Primary Ewing sarcoma of squamous temporal bone with intracranial extension: A case report

Primary Cranial Ewing sarcoma (ES) is rare and that of temporal bone is even rarer entity. Only a few sporadic cases have been reported and no such case has been reported from Eastern India In this report we describe a case of 18 yrs old male with primary cranial ES of squamous temporal bone involving intracranial and extracranial compartment. The patient presented with swelling in zygomatic fossa and imaging studies showed a mass originating in the right temporal bone. Gross total resection of the tumor was done and sent for histopathological study. The case was referred for radio-chemotherapy and had no recurrence up to eight months of follow up

Expression of isocitrate dehydrogenase 1 and tumor protein 53 in high-grade glioma and its correlation with the outcome – A prospective study at a tertiary care center in India

Background: Central nervous system tumors are the 10th most prevalent cause of mortality worldwide. The 2016 World Health Organization (WHO) classification of high grade gliomas (HGG) has identified Isocitrate dehydrogenase 1 (IDH 1) mutation as one of the primary molecular markers. Tumor protein 53 (p53) mutation is also closely associated with HGG. Aims and Objectives: The current study intended to ascertain the expression of IDH1 and P53 in patients with HGG and correlate that expression with clinical prognosis. Materials and Methods: The study included 34 patients with histopathological proven HGG. Relevant clinical information was recorded. The immunostaining results with anti-mouse monoclonal antibody for IDH 1 (R132H) and rabbit polyclonal antibody for p53 (RP 106-05) were statistically analyzed. Patients were followed up through telephone for a period of 1 year. Mortality within 1 year was regarded as a poor outcome. Results: About 85.29% (29/34) of the patients had Grade IV glioma, while only 14.71% (5/34) had Grade III glioma. Most patients with Grade III (3/5) (60.00%) and Grade IV (21/29) (72.41%) gliomas had p53 positivity. The majority of the patients with grade-III glioma (3/5) (60.00%) had IDH1 positivity, while most of the patients (23/29) (79.31%) with Grade IV gliomas had IDH1 negativity (P=0.0658). Age, gender, WHO grade, and adjuvant therapy did not show significant association with the outcome except for the p53 expression (P=0.0011*) and IDH1 expression (P=0.0025*). Correlation analysis showed a significant positive correlation between p53 makers with poor outcome (r=0.4781) and glioma grade (r=0.4028). Further, a negative yet insignificant correlation was recorded between IDH1 with age (r=−0.2285), p53 expression (r=−0.2568), and grade (r=−0.2988), although it showed a significant correlation with poor outcome (P=0.0001). Conclusion: p53-positive and IDH1-negative HGG had a significant correlation with the poor outcome. Thus, IDH1 and p53 are reliable markers for prognostication of HGG

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

Twist drill craniostomy vs Burr hole craniostomy in chronic subdural hematoma: A randomized study

Aim: To compare two most common operative procedures used in patients with chronic subdural hematomas - Twist drill craniostomy and Burr Hole Craniostomy.Material and Methods: The study was a prospective randomized controlled trial on patients with chronic subdural hematomas.Results: Both procedures are comparable with respect to outcome but surgical duration is statistically higher in Burr Hole craniostomy than Twist Drill Craniostomy.Conclusion: Twist Drill Craniostomy is procedure of choice in emergency surgical situation

The impact of lockdown on incidence of neurosurgery trauma patients in India

Objective: Covid19 pandemic challenged the global healthcare system and both developed and developing countries responded with their might to fight this global pandemic. Road traffic accidents are a major cause of morbidity and mortality in India and we studied the impact of lockdown on neurosurgery trauma patients in a tertiary care centre in India. Methods: Indian government announced complete lockdown on 25th march 2020 and India remained in complete lockdown till 31st May 2020. We included the patients admitted from 1st January 2020 to 24th March 2020 in pre lockdown period and25th march to  In this cross-sectional study we divided the patients into two groups of pre lockdown and lockdown period and incidence of neurosurgery trauma patients was assessed for Road Traffic Accident, assault, hit by animal and fall from height. Result: In our study 491 patients were admitted in pre lockdown and 369 patients were admitted in lockdown period. Road traffic accident patients were more in pre lockdown 39.5% (n=194) as compared to lockdown period 31.2% (n=115). However, cases of assaults were more in the lockdown period (14.6%, n=54) as compared to pre lockdown (3.9%, n=19). The death rate in neurosurgery trauma patients reduced significantly in lockdown (7.3%, n=27) as compared to pre lockdown (21.8%, n=107). Conclusion: The COVID19 pandemic induced lockdown resulted in a decrease in motor vehicle movements which further decreased the incidence of RTA and related trauma however incidence of assault-related trauma and cases increased significantly in this period. The overall outcome of such patients improved probably due to better utilization of available health care facilities

Medulloblastoma and ABO-Rh Blood Group: Evidence of an Association between the Distribution of Blood Group Antigens and Medulloblastoma

Objective Medulloblastoma is the most common central nervous system embryonal tumor and the most common malignant brain tumor of childhood. This study aims to find out the incidence of the ABO-Rh blood group in medulloblastoma patients of northern India to assess the utility of the blood group as a preclinical non-modifiable risk factor