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Mishra A, Agrawal D, Gupta D, Sinha S, Satyarthee GD, Singh PK. Traumatic spondyloptosis: a series of 20 patients. J Neurosurg Spine 2015; 22:647-52. [PMID: 25768668 DOI: 10.3171/2014.10.spine1440] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Spondyloptosis represents the most severe form of spondylolisthesis, which usually follows high-energy trauma. Few reports exist on this specific condition, and the largest series published to date consists of only 5 patients. In the present study the authors report the clinical observations and outcomes in a cohort of 20 patients admitted to a regional trauma center for severe injuries including spondyloptosis. METHODS The authors performed a retrospective chart review of patients admitted with spondyloptosis at their department over a 5-year period (March 2008-March 2013). Clinical, radiological, and operative details were reviewed for all patients. RESULTS In total, 20 patients with spondyloptosis were treated during the period reviewed. The mean age of the patients was 27 years (range 12-45 years), and 17 patients were male (2 boys and 15 men) and 3 were women. Fall from height (45%) and road traffic accidents (35%) were the most common causes of the spinal injuries. The grading of the American Spinal Injury Association (ASIA) was used to assess the severity of spinal cord injury, which for all patients was ASIA Grade A at the time of admission. In 11 patients (55%), the thoracolumbar junction (T10-L2) was involved in the injury, followed by the dorsal region (T1-9) in 7 patients (35%); 1 patient (5%) had lumbar and 1 patient (5%) sacral spondyloptosis. In 19 patients (95%), spondyloptosis was treated surgically, involving the posterior route in all cases. In 7 patients (37%), corpectomy was performed. None of the patients showed improvement in neurological deficits. The mean follow-up length was 37.5 months (range 3-60 months), and 5 patients died in the follow-up period from complications due to formation of bedsores (decubitus ulcers). CONCLUSIONS To the authors' best knowledge, this study was the largest of its kind on traumatic spondyloptosis. Its results illustrate the challenges of treating patients with this condition. Despite deformity correction of the spine and early mobilization of patients, traumatic spondyloptosis led to high morbidity and mortality rates because the patients lacked access to rehabilitation facilities postoperatively.
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Satyarthee GD, Borkar S, Tripathi A, Sharma BS. Transorbital penetrating cerebral injury with a ceramic stone: Report of an interesting case. Neurol India 2009; 57:331-3. [DOI: 10.4103/0028-3886.53285] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sinha S, Raheja A, Garg M, Moorthy S, Agrawal D, Gupta DK, Satyarthee GD, Singh PK, Borkar SA, Gurjar H, Tandon V, Pandey RM, Sharma BS. Decompressive craniectomy in traumatic brain injury: A single-center, multivariate analysis of 1,236 patients at a tertiary care hospital in India. Neurol India 2015; 63:175-83. [PMID: 25947980 DOI: 10.4103/0028-3886.156277] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECT To evaluate the outcome of patients undergoing a decompressive craniectomy (DC) in traumatic brain injury (TBI) and the factors predicting outcome. MATERIALS AND METHODS A total of 1,236 patients with TBI operated with a DC from January 2008 to December 2013 at a tertiary care hospital were included in the study. The data from the hospital computerized database was retrospectively analyzed and 324 (45%) patients were followed-up for a mean duration of 25.3 months (range 3-42 months) among the cohort of 720 alive patients. The institute's ethical committee clearance was obtained before the start of the study. RESULTS There were 81% males with a median age [interquartile range (IQR)] of 32 (23-45) years. The mortality rate and median (IQR) Glasgow outcome score (GOS) at discharge in patients presenting with minor, moderate, and severe head injury were 18%, 5 (4-5); 28%, 4 (1-5); and 47.4%, 2 (1-4), respectively. An overall favorable outcome (GOS 4 and 5) at discharge was observed in 46.5% patients and in 39% patients who presented with severe TBI. Only 7.5% patients were in a persistent vegetative state (PVS), while 78% had an overall favorable outcome at the last follow-up of surviving patients (P < 