R. Arora, Jitendra Shakya, Rajkumar Pannem, Suresh Sharma, S. Sadhasivam, V. Rawat, Rajashekhar Rekhapalli, R. Sihag, R. Mittal
Abstract Objective The COVID-19 pandemic has challenged the basic functioning of the health care system. There has been an adverse impact on non-COVID-19 patients due to a shift in healthcare delivery, which is underreported. This study aims to explore the impact of the pandemic on various aspects of non-COVID neurosurgical patients. Methods This descriptive cross-sectional study was conducted with a structured questionnaire to assess the physical, economic, and psychological impacts of the COVID-19 pandemic and lockdown measures on neurosurgical patients presenting to our hospital after a nationwide lockdown. Results Among 203 patients, non-neurotrauma and neurotrauma cases were 175 (86%) and 28 (16%), respectively. Among non-neurotrauma patients, 130 (64%) patients had cranial pathology. All 56 (27.6%) preoperative patients experienced rescheduling of surgery. Among 52 postsurgical patients, 47 (90%) had their adjuvant therapy delayed. Forty patients experienced deterioration in their neurological symptoms. Seventy-six (37%) patients sought medical attention from private hospitals. A severe contraction of income (≥ 25% of the income before lockdown) was experienced by families of 29 (14.3%) patients. Severe and very severe stress have been experienced by 24 (11.8%) and 14 (6.9%) patients, respectively. Severe and very severe anxiety was experienced by 32 (15.8%) and 9 (4.4%) patients. Conclusion The COVID-19 pandemic and nationwide lockdown had a tremendous impact on the physical, social, and psychological well-being of patients with non-COVID illnesses. We are yet to face the long-term implications of the delay due to this pandemic in scheduled surgical and adjuvant treatments of non-COVID neurosurgical patients.
{"title":"Impact of the COVID-19 Pandemic and Lockdown on Non-COVID Neurosurgical Patients: Lessons Learned","authors":"R. Arora, Jitendra Shakya, Rajkumar Pannem, Suresh Sharma, S. Sadhasivam, V. Rawat, Rajashekhar Rekhapalli, R. Sihag, R. Mittal","doi":"10.1055/s-0042-1757203","DOIUrl":"https://doi.org/10.1055/s-0042-1757203","url":null,"abstract":"Abstract Objective The COVID-19 pandemic has challenged the basic functioning of the health care system. There has been an adverse impact on non-COVID-19 patients due to a shift in healthcare delivery, which is underreported. This study aims to explore the impact of the pandemic on various aspects of non-COVID neurosurgical patients. Methods This descriptive cross-sectional study was conducted with a structured questionnaire to assess the physical, economic, and psychological impacts of the COVID-19 pandemic and lockdown measures on neurosurgical patients presenting to our hospital after a nationwide lockdown. Results Among 203 patients, non-neurotrauma and neurotrauma cases were 175 (86%) and 28 (16%), respectively. Among non-neurotrauma patients, 130 (64%) patients had cranial pathology. All 56 (27.6%) preoperative patients experienced rescheduling of surgery. Among 52 postsurgical patients, 47 (90%) had their adjuvant therapy delayed. Forty patients experienced deterioration in their neurological symptoms. Seventy-six (37%) patients sought medical attention from private hospitals. A severe contraction of income (≥ 25% of the income before lockdown) was experienced by families of 29 (14.3%) patients. Severe and very severe stress have been experienced by 24 (11.8%) and 14 (6.9%) patients, respectively. Severe and very severe anxiety was experienced by 32 (15.8%) and 9 (4.4%) patients. Conclusion The COVID-19 pandemic and nationwide lockdown had a tremendous impact on the physical, social, and psychological well-being of patients with non-COVID illnesses. We are yet to face the long-term implications of the delay due to this pandemic in scheduled surgical and adjuvant treatments of non-COVID neurosurgical patients.