Cognitive deficits in euthymic patients with bipolar disorder: State or trait marker?

Cognitive deficits have been demonstrated in people in the euthymic phase of bipolar disorder. This cross-sectional study compared euthymic bipolar disorder patients (N=30) with never psychiatrically ill controls (N=30) on a neuropsychological test battery containing tasks of executive function, the Wisconsin Card Sorting Test (WCST), attention and working memory, Digits Forward and Backward, and speed of information processing, Digit Symbol. Scores on the Mini Mental State Examination (MMSE) and Vocabulary Test did not differ between the groups. The bipolar group were significantly impaired compared to controls on various indices of executive function on the Wisconsin Card Sort Test and on the Digit tests. The impaired performance on the Digit tests, but not the WCST, was significantly associated with medication status, notably prescribed benzodiazepines. There was no significant effect of severity or course of illness on performance. The findings support the hypothesis that impairments in executive function are present between illness episodes in bipolar disorder, and so are not simply state markers

Transdural herniated lumbar disc disease with muscle patch for closure of durotomy – A Brief review of literature

Purpose Intradural migration of disc (IDMD) is a rare clinical entity accounting for 0.27–0.33% of all herniated disc diseases. Flimsy or dense adhesion between the ventral dural surface and the opposing posterior longitudinal ligament (PLL) is the principal pathology for intradural migrated disc. The most commonly affected lumbar segments are L4-5 (55%), L3-4 (16%), L5-S1 (10%) and less commonly L2L3 and L1L2. No imaging feature is characteristic and the management protocol of durotomy via an endoscopic method is unclear. Methods An L5S1 disc disease was operated by endoscopic method. Difficulty in separating the dural sac from PLL, dense adhesions prompting sharp dissection at this location and a calcified disc are the earliest evidence of intradural migration. MRI features of an intradural location are loss of continuity of posterior longitudinal ligament, beak-like appearance also known as “Hawk-beak sign”, peripheral enhancement around an intradural disc, fluid-filled intradural cyst. Magnification either by Microscope or Endoscope is of importance when dissecting the intradural disc so as to avoid the nerve root injury. Liberal use of fibrin glue and augmentation with muscle patch was performed. Results Ambulated by 48h and discharged by 5th day. Two and 9 months follow up showed no evidence of pseudomeningocoele. Conclusion Autologous muscle patch with fibrin glue for dural rent closure is a simple and effective method which can be performed by endoscopic or minimally invasive approaches. Suturing the dura, being a tedious and cumbersome procedure can be avoided

Analysis of Traumatic brain injury related to Kite flying festival: An institutional study

Introduction: Makar Sankranti or Uttarayan is the kite flying festival in India. The festival marks the end of winter and the beginning of summer as the sun moves to the Tropic of Cancer bringing with it longer and warmer days. But it turns into a difficult day for those who are hospitalised after suffering from kite flying related injuries. Aims & Objectives: The objective of this cross sectional study was to review the demographics, causes injury, severity, treatment and outcome of traumatic brain injuries in victims of this kite flying festival who were admitted in department of Neurosurgery on the occasion this year in January. Patients & Methods: A total of 46 traumatic brain injured patients was admitted under Neurosurgery Services that day, out of which 18 cases were related to kite flying related injury. Data of these 18 patients were analysed and outcome were measured at discharge. Result: kite flying festival related neurotrauma increase 39% more emergency admission burden as compared to routine days in neuro-emergency ward. Most common cause of head injury among them was fall from roof. Majority of them had mild head injury. Associated injuries to other part of body were present in 46% patients. Conclusion: Children were most affected due to unsupervised kite flying on roof and road side catching of kites. Depressed fracture was commonest type of traumatic brain injury. Strict attention to safety measures and parental supervision while flying kites can avoid many preventable injuries to life

Cerebellar pilomyxoid astrocytoma

Pilomyxoid astrocytomas (P.M.A) are new class of Pilocytic Astrocytoma (P.A.) which typically have their origin in hypothalamus and chiasmatic region. There are very few case reports of PMAs arising from cerebellum. Their imaging features are similar to PA but they behave more aggressively than PA. The authors report a case of 10 year old male child who presented with right cerebellar tumour diagnosed as PMA on histopathology

Isolated thoracic intramedullary epidermoid cyst - a rare entity

Intramedullary epidermoid cysts of the spinal cord are rare tumours, especially those not associated with spinal dysraphism. Around 60 cases have been reported in the literature. Of these, only 10 cases have had magnetic resonance imaging (MRI) studies. Here, we report a case of isolated intramedullary epidermoid tumour at D2-D3 level. The etiology, pathology, clinical features, MRI characteristics and surgical treatment of such rare intramedullary tumours are discussed