0.001). On multivariate analysis, the factors predictive of a favorable GOS at discharge were: a younger age (odds ratio (OR) 1.03, confidence interval (CI) = 1.02-1.04; P < 0.001), no pupillary abnormalities at admission (OR 2.28, CI = 1.72-3.02; P < 0.001), absence of preoperative hypotension (OR 1.91, CI = 1.08-3.38; P = 0.02), an isolated TBI (OR 1.42, CI = 1.08-1.86; P = 0.01), absence of a preoperative infarct (OR 3.68, CI = 1.74-7.81; P = 0.001), presence of a minor head injury (OR 6.33, CI = 4.07-9.86; P < 0.001), performing a duraplasty (OR 1.86, CI = 1.20-2.87; P = 0.005) rather than a slit durotomy (OR 3.95, CI = 1.67-9.35; P = 0.002), and, avoidance of a contralateral DC (OR 3.58, CI = 1.90-6.73; P < 0.001). CONCLUSIONS The severity of head injury, performing a duraplasty rather than a slit durotomy, avoidance of a contralateral DC, and the presence of preoperative hypotension, infarct, and/or pupillary asymmetry have the highest odds of predicting the short term GOS at the time of discharge, after a DC in patients with TBI. Although DC carries a high risk of mortality, the probability of the survivors having a favorable outcome is significantly more as compared to those who remain in a PVS.
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Agrawal D, Ahmed S, Khan S, Gupta D, Sinha S, Satyarthee GD. Outcome in 2068 patients of head injury: Experience at a level 1 trauma centre in India. Asian J Neurosurg 2016; 11:143-5. [PMID: 27057220 PMCID: PMC4802935 DOI: 10.4103/1793-5482.145081] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is one of the leading causes of death. Evidence-based guidelines for TBI care have been widely discussed, but in-hospital treatment and outcome of these patients has been highly variable especially in developing countries like India. OBJECTIVES To evaluate the epidemiology and outcome of patients with head injuries at a Level 1 trauma center in India. MATERIALS AND METHODS In this retro-prospective study, all patients with head injury who were admitted in the department of neurosurgery over a 15 months period (November 2007-January 2009) were included in the study. Post-resuscitation GCS was used for categorizing the severity of head injuries and outcome was assessed at discharge using GOS. All patients were managed as per laid down departmental protocols. RESULTS A total of 2068 patients of head injury were admitted during the study period. The mean age was 24 years (range 1-85). 71.4% were male and 28.6% were female. The most commonly involved age group was 20-40 years (43%) and the most common mode of injury was road traffic accidents (64%). 53% of the patients had severe head injury (GCS ≤ 8), 18% had moderate head injury (GCS 9 ≤ 13) and 29% had minor head injuries (GCS ≥ 14). The mean hospital stay was 14 days (range 1-62 days). Overall in-hospital mortality was 22% (454 cases). 39% died within 48 hours of injury. 2% of minor, 12% of moderate and 36% of severe head injured patients expired; Mortality was 38% in children (≤12 years). Amongst those who survived, 45% had good outcome (GOS 4 or 5), 13% were severely disabled (GOS 3) and 19% were vegetative (GOS 2). CONCLUSIONS This is the one of the largest single center study on severe head injuries and shows enormity of the problem facing developing countries like India.
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Satyarthee GD, Mahapatra AK. Tension pneumocephalus following transsphenoid surgery for pituitary adenoma - report of two cases. J Clin Neurosci 2003; 10:495-7. [PMID: 12852895 DOI: 10.1016/s0967-5868(03)00087-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Occurrence of symptomatic pneumocephalus following transsphenoid surgery is a rare event. Two cases of symptomatic pneumocephalus were observed in our series of 480 transsphenoidal surgeries. The first case reported presented with a head injury 4 years earlier and had a left frontotemporal haematoma evacuation. He underwent surgery for sellar mass extending into suprasellar region. He developed postoperative CSF rhinorrhea and in spite of conservative therapy, developed progressive visual deterioration necessitating a re-exploration and repair leading to resolution of the neurological deficits. The second case presented with delayed CSF rhinorrhea leading to rapid alteration in sensorium, requiring external ventricular drainage. The leak subsided without any further surgical intervention.