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"49 1","pages":"202 - 209"},"PeriodicalIF":0.2,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86723956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bilateral internal carotid artery (ICA) hypoplasia is a rare congenital anomaly. Their actual incidence is higher than what is reported as majority of them remains asymptomatic during lifetime. 1 It is important to differentiate congenital ICA hypoplasia from acquired causes of ICA stenosis like moyamoya disease. The most conclusive differentiating point is the size of the carotid canal that in congenital cases cannot be clearly made out. 2 Further unlike the supraclinoid stenosis of ICA in moyamoya disease, ICA hypoplasia here is much more proximal just distal to its point of origin. 3 Our case was a 27-year-old primigravida, who presented with severe headache. No other relevant positive points were there in the history. Clinical examination revealed neck rigidity. She was conscious, alert, oriented with no de fi cits. Computed tomographic (CT) brain showed extensive intra ventricular hemorrhage involving the lateral and third ventricles, specks of blood in the basal cisterns, and mild hydrocephalus. Bone windows revealed bilateral atretic carotid canals ( ► Fig. 1 ). CT angiography revealed hypoplasia of bilateral ICA that were only 1 to 1.5 mm in diameter and ended in string like structures on both sides. An aneurysm was seen arising from the distal cortical branches of the right P4 segment of posterior cerebral artery (PCA) ( ► Fig
{"title":"Bilateral Hypoplasia of the Internal Carotid Artery with Subarachnoid Hemorrhage and Distal Posterior Cerebral Artery Aneurysm","authors":"Pushpraj Patil, P. Sarma","doi":"10.1055/s-0042-1756506","DOIUrl":"https://doi.org/10.1055/s-0042-1756506","url":null,"abstract":"Bilateral internal carotid artery (ICA) hypoplasia is a rare congenital anomaly. Their actual incidence is higher than what is reported as majority of them remains asymptomatic during lifetime. 1 It is important to differentiate congenital ICA hypoplasia from acquired causes of ICA stenosis like moyamoya disease. The most conclusive differentiating point is the size of the carotid canal that in congenital cases cannot be clearly made out. 2 Further unlike the supraclinoid stenosis of ICA in moyamoya disease, ICA hypoplasia here is much more proximal just distal to its point of origin. 3 Our case was a 27-year-old primigravida, who presented with severe headache. No other relevant positive points were there in the history. Clinical examination revealed neck rigidity. She was conscious, alert, oriented with no de fi cits. Computed tomographic (CT) brain showed extensive intra ventricular hemorrhage involving the lateral and third ventricles, specks of blood in the basal cisterns, and mild hydrocephalus. Bone windows revealed bilateral atretic carotid canals ( ► Fig. 1 ). CT angiography revealed hypoplasia of bilateral ICA that were only 1 to 1.5 mm in diameter and ended in string like structures on both sides. An aneurysm was seen arising from the distal cortical branches of the right P4 segment of posterior cerebral artery (PCA) ( ► Fig","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"239 1","pages":"286 - 288"},"PeriodicalIF":0.2,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75576439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maruti Nandan, A. Patnaik, R. Sahu, Priyadarshi Dikshit, V. Maurya, K. Das, Raj Kumar
Glioblastoma multiforme (GBM) of cerebellar hemisphere is a rare entity and constitutes less than 1% of all the GBMs. The rarity of occurrence leads to significant challenge in differentiating morphologically from other subtypes of glioma in the posterior fossa. Previous studies have suggested that cerebellar GBM occurs in the younger age group as compared with the supratentorial counterpart.Here, we report a case of cerebellar GBM in a young adult and discuss the pathogenesis including radiological and pathological aspects involved in the treatment of cerebellar GBM.
