Feasibility of awake endoscopic third ventriculostomy in selected patients of obstructive hydrocephalus.

Background: Endoscopic third ventriculostomy (ETV) is usually performed under general anesthesia (GA) with proper head immobilization. However a few patients with hydrocephalus (HCP) may not be suitable for GA. Once the surgeon is familiar with endoscopic ventricular anatomy and gains adequate surgical experience with the procedure, ETV can be attempted under local anesthesia (LA) in selected patients.

Single-entry two-stage rotational outside-in technique for simultaneous ventriculostomy and pineal region biopsy using traditional ventricular endoscope: technical note and comparative review.

Background: Many methods are reported for simultaneous endoscopic 3 ventriculostomy and posterior 3 ventricular biopsy with their pros and cons. We describe a novel single-entry two-stage rotational outside-in technique using the common 6° ventriculoscope and contrast this with others.

Technique: Using a single burr hole, at the line extended from aqueduct through the larger foramen of Monro in parasagittal imaging, the ventricular endoscope is first inserted with 6° angled view anteroinferior, the tip of endoscope sheath just beyond the anterior part of the foramen, and ventriculostomy performed using flexible catheter's beveled cut end and balloon in a curvilinear trajectory using peripheral visualization.

Effectiveness of dietary diabetes insipidus bundle on the severity of postoperative fluid imbalance in pituitary region tumours: A randomized controlled trial.

Aim: To test the effectiveness of nurse-led dietary diabetes insipidus (DI) bundle on the severity of postoperative fluid imbalance in pituitary region tumours.

Design: Blinded randomized controlled trial.

Methods: Patients aged 18-65 operated for sellar-suprasellar tumours in an Indian tertiary care centre were enrolled through total enumeration sampling and underwent randomization with allocation concealment during Sep 2018-Feb 2019.

Clinical behaviour and outcome in pediatric glioblastoma: current scenario.

Pediatric glioblastoma (pGBM) is a rare entity accounting for only approximately 3% of all childhood brain tumors. Treatment guidelines for pGBM have been extrapolated from those in adult glioblastoma. Rarity of pGBM and underrepresentation of pediatric population in major studies precludes from defining the ideal treatment protocol for these patients.

Endonasal endoscopic versus microscopic transsphenoidal surgery in pituitary tumors among the young: A comparative study & meta-analysis.

Purpose: The transsphenoidal approach presents unique challenges in young, with scanty literature. This study compares the outcome of pituitary tumors among young in our center between endoscopic(EES) and microscopic(MTS) transsphenoidal surgery, with a meta-analysis.

Methods: Patients within 20 years were studied for their surgical approach to a favorable outcome of endocrine remission (ER) (functioning) or Gross/Near-Total resection (nonfunctioning), besides the need for retreatment.

Differential independent impact of the intraoperative use of navigation and angled endoscopes on the surgical outcome of endonasal endoscopy for pituitary tumors: a prospective study.

Despite widespread popularity of navigation and angled endoscopes in endonasal endoscopy, there are hardly few studies on their efficacy with the extent of resection or retreatment. This is probably the first study to assess the independent impact of these adjuncts among pituitary tumors. Patients with pituitary tumors undergoing endonasal endoscopy were prospectively studied for their demographics, clinico-radiological features, intraoperative use of navigation, and angled endoscopes, in relation to gross total resection (GTR), near total resection (NTR), endocrine remission, and retreatment.

Molecular Imaging Targeting Corticotropin-releasing Hormone Receptor for Corticotropinoma: A Changing Paradigm.

Background: Corticotrophin-releasing hormone (CRH) is the major regulator of adrenocorticotrophic hormone (ACTH) secretion from the anterior pituitary and acts via CRH-1 receptors (CRH-1R). Corticotropinoma though autonomous, still retain their responsiveness to CRH and hence, we hypothesize that in vivo detection of CRH-1 receptors on pituitary adenoma using Gallium-68 (68Ga)-tagged CRH can indicate the functionality of adenoma, and combining it with positron emission tomography-computed tomography (PET-CT) can provide requisite anatomical information.

Methods: Subjects with ACTH-dependent Cushing's syndrome (CS) (n = 27, 24 with Cushing's disease [CD], 3 with ectopic CS [ECS]) underwent 68Ga CRH PET-CT.

Relying too much on upfront radiosurgery: Indolent course misinterpreted as effectiveness of radiosurgery in a case of skull base chondrosarcoma.

Background: Skull base lesions are still considered surgically challenging and primary gamma knife radio surgery (GKRS) is gaining popularity. However the effectiveness of GKRS may be overrated especially in lesions with indolent course.

Case Description: We report a case of chondrosarcoma, mimicking a trigeminal schwannoma treated with upfront radio surgery.

Isolated cerebellar abscess by : A case report with review of literature.

Human nocardiosis is primarily an opportunistic infection affecting immunocompromised patients, however, one-third of them are immunocompetent. CNS involvement is less commonly reported and associated with a grave prognosis. The majority of these patients are organ transplant recipients on immune suppressants.

Do Glioblastomas with Syndromic Association Have Better Prognosis? A Case of Supratentorial Glioblastoma with Embryonal Tumor Differentiation in a Child with Multiple Enchondromatosis.

Glioblastoma (GBM) is an aggressive cancerous neoplasm of the brain that has numerous morphological subtypes. Primitive neuroectodermal differentiation (hereafter, referred to as embryonal tumor [ET] differentiation) in GBM is one of them and is known to occur in adults. Their presentation in pediatric population is rare and can be a source of diagnostic confusion.

Developmental Retrocerebellar Cysts: A New Classification for Neuroendoscopic Management and Systematic Review.

Objective: Posterior fossa cystic malformations are diversely classified with considerable overlap without therapeutic relevance. These cysts posterior to the cerebellum, presenting in children younger than 5 years, are labeled developmental retrocerebellar cysts (DRCCs) under a new classification in relation to neuroendoscopy.

Methods: DRCC was categorized as type 0 for asymptomatic enlarged cistern magna and was not treated.

Median Supraorbital Keyhole Approach for Clipping Ruptured Distal Anterior Cerebral Artery Aneurysm: Technical Report with Review of Literature.

Background: The minimally invasive approach to distal anterior cerebral artery (DACA) aneurysms has not gained much acceptance due to difficulties associated with the conventional frontal paramedian approach. The more proximal basal interhemispheric approach, however, necessitates extensive dissection of soft tissues. We describe a novel minimally invasive median supraorbital keyhole craniotomy with a basal interhemispheric approach for clipping a ruptured DACA aneurysm.

Twin Middle Cerebral Artery with Aneurysm: A Variant of Early Bifurcation or a Discrete Entity.

The middle cerebral artery (MCA) usually bifurcates into a superior or frontal and inferior or temporal branch. However, it may have various branching pattern, and there may be additional arteries from the anterior circulation supplying its territory. The majority of them remain asymptomatic.

Penetrating orbital trauma leading to trans-orbital brain herniation.

Introduction: Development of a posttraumatic herniation of brain parenchyma through the orbit is a rare complication of orbital roof fracture. Mostly, the injury is due to a direct impact to the frontal region resulting in orbital roof fracture with dural defect and herniation of cerebrospinal fluid or brain parenchyma. These patients present with acute or gradually progressive proptosis with impending risk of loss of vision and mandate surgical decompression of optic nerve with watertight closure of the dural defect.