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Case Reports |
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Satyarthee GD, Mahapatra AK. Pituitary apoplexy in a child presenting with massive subarachnoid and intraventricular hemorrhage. J Clin Neurosci 2006; 12:94-6. [PMID: 15639425 DOI: 10.1016/j.jocn.2003.10.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2003] [Accepted: 10/29/2003] [Indexed: 11/28/2022]
Abstract
A case of pituitary apoplexy in a child with massive subarachnoid and intraventricular hemorrhage is reported. The patient presented with a sudden onset of headache, diminution of visual acuity and a bitemporal visual field defect. Computerized tomography revealed a massive subarachnoid hemorrhage with extension of blood into the third ventricle. Angiography did not show an aneurysm. The patient was operated on and altered blood within a necrotic pituitary adenoma was decompressed. His vision and field defect improved along with resolution of headache in the postoperative period.
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Satyarthee GD, Mahapatra AK. Craniofacial surgery for giant frontonasal encephalocele in a neonate. J Clin Neurosci 2002; 9:593-5. [PMID: 12383426 DOI: 10.1054/jocn.2001.1114] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A 5-day-old neonate with a frontonasal encephalocele is reported. He was referred to our institute with a swelling on the glabella not associated with cerebrospinal fluid (CSF) leak. The baby was the first born of a non-consanguinous marriage. The baby had a swelling over the glabella, 7 cm in diameter. The swelling had healthy covering with a raw area at the centre without any CSF leak. A magnetic resonance imaging scan showed a soft tissue swelling containing tissue iso-intense to normal brain. The internal bony defect was at the junction of the frontal and ethmoid bones, in front of the crista galii, in the floor of the anterior cranial fossa. The baby was operated on the 11th day after birth. A one-stage repair of encephalocele was performed, along with correction of hypertelorism and reconstruction of the nasal bridge. The postoperative period was unremarkable. The baby was discharged from hospital on the 10th postoperative day.
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Case Reports |
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Satyarthee GD, Mahapatra AK. Unusual neuro-ophthalmic presentation of anterior communicating artery aneurysm with third nerve paresis. J Clin Neurosci 2004; 11:776-8. [PMID: 15337148 DOI: 10.1016/j.jocn.2003.11.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2003] [Accepted: 11/14/2003] [Indexed: 11/24/2022]
Abstract
Paresis of the oculomotor nerve associated with subarachnoid haemorrhage is considered a hallmark of aneurysms located at the junction of the internal carotid artery and posterior communicating artery. Third nerve palsy can also be caused by those aneurysms located in the intracavernous part of the internal carotid artery, basilar artery, posterior cerebral artery and superior cerebellar artery. However, oculomotor nerve paresis caused by an anterior communicating artery aneurysm is a very uncommon occurrence. We report a case of an elderly female with sudden severe headache who developed an acute third nerve paresis. Angiography revealed an anterior communicating artery aneurysm. Management and the pertinent literature are reviewed along with the mechanism of third nerve compression.
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Satyarthee GD, Mehta VS, Vaishya S. Ganglioglioma of the spinal cord: Report of two cases and review of literature. J Clin Neurosci 2004; 11:199-203. [PMID: 14732385 DOI: 10.1016/s0967-5868(03)00124-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Ganglioglioma can involve any part of the central nervous system. Mostly ganglioglioma occur in temporal lobe. Spinal cord ganglioglioma is a very rare entity. We report two cases of cervico-dorsal region ganglioglioma, who underwent complete surgical excision. In the postoperative period they had transient deterioration of their neurological status that gradually recovered with follow-up.