{"title":"Unexpected Prolonged Survival in a Case of Cerebellar GBM: An Interesting Case with Literature Review","authors":"Maruti Nandan, A. Patnaik, R. Sahu, Priyadarshi Dikshit, V. Maurya, K. Das, Raj Kumar","doi":"10.1055/s-0042-1744246","DOIUrl":"https://doi.org/10.1055/s-0042-1744246","url":null,"abstract":"Glioblastoma multiforme (GBM) of cerebellar hemisphere is a rare entity and constitutes less than 1% of all the GBMs. The rarity of occurrence leads to significant challenge in differentiating morphologically from other subtypes of glioma in the posterior fossa. Previous studies have suggested that cerebellar GBM occurs in the younger age group as compared with the supratentorial counterpart.Here, we report a case of cerebellar GBM in a young adult and discuss the pathogenesis including radiological and pathological aspects involved in the treatment of cerebellar GBM.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88118507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Unilateral non-pulsating proptosis can be caused by lesions with intraorbital extensions compressing the globe including sphenoid wing en plaque meningiomas and paranasal sinuses lesions. Patients and Methods We operated on 20 patients with unilateral non-pulsating proptosis using fronto-temporo-orbito-zygomatic (FTOZ) approach with orbital reconstruction in six patients. Eighteen patients had sphenoid wing en plaque meningioma, 1 patient had paranasal sinuses fungal infection with intraorbital and intracranial extension, and 1 patient had frontal sinus dermoid with intraorbital extension. Results Proptosis was corrected in 50% of the patients, improved in 25%, and remained stationary in 25%. Vision improved in three patients, remained stationary in three, and deteriorated in one patient. Two patients had temporary oculomotor ophthalmoplegia that resolved within 3 months. Conclusion Although it is an invasive approach, FTOZ gives excellent exposure of the orbit and anterolateral skull base that allows the excision of intracranial lesions with orbital extension. If needed, the orbit could be reconstructed easily due to excellent exposure.
{"title":"Fronto-Temporo-Orbito-Zygomatic Approach with Orbital Reconstruction in Lesions causing Unilateral Non-pulsating Proptosis","authors":"M. Darwish, A. Moawad","doi":"10.1055/s-0042-1744249","DOIUrl":"https://doi.org/10.1055/s-0042-1744249","url":null,"abstract":"\u0000 Background Unilateral non-pulsating proptosis can be caused by lesions with intraorbital extensions compressing the globe including sphenoid wing en plaque meningiomas and paranasal sinuses lesions.\u0000 Patients and Methods We operated on 20 patients with unilateral non-pulsating proptosis using fronto-temporo-orbito-zygomatic (FTOZ) approach with orbital reconstruction in six patients. Eighteen patients had sphenoid wing en plaque meningioma, 1 patient had paranasal sinuses fungal infection with intraorbital and intracranial extension, and 1 patient had frontal sinus dermoid with intraorbital extension.\u0000 Results Proptosis was corrected in 50% of the patients, improved in 25%, and remained stationary in 25%. Vision improved in three patients, remained stationary in three, and deteriorated in one patient. Two patients had temporary oculomotor ophthalmoplegia that resolved within 3 months.\u0000 Conclusion Although it is an invasive approach, FTOZ gives excellent exposure of the orbit and anterolateral skull base that allows the excision of intracranial lesions with orbital extension. If needed, the orbit could be reconstructed easily due to excellent exposure.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90142045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 30-year-old female patient was diagnosed with right medial sphenoid wing meningioma when she was evaluated for her headache and dizziness. She underwent craniotomy and excision and, biopsy showed grade 1 microcystic meningioma with an MIB-1 labeling index of 1 to 2%. Her follow-up magnetic resonance imaging (MRI) at
{"title":"Recurrent Temporal Meningioma as Exophytic Mass from the External Auditory Canal","authors":"Sundarakrishnan Dharanipathy, Shweta Kedia","doi":"10.1055/s-0042-1757204","DOIUrl":"https://doi.org/10.1055/s-0042-1757204","url":null,"abstract":"A 30-year-old female patient was diagnosed with right medial sphenoid wing meningioma when she was evaluated for her headache and dizziness. She underwent craniotomy and excision and, biopsy showed grade 1 microcystic meningioma with an MIB-1 labeling index of 1 to 2%. Her follow-up magnetic resonance imaging (MRI) at","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"6 2","pages":"184 - 185"},"PeriodicalIF":0.2,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72578224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Turki Elarjani, Othman Bin Alamer, Othman Alhammad
Abstract Background and Study Aim Hydrocephalus is a common disease of the pediatric population, with cerebrospinal fluid diversion as the management of choice. All current insertion techniques require craniometrics calculation that may not be applicable for pediatric patients, due to significant variation in head circumference. We describe a complementary method of inserting ventricular catheters, devoid of craniometrics. Materials and Methods The insertion site is based on two imaginary lines on the sagittal plane (superior and inferior limits) and four imaginary lines on the axial plane of a computed tomography/magnetic resonance imaging. The insertion point is chosen based on the shortest location from the outer table of the bone to the ventricle. The length of catheter insertion is calculated based on the distance between the calvarial outer table and the foramen of Monro. Results Two case examples of ventricular catheter insertions, in pediatric patients with noncommunicating hydrocephalus, are described. External ventricular drain and ventriculoperitoneal shunt were inserted using this technique, with no required craniometrics measurements. Conclusion This complementary method of inserting ventricular catheters can be easily tailored and implemented by junior neurosurgical residents to senior neurosurgeons as it precludes the measurement of the catheter insertion points.
