Endoscopic Suturing of Skull Base Dura and its Effectiveness in Preventing CSF Leak.

Proper skull base repair is essential in preventing postoperative cerebrospinal fluid (CSF) leak following endonasal endoscopic skull base surgery. Direct suturing of the skull base dura is desirable but difficult. Here, we discuss the effectiveness of endoscopic suturing of skull base dura in cases of skull base lesions with intraoperative CSF leak.

Assessment of contamination level of radon (Rn) in drinking water around Tulsishyam geothermal area and Savarkundla fault in Saurashtra, India.

This study aimed to estimate radon concentrations in groundwater and surface water to evaluate radon (Rn) contamination in drinking water within the Amreli region of Saurashtra, Gujarat, India. Water samples from 84 sites, covering about 3000 km, were analyzed using the RAD7 device from Durridge Instruments. Samples were collected in 250 ml radon-tight bottles.

Analysis of the treatment planning metrics and their correlation with morphology of intracranial lesions in Gamma Knife stereotactic radiosurgery.

Background: Gamma Knife Radiosurgery (GKRS) has established a role in treating various benign brain pathologies. The radiosurgery planning necessitates a proper understanding of radiation dose distribution in relation to the target lesion and surrounding eloquent area. The quality of a radiosurgery plan is determined by various planning parameters.

Suturing and Closure of Diaphragma Sella to Augment Sellar Floor Repair after Endonasal Endoscopic Resection of Large Pituitary Adenoma.

 Large pituitary adenoma often pushes the diaphragma sella and extends to the suprasellar compartment. The thinned out diaphragma may get opened during endonasal endoscopic surgery and pose high risk for cerebrospinal fluid (CSF) leak. Such larger defects are difficult to plug with fat graft that tends to slip in to the subarachnoid space.

Coconut husk-lignin derived carbon dots incorporated carrageenan based functional film for intelligent food packaging.

Carbon dots (CDs) derived from sustainable natural feed-stocks like lignin have gained wide acceptance by virtue of their renewability and promising potential in intelligent sensing applications. The precursor lignin is isolated from agro-biomass waste, coconut husk through sodium hydroxide based extraction process. CDs are synthesised from amine functionalized lignin through solvothermal process and integrated into carrageenan biopolymer matrix (1, 2 and 3 wt%).

Radiosurgical Decompression of Trigeminal Nerve and Its Correlation with Functional Outcome in Tumor-Related Trigeminal Neuralgia.

Background: Target selection during Gamma Knife radiosurgery (GKRS) in cases of tumor-related trigeminal neuralgia is always debatable. We analyzed the correlation of regression of tumor size and degree of release of the nerve with long-term pain control.

Methods: Between March 2012 and March 2023, 50 cases of tumor-related trigeminal neuralgia were treated with GKRS (tumor was targeted).

Dysregulated Genes and Signaling Pathways in the Formation and Rupture of Intracranial Aneurysm.

Intracranial aneurysm (IA) has the potential to rupture. Despite scientific advances, we are still not in a position to screen patients for IA and identify those at risk of rupture. It is critical to comprehend the molecular basis of disease to facilitate the development of novel diagnostic strategies.

Morphology of intra tumoral cystic vestibular schwannoma and their response to gammaknife radiosurgery.

Background: Cystic vestibular schwannoma (CVS) traditionally considered as poor responder to gammaknife radiosurgery (GKRS). Their longterm radiobiological behavior is less known. Here we discuss 38 cases with intra tumoral cyst CVS primarily treated with GKRS.

Magnetic Resonance Tractography and Intraoperative Direct Electrical Stimulation in Eloquent Area Glioma Surgery for 102 Cases: A Tertiary Care Center Experience From Northwest India.

Objective: Surgery of eloquent area gliomas is challenging and requires monitoring of the nearby white fiber tracts. In the present study, we analyzed 102 patients with eloquent region gliomas and discussed the concept of intraoperative dynamic white fiber tract navigation and monitoring.

Methods: A total of 102 patients with an eloquent area glioma (52 insular, 29 motor area, 21 temporoparietal) were evaluated.

Primary Intraventricular Phaeohyphomycosis: An Atypical Presentation of Neurotropic Fungus.

Cerebral fungal infections are usually reported secondary to contiguous spread from paranasal sinuses or orbit, hematogenous spread, traumatic brain injury, or immunocompromised conditions. Primary isolated intraventricular phaeohyphomycosis is rare. We report a 29-year-old man who presented with acute symptomatic unilateral hydrocephalus with an intraventricular lesion.

Tetraventricular hydrocephalus with aqueductal flow void: an overlooked entity having consistent improvement following endoscopic third ventriculostomy.

Background: Tetraventricular Hydrocephalus (TetHCP) is a heterogeneous group of cerebrospinal fluid (CSF) flow disorders having varying success rates with Endoscopic third ventriculostomy (ETV). This is report on the efficacy and rationale of ETV in a specific subset of primary TetHCP with aqueductal CSF flow voids.

Methods: Patients of primary acquired TetHCP presenting with increasing head size and/or headache having aqueductal CSF flow void on sagittal Magnetic Resonance Imaging (MRI) were included in this study.

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.

UV-Curable Bio-Based Pressure-Sensitive Adhesives: Tuning the Properties by Incorporating Liquid-Phase Alkali Lignin-Acrylates.