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Borkar SA, Tripathi AK, Satyarthee GD, Rishi A, Kale SS, Sharma BS. Fronto-orbital intradiploic transitional meningioma. Neurol India 2009; 56:205-6. [PMID: 18688153 DOI: 10.4103/0028-3886.42006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Letter |
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Agrawal D, Gupta D, Mahapatra AK, Ailawadhi P, Satyarthee GD, Sinha S. Use of O-arm for spinal surgery in academic institution in India: Experience from JPN apex trauma centre. Neurol India 2011; 59:590-3. [DOI: 10.4103/0028-3886.84343] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Prasad GL, Borkar SA, Satyarthee GD, Mahapatra AK. Split cord malformation with dorsally located bony spur: Report of four cases and review of literature. J Pediatr Neurosci 2013; 7:167-70. [PMID: 23559998 PMCID: PMC3611900 DOI: 10.4103/1817-1745.106469] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Split cord malformations (SCM) with a dorsally located bony spur are a very rare entity. The authors report a series of four such cases. The literature is reviewed regarding the pathogenesis and management of this uncommon variant of SCM. The presenting features include - scoliosis with motor and autonomic dysfunction (n = 1), scoliosis with cutaneous patch (n = 1), hypertrichotic area (n = 1), and motor deficits alone (n = 1). The location of spur was thoracic and lumbar in two patients (50%) each. Low-lying conus was present in three patients. Long segment syrinx was present in one patient. With respect to the bony anomalies, two patients had a hypertrophied posterior arch (HPA) and one patient had a dysraphic spine. All patients underwent surgical excision of the spur with detethering, if a low-lying conus was present. Two patients developed transient worsening of the neurological status after surgery which recovered at the time of the last follow-up; in both these patients, there was a HPA and a low-lying conus. Surgical excision of the spur with detethering of filum, in cases of low-lying conus, is the treatment of choice. Risk of post-operative worsening of the neurological status is increased in cases in which there is concomitant presence of HPA.
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Agrawal D, Joshua SP, Gupta D, Sinha S, Satyarthee GD. Can glasgow score at discharge represent final outcome in severe head injury? J Emerg Trauma Shock 2012; 5:217-9. [PMID: 22988398 PMCID: PMC3440886 DOI: 10.4103/0974-2700.99685] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Accepted: 12/24/2011] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Patients with head injury continue to improve over time and a minimum follow-up of six months is considered necessary to evaluate outcome. However, this may be difficult to assess due to lack of follow-up. It is also well known that operated patients who return for cranioplasty usually have the best outcome. AIMS AND OBJECTIVES To assess the outcome following severe head injury using cranioplasty as a surrogate marker for good outcome. MATERIALS AND METHODS This was a retrospective study carried out from January 2009 to December 2010. All patients with severe head injury who underwent decompressive craniectomy (DC) in the study period were included. Patients who came back for cranioplasty in the same period were also included. Case records, imaging and follow up visit data from all patients were reviewed. Glasgow Coma Score (GCS) on admission and Glasgow Outcome Score (GOS) at discharge were assessed. OBSERVATIONS AND RESULTS Of the 273 patients, 84.25% (n=230) were males and 15.75% (n= 43) were females. The mean age was 34.3 years (range 2-81 years, SD 16.817). The mean GCS on admission was 5.615 (range 3-8, SD 1.438). The in-hospital mortality was 54% (n=149). Good outcome (GOS of 4 or 5) at discharge was attained in 22% (n=60) patients. Sixty five patients returned for cranioplasty (with a GOS of 4 or 5) during the study period. There was no statistical difference in the number of patients discharged with good outcome and those coming back for cranioplasty in the study period (P>0.5). Patients who came back for cranioplasty were younger in age (mean age 28.815 years SD 13.396) with better admission GCS prior to DC (mean GCS 6.32 SD1.39). CONCLUSIONS In operated severe head injury patients significant number of patients (24% in our study) have excellent outcome. However, insignificant number of patients had further improvement to GOS 4 or 5 (good outcome) from the time of initial discharge. This suggests that due to lack of intensive rehabilitative facilities, GOS at discharge may be representative of final outcome in the vast majority of cases of severe head injury in developing countries like India.