{"title":"Ventricular Catheter Insertion on the Occipital and Parietooccipital Bone: A Nonmetric Complementary Technique","authors":"Turki Elarjani, Othman Bin Alamer, Othman Alhammad","doi":"10.1055/s-0042-1756507","DOIUrl":"https://doi.org/10.1055/s-0042-1756507","url":null,"abstract":"Abstract Background and Study Aim Hydrocephalus is a common disease of the pediatric population, with cerebrospinal fluid diversion as the management of choice. All current insertion techniques require craniometrics calculation that may not be applicable for pediatric patients, due to significant variation in head circumference. We describe a complementary method of inserting ventricular catheters, devoid of craniometrics. Materials and Methods The insertion site is based on two imaginary lines on the sagittal plane (superior and inferior limits) and four imaginary lines on the axial plane of a computed tomography/magnetic resonance imaging. The insertion point is chosen based on the shortest location from the outer table of the bone to the ventricle. The length of catheter insertion is calculated based on the distance between the calvarial outer table and the foramen of Monro. Results Two case examples of ventricular catheter insertions, in pediatric patients with noncommunicating hydrocephalus, are described. External ventricular drain and ventriculoperitoneal shunt were inserted using this technique, with no required craniometrics measurements. Conclusion This complementary method of inserting ventricular catheters can be easily tailored and implemented by junior neurosurgical residents to senior neurosurgeons as it precludes the measurement of the catheter insertion points.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"146 3-4","pages":"071 - 075"},"PeriodicalIF":0.2,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72482210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Spinal tuberculosis (TB) is well studied and described in the literature. It is known to occur anywhere along the transverse plane of the spine. Vertebral TB accounts for less than 1% of all TB infections in the body and more than 50% of musculoskeletal infections. It is considered the most serious type of skeletal TB, with possible neurological symptoms due to compression of neural structures. It may also lead to deformity and significant vertebral structure destruction and instability. Though non-osseous intraspinal extradural tuberculous granulation tissue is reported in several instances, to the best of our knowledge and thorough literature search, the post-laminectomy occurrence of extradural tuberculous granuloma is not reported in the literature so far. Whether it is the reactivation of previously dormant tuberculous infection or naive infection is elusive. Surgical excision and anti-tuberculous therapy is the mainstay of treatment.
{"title":"Post-Laminectomy Non-Osseous Intraspinal Extradural Tuberculous Granulation Tissue: An Undescribed Entity","authors":"Jeyaselva Senthilkumar Thotlampatti Pachiyappan, Sekar Chinnamuthu","doi":"10.1055/s-0042-1744251","DOIUrl":"https://doi.org/10.1055/s-0042-1744251","url":null,"abstract":"Spinal tuberculosis (TB) is well studied and described in the literature. It is known to occur anywhere along the transverse plane of the spine. Vertebral TB accounts for less than 1% of all TB infections in the body and more than 50% of musculoskeletal infections. It is considered the most serious type of skeletal TB, with possible neurological symptoms due to compression of neural structures. It may also lead to deformity and significant vertebral structure destruction and instability. Though non-osseous intraspinal extradural tuberculous granulation tissue is reported in several instances, to the best of our knowledge and thorough literature search, the post-laminectomy occurrence of extradural tuberculous granuloma is not reported in the literature so far. Whether it is the reactivation of previously dormant tuberculous infection or naive infection is elusive. Surgical excision and anti-tuberculous therapy is the mainstay of treatment.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"25 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82018410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Prajapati, Mohd Faheem, S. Kannaujia, Anurag Yadav
Abstract Pilocytic astrocytomas are well-circumscribed, predominantly cystic mass lesions that have a discrete mural nodule. Giant, solid pilocytic astrocytoma is uncommon. Its characteristic imaging features are described.
