Microsurgical Clipping of Distal Basilar Trunk Aneurysm during Adenosine-Induced Profound Hypotension.

A 46-year-old male presented with a history of sudden severe headache 1 week back, altered sensorium and right hemiparesis for 2 days. On examination, Glasgow Coma Scale (GCS) was E4V4M6 and the patient had right hemiparesis (power - 4/5). Computed tomography (CT) revealed diffuse subarachnoid hemorrhage (Fisher's Grade III).

The Outcome Analysis and Complication Rates of Tracheostomy Tube Insertion in Critically Ill Neurosurgical Patients; A Data Mining Study.

Objectives: To assess the impact, timing, the intra and early post-operative complications and the survival outcome of tracheostomy in critically ill neurosurgery patients.

Methods: This study was a retrospective data mining where data was collected from hospital records from 175 consecutive patients who underwent tracheostomy in the department of Neurosurgery at the Narayna Medical College Hospital, Nellore, India from Jan 2016 to April 2018. A proforma was used to note down the details on the patient status before and after tracheostomy: Glasgow coma scale (GCS), procedure and intra and post-operative complications, type of tracheostomy cannula, details of decannulation, respiration difficulties, and problems with wound, swallowing difficulties, and voice difficulties, stay in intensive care unit (ICU) and hospital and survival status of the patient.

Speech and Swallowing Function Outcome Following Early Tracheostomy in Patients Who Underwent Neurosurgical Intervention.

Background: Evaluation of late-onset speech and swallowing complications of tracheostomy on neurotrauma cases, as the most common intensive care unit procedure, needs to be evaluated.

Objectives: A prospective study conducted in a tertiary care teaching hospital to find the late-onset speech and swallowing complications of tracheostomy in neurotrauma cases.

Materials And Methods: This prospective observational study was conducted in the intensive care unit on intubated patients needing elective tracheostomy at a tertiary care teaching institute in South India with a dedicated referral trauma center.

Management Issues in a Case of Congenital Craniovertebral Junction Anomaly with Aberrant Retropharyngeal Midline Course of Bilateral Cervical Internal Carotid Arteries at C1-C2.

Background: Aberrant medial retropharyngeal prevertebral course of the internal carotid arteries (ICAs) is extremely uncommon. In oropharyngeal surgeries, like transoral odontoidectomy (TOO), this unrecognized aberrant retropharyngeal course of ICAs can result in devastating complications secondary to inadvertent injury of ICAs. We describe this aberrant course of ICAs in a patient with a craniovertebral junction (CVJ) anomaly with a dysmorphic C1 lateral mass on one side and discuss in detail various management issues in this complex case.