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Kumar A, Mahapatra AK, Satyarthee GD. Congenital spinal lipomas: Role of prophylactic surgery. J Pediatr Neurosci 2012; 7:85-9. [PMID: 23248681 PMCID: PMC3519090 DOI: 10.4103/1817-1745.102562] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Congenital spinal lipomas constitute an important group of lesions causing tethered cord syndrome. Management of these lesions is challenging and role of prophylactic surgery for these lesions is still controversial. Hence, current study was undertaken with the aim to evaluate the role of prophylactic surgery in the management of these lesions. MATERIALS AND METHODS A total of 147 consecutive patients, treated over a period of 10 years (January 2001-December 2010), are retrospectively analyzed. RESULTS In our study, 93 patients had conus lipomas, 26 had filum lipomas and 28 had only lipomeningomyelocele. Boys and girls were almost equally represented. The age of patients at the time of surgery ranged from 15 days to 34 years with an average of 62 months (5.2 years). Neurological deficits were present in 101 (68) patients. The patients with neurological deficits were older in comparison to those neurologically intact (average age 6.2 versus 2.8 years, respectively). Difference in age between the two groups was statistically significant (P value 0.03). Neurological deterioration was observed in 8 (5) patients following surgery, out of which six patients developed transient deterioration and only two, had persisting deficits. None of the neurologically asymptomatic patients developed persistent neurological deficits. In the symptomatic group, nine patients (9) showed improvement in neurological status after surgery. CONCLUSIONS In author's view, prophylactic surgery for congenital spinal lipomas is safe and effective. However, a well designed randomized controlled trial, to definitely and objectively prove the usefulness of prophylactic surgery is needed.
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Abstract
Tuberculoma involving the sellar and suprasellar region is extremely rare. Sellar region tuberculoma usually presents with endocrinopathy of hypofunction, rarely hyperfunction or normal function of the anterior pituitary. However, sellar-suprasellar tuberculoma presenting with diabetes insipidus (DI) is very rare. We report the case of a 32 year old housewife presenting with DI and secondary amenorrhea, who had a sellar-suprasellar mass on MRI. She underwent a transnasal transsphenoidal surgical removal of the pituitary mass, which was tubercular in nature on histology. She received antitubercular treatment and hormonal replacement therapy. She was well at last follow-up, 3 years after surgery.
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Case Reports |
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Satyarthee GD, Mahapatra AK. Presacral neurenteric cyst in an infant. Pediatr Neurosurg 2003; 39:222-4. [PMID: 12944706 DOI: 10.1159/000072477] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2002] [Accepted: 04/17/2003] [Indexed: 11/19/2022]
Abstract
Intraspinal neurenteric cysts are rare congenital cystic lesions, formed due to displacement of elements forming the alimentary canal. We report an 11-month-old infant presenting with a soft, fluctuant and transilluminant swelling posterior to the anus since birth; the size of the swelling varied with alterations in intraspinal pressure subsequent to crying, coughing, or sneezing. MRI showed a multiloculated lesion anterior to the sacrum and coccyx. Near total excision was carried out without any worsening in the neurological status.
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Case Reports |
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Satyarthee GD, Mahapatra AK. Unusual presentation of petro-clival chondrosarcoma: short report. J Clin Neurosci 2008; 11:539-42. [PMID: 15177406 DOI: 10.1016/j.jocn.2003.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2002] [Accepted: 07/17/2003] [Indexed: 11/22/2022]
Abstract
Skull base chondrosarcoma is a rare neoplasm. Our patient presented with acute onset of diplopia along with symptoms of lower cranial nerve palsies in 1997. She showed complete resolution of symptoms following a short course of antibiotics and remained quiescent for three years. However, remission of symptoms in chondrosarcoma is unusual. An unusual case of a patient with petroclival low grade chondrosarcoma, who presented with relapse of symptoms after three years and was treated with surgery and radiotherapy, is presented.
