Prospective Nonrandomized Analytical Comparative Study of Clinicoradiological Relationship and Quality of Life between Lumbar Interbody Fusion and Posterolateral Lumbar Fusion.

Study Design: This prospective, nonrandomized, analytic comparative study analyzed the outcome of 100 patients who underwent spinal fusion surgeries (Posterolateral fusion (PLF) and posterior lumbar interbody fusion [PLIF]) with 6 months of follow-up.

Objective: The aim of our study was to compare clinicoradiological outcome of the lumbar spinal fusion surgeries (PLF vs. PLIF/transforaminal lumbar interbody fusion [TLIF]), to assess the quality of life pre- and post-operatively in all patients, and to compare the results within the groups.

A large primary orbital lymphoma with proptosis: A case report and review.

Background: Primary orbital lymphomas are a rare subset of tumors constituting 1-2% of non-Hodgkin's lymphoma. They are mostly indolent B-cell lymphomas presenting with gradual progressive proptosis, decreased visual acuity, restricted ocular mobility, and diplopia. The role of surgery is mainly for obtaining a biopsy.

Mirror image of bilateral DACA aneurysm with its successful surgical management.

Background: Among various locations of intracranial aneurysms reported in the literature, two different aneurysms situated symmetrically opposite on bilateral distal anterior cerebral arteries (DACA) are very rare.

Case Description: Here, we report a rare case of mirror image distal anterior cerebral aneurysm in a middle-aged male patient. The patient presented with severe headache and loss of consciousness.

Intrinsic epidermoid of the brain stem: case report and review of the literature.

Purpose: Purely cystic brain stem epidermoid is a rare diagnosis among all brainstem cystic lesions. Further, it is very rare in pediatric age group.

Methods: Here, we are reporting a rare case of completely cystic brain stem epidermoid in a child.

Surgical management of acromegaly: Long term functional outcome analysis and assessment of recurrent/residual disease.

Context: Functional growth hormone producing adenomas have long-term deleterious effects on the visual apparatus, the cardiovascular and musculoskeletal systems, and often predispose to malignancies. Since persistence of acromegaly affects outcome and quality of life, therapeutic interventions become mandatory.

Aim: This study represents an analysis of long-term clinical and endocrinal outcome of 115 patients of acromegaly after surgical management.

Choroid plexus tumors: A clinico-pathological and neuro-radiological study of 23 cases.

Background: Choroid plexus tumors are intraventricular tumors derived from choroid plexus epithelium.

Aim: To study the choroid plexus tumors with reference to their clinical, radiological, and pathological features.

Materials And Methods: The study was performed by the retrospectively reviewing the clinical, radiological, and pathological records of patients of choroid plexus tumors.

Posterior inferior cerebellar artery aneurysms: Anatomical variations and surgical strategies.

Context: Posterior inferior cerebellar artery (PICA) aneurysms are associated with multiple anatomical variations of the parent vessel. Complexities in their surgical clipping relate to narrow corridors limited by brain-stem, petrous-occipital bones, and multiple neurovascular structures occupying the cerebellomedullary and cerebellopontine cisterns.

Aims: The present study focuses on surgical considerations during clipping of saccular PICA aneurysms.

Atlantoaxial dislocation.

Atlanto-axial dislocations (AADs) may be classified into four varieties depending upon the direction and plane of the dislocation i.e. anteroposterior, rotatory, central, and mixed dislocations.

The "moustache" sign: localized intervertebral disc fibrosis and panligamentous ossification in ankylosing spondylitis with kyphosis.

Localized intervertebral disc and ligamentous ossification may precipitate neurological deficits at any time during the natural course of ankylosing spondylitis (AS). We report 2 patients with AS with "moustache' sign (localized intervertebral disc fibrosis and panligamentous ossification) and neurological deficits. One patient had syndesmophytosis (with paraparesis secondary to thoracic spinal canal stenosis), and the other had "bamboo spine" above and below the involved level.

Os odontoideum with "free-floating" atlantal arch causing C1-2 anterolisthesis and retrolisthesis with cervicomedullary compression.

Background: Os odontoideum (OO) with C1-2 anterolisthesis and retrolisthesis may cause cervicomedullary injury both from anterior and posterior aspects. We analyzed fourteen such patients for biomechanical issues, radiological features and management of OO with free-floating atlantal arch and review pertinent literature.

Materials And Methods: Fourteen patients having nonsyndromic, reducible atlantoaxial dislocation (AAD) with orthotopic OO were analyzed.

Postauricular, transpetrous, presigmoid approach for extensive skull base tumors in the petroclival region: the successes and the travails.

Purpose: Postauricular, transpetrous, presigmoid approach combines a supra/infratentorial exposure with partial petrosectomy to access third to the twelfth cranial nerves and extraaxial lesions situated anterolateral to brainstem. It provides a shorter working distance to large petrosal, petroclival, cerebellopontine, and cerebellomedullary cisternal lesions and their extensions to the subtemporal-infratemporal areas. This study reviews the surgical technique, corridors of extension, and complications encountered utilizing this approach for excising extensive lesions in these locations.

Effect of spinal cord signal intensity changes on clinical outcome after surgery for cervical spondylotic myelopathy.