{"title":"Cervicomedullary Purely Solid, Giant Pilocytic Astrocytoma","authors":"H. Prajapati, Mohd Faheem, S. Kannaujia, Anurag Yadav","doi":"10.1055/s-0042-1757206","DOIUrl":"https://doi.org/10.1055/s-0042-1757206","url":null,"abstract":"Abstract Pilocytic astrocytomas are well-circumscribed, predominantly cystic mass lesions that have a discrete mural nodule. Giant, solid pilocytic astrocytoma is uncommon. Its characteristic imaging features are described.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"2 1","pages":"284 - 285"},"PeriodicalIF":0.2,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83670393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashutosh Roy, S. Jaiswal, A. Bajaj, Awdhesh Yadav, M. Jaiswal, B. Ojha, A. Chandra, C. Srivastava
Abstract Background With an increasing number of cases of COVID-19 disease, the Indian government announced a complete lockdown on March 24, 2020, and the country remained under complete lockdown in April 2020. After ramping up health infrastructure and although cases were on the rise, the lockdown was ordered to gradually lift in May 2020. Methodology It was a retrospective cross-sectional study of all patients admitted to our medical college trauma center in April 2020 and who were compared with April 2019. We studied the prevalence and outcome of road traffic accidents (RTA), assault, and fall from height (FFH) victims admitted to our trauma center. Data were collected using an Excel sheet, and statistical analysis was done using the latest available SSPS software. Results Our study groups included 124 trauma patients from April 2020 as compared with 322 trauma patients from April 2019. The intense lockdown resulted in a decrease in the number of RTA (−72%), FFH (–29%), and assault patients (–7%). There was no statistically significant change in patients' care and management at our center in terms of mortality and morbidity. No Covid-19-positive neurosurgery trauma patients were admitted in April 2020 to our center. Conclusion During the stringent lockdown period of April 2020, there was a significant decrease in the number of trauma victims, especially RTAs. The intense lockdown resulted in a significant decrease in the proportion of trauma victims under the influence of alcohol, head injuries, fractures, and dislocations along with a decrease in the number of cases of assaults and FFH as compared with the unlock period.
{"title":"Effect of Lockdown on Neurosurgery Trauma Patients in a Tertiary Care Hospital in India","authors":"Ashutosh Roy, S. Jaiswal, A. Bajaj, Awdhesh Yadav, M. Jaiswal, B. Ojha, A. Chandra, C. Srivastava","doi":"10.1055/s-0042-1744243","DOIUrl":"https://doi.org/10.1055/s-0042-1744243","url":null,"abstract":"Abstract Background With an increasing number of cases of COVID-19 disease, the Indian government announced a complete lockdown on March 24, 2020, and the country remained under complete lockdown in April 2020. After ramping up health infrastructure and although cases were on the rise, the lockdown was ordered to gradually lift in May 2020. Methodology It was a retrospective cross-sectional study of all patients admitted to our medical college trauma center in April 2020 and who were compared with April 2019. We studied the prevalence and outcome of road traffic accidents (RTA), assault, and fall from height (FFH) victims admitted to our trauma center. Data were collected using an Excel sheet, and statistical analysis was done using the latest available SSPS software. Results Our study groups included 124 trauma patients from April 2020 as compared with 322 trauma patients from April 2019. The intense lockdown resulted in a decrease in the number of RTA (−72%), FFH (–29%), and assault patients (–7%). There was no statistically significant change in patients' care and management at our center in terms of mortality and morbidity. No Covid-19-positive neurosurgery trauma patients were admitted in April 2020 to our center. Conclusion During the stringent lockdown period of April 2020, there was a significant decrease in the number of trauma victims, especially RTAs. The intense lockdown resulted in a significant decrease in the proportion of trauma victims under the influence of alcohol, head injuries, fractures, and dislocations along with a decrease in the number of cases of assaults and FFH as compared with the unlock period.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"81 1","pages":"260 - 264"},"PeriodicalIF":0.2,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78740428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Venkatesh Pothula, Ajay Kumar, Sameer Vyas, V. Bhatia, B. Radotra, S. Gupta