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Agrawal D, Sahoo S, Satyarthee GD, Gupta D, Sinha S, Misra MC. Initial experience with mobile computed tomogram in neurosurgery intensive care unit in a level 1 trauma center in India. Neurol India 2012; 59:739-42. [PMID: 22019661 DOI: 10.4103/0028-3886.86551] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Neurosurgical patients, in particular patients with severe head injury require frequent computed tomogram (CT) of the head, usually at short notice. A mobile CT may prove to be invaluable for these patients. This report reviews the initial experience with a mobile CT at tertiary trauma center. A total of 1292 head CT scans were done during 9 months study period with an average of 4.78 CT scans for day. Of the 563 patients in whom the detailed prospective data was available, 456 (81%) patients were on ventilator, 450 (80%) patients were on sedation, and 37 (6.5%) patients were on ionotropic support at the time of doing CT scan. The mean Glasgow Coma Scale score at the time of CT was 8.1 (range 3-15). The average time to do a CT scan (from time of request to transmission into picture archiving and communication system) was 12.6 min (range 7.8-47 min). Image quality was judged to be excellent by all the neurosurgical faculty in the intensive care unit. During the study period, the main CT scanner broke down four times (for variable time periods) and the mobile CT scanner could manage the load of severe head injured patients in the casualty without any problems. The mobile CT machine itself broke down 36 times and the mean response time was 12.5 h (range 1-144 h) during each breakdown point. This experience suggests that mobile CT is extremely useful in the management of patients with severe traumatic brain injury and can be recommended for any high-volume neurosurgery department in the country.
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Satyarthee GD, Sharma BS, Borkar S. Conus ependymoma with holocord syringomyelia. Neurol India 2009; 57:353-4. [DOI: 10.4103/0028-3886.53271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Satyarthee GD, Chipde H. Diencephalic Syndrome as Presentation of Giant Childhood Craniopharyngioma: Management Review. J Pediatr Neurosci 2018; 13:383-387. [PMID: 30937076 PMCID: PMC6413612 DOI: 10.4103/jpn.jpn_179_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Diencephalic syndrome (DES) is an extremely uncommon occurrence, and approximately 100 cases have been reported. It presents as a failure to thrive in infants and children but rarely occurs in adult population. The characteristic clinical features of DES include severely emaciated body, normal linear growth and normal or precocious intellectual development, hyperalertness, hyperkinesis, and euphoria usually associated with intracranial sellar–suprasellar mass lesion, usually optico-chiasmatic glioma or hypothalamic mass. DES as a presentation of craniopharyngioma is extremely uncommon but can also occur with brain stem mass. Detailed PubMed and MEDLINE search for craniopharyngioma associated with DES yielded only six cases in children below 6 years of age. Thus, we reviewed a total of seven cases including previously published six cases and added additional our own case. Overall, the mean age at diagnosis was 4.15 years with male:female ratio of 4:3, the mean time interval between symptom of DES appearance and final diagnosis was 6.6 months. The most commonly observed symptom of DES was weight loss (85%). The clinical feature, imaging, and management of such rare syndrome along with pertinent literature are briefly reviewed.
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Review |
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Kumar A, Varshney G, Singh PK, Agrawal D, Satyarthee GD, Chandra PS, Kale SS, Mahapatra AK. Traumatic Atlantoaxial Spondyloptosis Associated with Displaced Odontoid Fracture: Complete Reduction via Posterior Approach Using “Joint Remodeling” Technique. World Neurosurg 2018; 110:609-613. [DOI: 10.1016/j.wneu.2017.09.097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/11/2017] [Accepted: 09/13/2017] [Indexed: 01/04/2023]
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Gupta DK, Satyarthee GD, Sharma MC, Mahapatra AK. Hypothalamic glioma presenting with seizures. a case report and review of the literature. Pediatr Neurosurg 2006; 42:249-53. [PMID: 16714868 DOI: 10.1159/000092364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2005] [Accepted: 10/02/2005] [Indexed: 11/19/2022]
Abstract
A rare case of hypothalamic glioma in a 7-year-old boy presenting with seizures and diabetes insipidus is reported. Near total decompression of the hypothalamic glioma was done successfully using subfrontal approach. The patient had a stormy postoperative course due to status epilepticus but went on to make a complete recovery. Postoperative radiotherapy/chemotherapy was not given in view of tumor histology (low grade glioma), patient's age and tumor location. Patient remains symptom and seizure free on antiepileptics at 3-year follow-up. The case is presented in the light of its rarity and the literature is reviewed.