Object: The presence of intramedullary T2 high signal intensity changes in patients with cervical spondylotic myelopathy (CSM) indicates the existence of a chronic spinal cord compressive lesion. However, the prognostic significance of signal intensity changes remains controversial. The purpose of this study was to evaluate the effect of spinal cord T2 signal intensity changes on the outcome after surgery for CSM.

Pediatric colloid cysts of the third ventricle: management considerations.

Purpose: Pediatric colloid cysts (CC) have a congenital origin, and yet, there are very few studies focussing exclusively on their occurrence in the pediatric population. Pediatric CC has been associated with more aggressive clinical and radiological patterns than their adult counterparts. In this study, undertaken on children with anterior third ventricular CC, excised using the interhemispheric transcallosal approach, the characteristic clinicoradiological features and management options are studied.

Fronto-temporo-orbitozygomatic craniotomy and "half-and-half" approach for basilar apex aneurysms.

Background: Basilar apex aneurysms (BAA) are located in interpeduncular cistern surrounded by eloquent neurovascular structures. Surgical access is difficult due to narrow surgical corridors and requires traversing through a depth of 6-8 cm of subarachnoid space.

Aim: Surgical management of BAAs clipped using frontotemporal craniotomy, orbitozygomatic osteotomy with combined subtemporal and transylvian (half and half) approach is discussed.

Tentorial meningiomas: operative nuances and perioperative management dilemmas.

Purpose: Tentorial meningiomas, comprising approximately 3-6% of all intracranial meningiomas, are complex entities with an intricate relationship to surrounding structures and require multiple surgical approaches. In the present study, the rationale for deciding the approaches for TMs and the perioperative management dilemmas were evaluated.

Methods: Thirty-seven patients (28 primary [supratentorial (2), infratentorial (20) and both (6)] and nine complex [cerebellopontine (CP) angle (5) and petroclival (4)] underwent surgery using the occipital transtentorial, supracerebellar infratentorial, subtemporal transtentorial, bioccipital suboccipital, midline suboccipital, retrosigmoid, and combined pre and retrosigmoid approaches.

Choroid plexus papilloma in children: Diagnostic and surgical considerations.

Background: Choroid plexus papilloma (CPP) is a benign neoplasm that arises from the ventricular choroid plexus. The clinical features, radiological characteristics, and treatment have been discussed in this study for a pediatric population.

Methods: Over an eight-year period, seven pediatric (≤12 years) CPP patients were treated.

Primary midbrain germinoma.

An 11-year-old boy presented with a 4-month history of progressive holocranial headache, intermittent vomiting and visual blurring. Later, he began walking unsteadily, with progressive bilateral visual and hearing loss. He had had two episodes of abnormal tonic posturing the day prior to admission.

Surgical strategies for giant medial sphenoid wing meningiomas: a new scoring system for predicting extent of resection.

Background: Surgical management of giant medial sphenoid meningiomas (> or =5 cm in maximum dimension) is extremely challenging due to their intimate relationship with vital neural structures like the optic nerve, cranial nerves of the cavernous sinus and the cavernous internal carotid artery. Their surgical management is presented incorporating a radiological scoring system that predicts the grade of tumour excision.

Materials And Methods: 20 patients of giant medial sphenoidal wing meningioma (maximum tumour dimension range: 5.

Pediatric intracranial aneurysms: an institutional experience.

Introduction: Intracranial aneurysms are extremely uncommon in the pediatric population. Their epidemiology is poorly understood, and certain features make them unique. In our study we analyzed pediatric intracranial aneurysm patients to gain an insight into the epidemiology, clinicoradiological profile and outcome.

Taste dysfunction in vestibular schwannomas.

Background: Gustatory dysfunction associated with vestibular schwannomas (VS) is a poorly represented clinical presentation.

Materials And Methods: One hundred and forty-nine cases operated from 1997 to 2005 where at least six-month follow-up was available were included. All patients were tested for taste sensations using four modalities of standard taste solutions.

Association of methylenetetrahydrofolate reductase genetic polymorphisms with atlantoaxial dislocation.

Object: Genetic mechanisms of atlantoaxial dislocation (AAD) have not previously been elucidated. The authors studied association of polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene, which encodes enzymes of the folate pathway (implicated in causation of neural tube defects [NTDs]), in patients with AAD.

Methods: Molecular analysis of MTHFR polymorphisms (677C-->T, cytosine to thymine and, 1298A-->C, adenine to cytosine, substitutions) was carried out using polymerase chain reaction and restriction enzyme digestion in 75 consecutive patients with AAD and in their reducible (nine patients, 12%) and irreducible (66 patients, 88%) subgroups.

Occipitocervical contoured rod stabilization: does it still have a role amidst the modern stabilization techniques?

Background: The occipitocervical contoured rod (CR) stabilization for use in craniovertebral junction (CVJ) pathologies is an effective and economical technique of posterior fusion (PF).

Aims: The various indications for CR in CVJ pathologies are discussed.

Settings And Design: Retrospective analysis.

Intraventricular meningiomas: a surgical challenge.

Background: Primary intraventricular meningiomas (IVM) pose a surgical challenge as they often remain asymptomatic until they become very large; have close proximity to vital intraventricular structures; and, their vascular supply is often encountered only after significant tumor debulking. In this study, the surgical management of IVM is discussed.

Methods: Between 1989 and 2003, nine patients (7 with lateral and 2 with fourth ventricular) IVM, were operated upon.