Objectives Consistency of meningioma is important for preoperative planning, surgical resection, and predicting surgical outcomes. We prospectively evaluated the utility of the apparent diffusion coefficient (ADC) values to assess the consistency of meningioma. Methods Preoperative magnetic resonance imaging (MRI) was performed on 23 patients with meningioma before undergoing surgical resection and the average/mean of ADC minimum (ADCmin), maximum (ADCmax), and mean (ADCmean) values were calculated. Intraoperatively, the meningiomas were characterized as firm or soft and correlated with ADC values. Results ADCmin, ADCmax, and ADCmean values of soft and firm meningiomas were significantly different with a p-value of < 0.05. ADCmin value of < 691.3 × 10−6 mm2/s had 80% sensitivity and 84.6% specificity for identifying firm from the soft tumors with the area under the curve (AUC) = 0.862, p-value of 0.004, positive predictive value (PPV) 80, and negative predictive value (NPV) 84.6. ADCmax value of < 933.6 × 10−6 mm2/s had 70% sensitivity and 84.6% specificity for identifying firm from the soft tumors with AUC = 0.823, p-value of 0.009, PPV 77.8, and NPV 78.6. ADCmean value of < 840.8 × 10−6 mm2/s had 90% sensitivity and 76.9% specificity for identifying firm from the soft tumors with AUC = 0.900, p-value of 0.001, PPV 75, and NPV 90.9. Conclusion Diffusion-weighted MRI using ADC minimum, ADC maximum, and ADC mean values can be used to differentiate firm from soft meningiomas. Meningiomas with hard consistency showed relatively low ADC values.
{"title":"Preoperative Assessment and Prediction of Consistency of Intracranial Meningioma Utilizing the Apparent Diffusion Coefficient Values","authors":"Venkatesh Pothula, Ajay Kumar, Sameer Vyas, V. Bhatia, B. Radotra, S. Gupta","doi":"10.1055/s-0042-1750357","DOIUrl":"https://doi.org/10.1055/s-0042-1750357","url":null,"abstract":"\u0000 Objectives Consistency of meningioma is important for preoperative planning, surgical resection, and predicting surgical outcomes. We prospectively evaluated the utility of the apparent diffusion coefficient (ADC) values to assess the consistency of meningioma.\u0000 Methods Preoperative magnetic resonance imaging (MRI) was performed on 23 patients with meningioma before undergoing surgical resection and the average/mean of ADC minimum (ADCmin), maximum (ADCmax), and mean (ADCmean) values were calculated. Intraoperatively, the meningiomas were characterized as firm or soft and correlated with ADC values.\u0000 Results ADCmin, ADCmax, and ADCmean values of soft and firm meningiomas were significantly different with a p-value of < 0.05. ADCmin value of < 691.3 × 10−6 mm2/s had 80% sensitivity and 84.6% specificity for identifying firm from the soft tumors with the area under the curve (AUC) = 0.862, p-value of 0.004, positive predictive value (PPV) 80, and negative predictive value (NPV) 84.6. ADCmax value of < 933.6 × 10−6 mm2/s had 70% sensitivity and 84.6% specificity for identifying firm from the soft tumors with AUC = 0.823, p-value of 0.009, PPV 77.8, and NPV 78.6. ADCmean value of < 840.8 × 10−6 mm2/s had 90% sensitivity and 76.9% specificity for identifying firm from the soft tumors with AUC = 0.900, p-value of 0.001, PPV 75, and NPV 90.9.\u0000 Conclusion Diffusion-weighted MRI using ADC minimum, ADC maximum, and ADC mean values can be used to differentiate firm from soft meningiomas. Meningiomas with hard consistency showed relatively low ADC values.","PeriodicalId":53938,"journal":{"name":"Indian Journal of Neurosurgery","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86117810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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