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Case Reports |
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Bora S, Kumar A, Mishra S, Satyarthee GD, Singh PK, Sawarkar D, Verma S, Borkar S, Sharma R, Chandra SP, Kale SS. Intracranial aspergillosis amongst immunocompetent patients: An experience with combined surgical and medical management of 18 patients. Clin Neurol Neurosurg 2019; 186:105511. [PMID: 31505434 DOI: 10.1016/j.clineuro.2019.105511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/28/2019] [Accepted: 09/02/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Fungal infections of central nervous system (CNS) commonly affect immunocompromised patients, however, recently such cases have been reported even amongst immunocompetent patients. PATIENTS & METHODS In this study, we retrospectively analyzed outcome of 18 immunocompetent patients with histopathologically proven intracranial Aspergillosis undergoing combined surgical and medical management. RESULTS The age of patients ranged from 5-65 years. Fourteen out of 18 patients had well defined lesions while 4 had diffuse disease. Paranasal sinuses were involved in 8 & cavernous sinus in 3 patients. Six patients had hydrocephalus. Four patients developed infarcts during their clinical course. Surgical interventions included gross (n = 4) or subtotal excision (n = 8), decompressive craniectomy & biopsy of lesion (n = 4), biopsy only (n = 2) and ventriculoperitoneal shunt placement (n = 6). All patients received postoperative antifungal therapy. The duration of follow up ranged from 10-60 months. Overall mortality was 44.4%. Mortality amongst patients undergoing gross total and subtotal excision was 25% & 50% respectively. Patients undergoing DC had a mortality of 25%. Both patients undergoing only biopsy died. Hydrocephalus was associated with a very high mortality (83.3%). Amongst surviving patients (n = 10), 6 patients became disease free & rest 4 had stable disease at last follow up. CONCLUSIONS Intracranial aspergillosis is associated with high morbidity & mortality even amongst immunocompetent patients. An aggressive multidisciplinary management is thus needed to improve outcome. Our study shows that a combination of surgical excision or decompressive craniectomy and antifungal therapy can be helpful in improving prognosis of these patients.
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Journal Article |
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Borkar SA, Satyarthee GD, Das P, Suri V. Isolated brain metastasis from malignant melanoma of choroid seven years following enucleation. Neurol India 2009; 57:92-4. [PMID: 19305092 DOI: 10.4103/0028-3886.48798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Letter |
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Moscote-Salazar LR, Koller O, Valenzuela S, Narvaez-Rojas A, Satyarthee GD, Mo-Carrascal J, Maraby J. Neurosurgical Implications of Osteogenesis Imperfecta in a Child after Fall: Case Illustration. J Pediatr Neurosci 2018; 13:459-461. [PMID: 30937089 PMCID: PMC6413607 DOI: 10.4103/jpn.jpn_9_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Osteogenesis imperfecta (OI) is a group of hereditary genetic pathologies of connective tissue, which is characterized by bone fragility and fractures. It is classified into types I, II, III, IV, V, and VI. The disorder is caused by an autosomal-dominant mutation in one of the two genes that encode the alpha chains of type I collagen, COL1A1 and COL1A2. Several central nervous system abnormalities have been described in children with OI, however, it has been through various case reports. The neurological abnormalities that have been described are macrocephaly, ventriculomegaly, myelopathy, cranial neuropathy, basilar invagination, obstructive hydrocephalus, cranial fractures, and intracranial hemorrhage. In this report, we describe the clinical case of a child with parietal fracture; the main objective of this work being to show one of the several neurological implications that children with OI can present, and their implications for the pediatric neurosurgeons as neurosurgical complications are very frequent.
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Case Reports |
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