Renewable pressure-sensitive adhesive (PSA) is an emerging field in adhesive industries as it is an excellent green alternative to depleting petroleum-sourced adhesives. Herein, we report the development of novel bio-sourced UV-curable PSAs with ∼50% biomass content originating from alkali lignin, cardanol, and linseed oil. Bio-based prepolymers cardanoldiol acrylate (CDA) and acrylated epoxidized linseed oil (AELO) were synthesized and used to prepare polyurethane acrylate (PUA)-based PSA systems.

Primary Spinal Intradural Ewing's Sarcoma: Hemorrhagic Presentation with Acute Neurological Deterioration in Two Pediatric Patients.

Extraosseous primary spinal intradural Ewing's sarcoma (ES) is an unusual entity. Bleed within such tumors with acute neurological worsening is extremely rare, especially in the pediatric age. In this article, we present two children with intradural-extramedullary ES who had sudden decline in their neurological status consequent to an intratumoral hemorrhage.

Revisiting Intraoperative 2D USG with Saline-Air Mixture as Contrast for Resection of Eloquent Area Glioma in Resource-Deficient Countries.

 Advanced ultrasound, intraoperative magnetic resonance imaging (MRI), neuromonitoring, and aminolevulenic acid have improved the resection and safety of eloquent area gliomas. However, availability of these modern gadgets is a major concern in resource-deficient countries. A two-dimensional ultrasonography 2D USG is cheaper, provides real-time imaging, and is already established but underutilized instrument.

Medulloblastoma and esthesioneuroblastoma in a pediatric patient: a co-incidence or result of common genetic anomaly.

Introduction: Medulloblastoma is the commonest embryonal brain tumor in children. Their association with other neuroepithelial brain tumors is less known. Here we discuss a pediatric patient who developed esthesioneuroblastoma 2 years after treatment of medulloblastoma.

Methacrylated alkali lignin grafted P(Nipam-Co-AAc) copolymeric hydrogels: Tuning the mechanical and stimuli-responsive properties.

The current study reports the preparation of lignin grafted temperature and pH responsive hydrogels through copolymerization of N-isopropylacrylamide, acrylic acid and varying amount of lignin methacrylate (LMA = 50, 100, 150 and 200 mg) as crosslinker adopting radical polymerization technique. Functional group and structural characterizations were carried out to confirm hydrogels synthesis and their network structure. The variation in pore size on addition of lignin revealed the tuning of pores as well as swelling capacity of the hydrogels by suitable amount of LMA.

Temporalis Muscle cysticercosis: Common Parasite at Uncommon Location.

Isolated involvement of the temporalis muscle by cysticercosis is uncommon. The clinical features may mimic other inflammatory conditions of maxilofacial region or that of temporal headache. We describe here a case of right temporalis muscle cysticercosis that was initially misdiagnosed as dental caries.

MR Venography in Gamma Knife Radiosurgery for Parasagittal Meningiomas: A Technical Note with the Rationale of Venous Protection and a Review of Literature.

Postradiosurgery symptomatic brain edema may be seen with parasagittal meningioma owing to its proximity to major venous sinuses and cortical veins. Venous preservation radiosurgery planning is less described. Here, we discuss a new method of tumor volume contouring on postcontrast magnetic resonance venogram (CEMRV) images safely excluding the adjacent cortical veins and sinuses.

Feasibility of Conducting a Virtual Exit Exam in Neurosurgery During the SARS-COV19 Pandemic.

Background: Skills assessment forms an integral part of the exit examination in neurosurgical training programs. The established method of evaluating trainees for their clinical knowledge and surgical proficiency in the operating room is not feasible in the current time of SARS-COV19 pandemic.

Objective: The feasibility of conducting such an assessment using case modules on an online meeting platform is discussed.

Head injury care in a low- and middle-income country tertiary trauma center: epidemiology, systemic lacunae, and possible leads.

Background: Although head injury (HI) from low- and middle-income countries (LMIC) heavily contributes to the global disease burden, studies are disproportionately less from this part of the world. Knowing the different epidemiological characteristics from high-income nations can target appropriate prevention strategies. This study aims to provide a comprehensive overview of the clinico-epidemiological data of HI patients, focusing on the existing challenges with possible solutions from a developing nation's perspective.

Giant skull base mass need not be a tumor - a rare presentation of IgG4-related disease.

Background: Giant intracranial 'IgG4-related' lesions are uncommon. They may present as pachymeningitis or localized mass. Here we report, probably, the largest IgG4 skull base mass ever to be reported.

The collateral fallout of COVID19 lockdown on patients with head injury from north-west India.

Background: The COVID19 lockdown has altered the dynamics of living. Its collateral fallout on head injury care has not been studied in detail, especially from low- and middle-income countries, possibly overwhelmed more than developed nations. Here, we analyze the effects of COVID19 restrictions on head injury patients in a high-volume Indian referral trauma center.

The Risk of Spread of Infection During Craniotomy/Craniostomy on Patients with Active Coronavirus Disease 2019 (COVID-19) Infection: Myth or Fact?

Objectives: Craniotomies/craniostomies have been categorized as aerosol-generating procedures and are presumed to spread coronavirus disease 2019 (COVID-19). However, the presence of severe acute respiratory distress syndrome coronavirus 2 virus in the generated bone dust has never been proved. Our objective is to evaluate the presence of virus in the bone dust (aerosol) generated during emergency neurosurgical procedures performed on patients with active COVID-19.