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Kaur K, Panda NB, Mahajan S, Ram T. Irresistible Laughter-A Rare Presentation of Intracranial Tumor: Irony of Neurocircuitry. Asian J Neurosurg 2024; 19:347-348. [PMID: 38974429 PMCID: PMC11226294 DOI: 10.1055/s-0043-1772767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Affiliation(s)
- Kirandeep Kaur
- Division of Neuroanaesthesia, Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nidhi B. Panda
- Division of Neuroanaesthesia, Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shalvi Mahajan
- Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India
| | - Tulasi Ram
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Stamenović J, Živadinović B, Đurić V. Case report: Unilateral paralysis of the hypoglossal nerve as the only clinical sign of clivus meningioma - a case report and literature review. Front Oncol 2024; 14:1337680. [PMID: 38327744 PMCID: PMC10847574 DOI: 10.3389/fonc.2024.1337680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction Clivus meningiomas are benign tumors that occur at the skull base in the posterior cranial fossa. Symptoms usually progress several months or years before diagnosis and may include: headache, vertigo, hearing impairment, ataxia with gait disturbances, sensory problems. In the neurological findings, paralysis of the lower cranial nerves is most often seen, which in the later course can be accompanied by cerebellar and pyramidal signs until the development of a consciousness impairment. Case presentation We presented the case of a patient who at the time of diagnosis had only unilateral hypoglossal nerve paralysis with dysarthria and mild dysphagia. After the neurosurgical procedure, pathohistological analysis confirmed meningothelial meningioma. Conclusion Early recognition of clivus tumors, which include meningiomas, is necessary in order to implement an adequate therapeutic procedure and prevent further deterioration of the patient's condition.
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Affiliation(s)
- Jelena Stamenović
- Faculty of Medicine, University of Niš, Niš, Serbia
- Neurology Clinic, University Clinical Center Niš, Niš, Serbia
| | - Biljana Živadinović
- Faculty of Medicine, University of Niš, Niš, Serbia
- Neurology Clinic, University Clinical Center Niš, Niš, Serbia
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Ruparelia J, Gosal JS, Kokkula P, Garg M, Bhaskar S, Panda S, Tiwari S, Jha DK, Kaur M, Bhatia PK. The Yin and Yang of Operating on a Posterior Fossa Meningioma: The Schmahmann Syndrome. Neurol India 2022; 70:1661-1664. [PMID: 36076679 DOI: 10.4103/0028-3886.355121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The cerebellum is classically linked with control of motor function, such as coordination, balance, and regulation of movement. There is an increasing awareness, now, of the non-motor functions of the cerebellum, and the occurrence of behavioral anomalies with cerebellar disorders. We present the first report of Schmahmann syndrome (cerebellar cognitive affective syndrome [CCAS]) occurring secondary to posterior fossa meningioma excision. A 35-year-old lady with a posterior fossa meningioma developed an infarct of the right posterosuperior cerebellar hemisphere and ipsilateral superior vermis, following suboccipital craniotomy and tumor resection. Few days after the surgery, she presented with aggressive and emotional behavior, irrelevant talk, and emotional lability. The CCAS scale was administered, and she scored poorly on almost all parameters. A neuropsychological evaluation was also done. The occurrence of CCAS, posterior fossa syndrome (PFS), and behavioral abnormalities like abnormal pathological laughter/crying provides further clinical evidence of the "affective" functions of the cerebellum, modulated mainly by the posterior lobe and vermis of the cerebellum.
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Affiliation(s)
- Jigish Ruparelia
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Jaskaran S Gosal
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Praneeth Kokkula
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Mayank Garg
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Suryanarayanan Bhaskar
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Samhita Panda
- Department of Neurology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Sarbesh Tiwari
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Deepak K Jha
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Manbir Kaur
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Pradeep K Bhatia
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
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Gosal JS, Khatri D, Panda S, Bhaskar S, Das KK. Letter to the Editor: 'The Laughing Disease'-From Kuru to the Joker's Sinister Laugh and Madness. World Neurosurg 2020; 140:453-454. [PMID: 32797971 DOI: 10.1016/j.wneu.2020.05.134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Jaskaran Singh Gosal
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, India.
| | - Deepak Khatri
- Department of Neurosurgery, Lenox Hill Hospital, New York, New York, USA
| | - Samhita Panda
- Department of Neurology, All India Institute of Medical Sciences, Jodhpur, India
| | | | - Kuntal Kanti Das
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Pathological Laughter and Crying in Patients with Brainstem Tumors. World Neurosurg 2019; 126:699. [DOI: 10.1016/j.wneu.2019.02.191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 11/19/2022]
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Gosal JS, Das KK, Behari S. In Reply to "Pathological Laughter and Crying in Patients with Brainstem Tumors". World Neurosurg 2019; 126:700. [PMID: 31546334 DOI: 10.1016/j.wneu.2019.03.154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Jaskaran Singh Gosal
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Kuntal Kanti Das
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
| | - Sanjay Behari
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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