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Papers by Tamajyoti Ghosh

Research paper thumbnail of Recurrence and Functional Outcome Following Resection of Craniopharyngioma

Iran J Neurosurg, 2023

Background and Aim: Craniopharyngiomas (CP) are histologically benign tumors of the sellarsuprase... more Background and Aim: Craniopharyngiomas (CP) are histologically benign tumors of the sellarsuprasellar region and are associated with significant morbidity. Due to the lack of knowledge of the factors responsible for the recurrence of CP and the challenges in surgeries for recurrent CP studies, it is necessary to determine the predictive factors for CP patients for preoperative prognosis and also for proper planning of surgery for a better functional outcome. Using"primum non nocere" or "do no harm" rule, our study tries to find out the optimum surgical strategy to have a better functional outcome as well as to reduce recurrence. Methods and Materials/Patients: This study is a 5-year retrospective analysis of the institutes of neuropathology database and clinical and radiological data with 12 months of follow-up in such patients Results: Out of 72 patients, 33 were men and 39 were women with a mean age of 17.34 years. A total of 11 patients underwent gross total resection (GTR) and the rest 61 patients were operated by subtotal resection (STR) followed by radiotherapy (RT). The recurrence rate in GTR and STR+radiotherapy (RT)was 1% and 24%, respectively. Eighteen cases had a poor postoperative outcome with a mortality rate of 6.98. Postoperative visual loss, obesity, neurological deficit, and diabetes insipidus (DI) were more common in the GTR group, while postoperative endocrinal dysfunction was more common in the STR+RT group. Also, older age, preoperative vision loss, hypothalamus invasion, and GTR were associated with poor postoperative outcomes. Conclusion: Patient-tailored resection should be performed for better functional outcomes with acceptable recurrence rates. Preoperative risk factor analysis helps to make proper surgical decisions regarding the extent of resection.

Research paper thumbnail of Dorsal spine intradural extramedullary hemangiopericytoma: a case report

Ukrainian neurosurgical journal, Dec 30, 2021

Hemangiopericytomas are rare CNS Neoplasms constituting <1% of CNS tumours. They are more commonl... more Hemangiopericytomas are rare CNS Neoplasms constituting <1% of CNS tumours. They are more commonly seen in cranium than in spine where they present as Intradural extramedullary in location. They rarely metastasize to Lung and Bone.World Health Organization Classification of Tumors of the Central Nervous System (CNS WHO) assigned the combined term solitary fibrous tumor/ hemangiopericytoma (SFT/HPC) to such lesions in 2016 due to their same genetic makeup. Case report: Our case is about a 61-year-old diabetic male who presented with insidious onset, gradually progressive thoracic backache and asymmetric weakness with tightness and numbness of both lower limbs for last 6 months with no sphincter incontinence and bed bound for last 15 days. Clinically he had asymmetric spastic paraparesis of lower limb. His MRI Dorsal spine showed a 1.5 × 2 cm heterogeneously contrast enhancing Intradural lesion at D6-D7 compressing the cord from dorsolaterally with extensive cord edema from C5 to L2. Preoperative diagnosis of Meningioma/ Metastasis was made and patient underwentD5-D7 laminectomy and tumour excision. Intraoperative findings, there was no dural attachment, there were multiple tortuous blood vessels overlying greyish pink, fleshy, suckable, highly vascular, capsulated tumor posterolateral to cord. The superior aspect of tumor was adherent to cord with no clear interface. Tumor was seen separate from Left D7 nerve root. Post operatively patient improved symptomatically and neurologically. His HPE was suggestive of Hemangiopericytoma WHO Grade II (IHC markers CD34 and CD 31 was positive and KI 67% index of 10-15%). Patient has been on follow up and planned for metastatic workup. Conclusion: Spinal Hemangiopericytoma are rare disease with nonspecific radiological features making preoperative diagnosis difficult. Differential diagnosis of hemangiopericytoma should be kept in case of atypical and high-grade radiological features. Gross total resection without compromising the neurological status should be the goal to prevent local recurrence. Proper consensus regarding the follow up and adjuvant therapies of spinal Hemangiopericytoma are still lacking.

Research paper thumbnail of Aneurysmal bone cyst of dorsal spine presenting with paraparesis in a pediatric patient: a case report

Ukrainian neurosurgical journal, Jun 29, 2023

Aneurysmal bone cyst (ABC) are rare benign tumours of spine. They most commonly presents with bac... more Aneurysmal bone cyst (ABC) are rare benign tumours of spine. They most commonly presents with backache. However neurological deficit in spinal ABCs are not uncommon. Magnetic resonance imaging of ABC may sometimes be confused with osteosarcoma or Giant cell tumours. Treatment options are varied but complete excision of tumour with spine stabilisation should be the goal. Clinical case: Here we presented the case of a 13 year old girl presenting with spastic paraparesis and bladder incontinence with MRI dorsal spine suggestive of an expansile lesion of D5 body. She underwent subtotal corpectomy with fixation of spine. Biopsy was suggestive of aneurysmal bone cyst. Post operative neurological outcome was excellent and followup scans over 2 year period suggest complete remission. Discussion: ABC are non neoplastic expansile bone lesion consisting of blood filled spaces separated by connective tissue septa of bony trabeculation and osteoclastic giant cells. Similar to our case it is seen more commonly in young females. Lumbar spine has higher incidence of ABC as compared to dorsal and cervical spine. Most common presentation is backache. Surgical options for ABC include intralesional curettage, en bloc resection followed by fixation. Vertebroplasty is also a treatment option to reinforce spinal stability. Post operative radiotherapy also can be considered in partially resected cases. Although ABC have high recurrence rate of 10-44% which has been reported with 2 years following surgery. However our patients continue to have no radiological evidence of recurrence on 2 year follow up. Conclusion: ABCs are benign tumour which may present with neurological deficit. Although treatment of ABC remains controversial but early surgery with complete removal of tumour in patients with neurological deficit provides excellent recovery. However due to high recurrence rate regular follow up is necessary.

Research paper thumbnail of Aneurysmal bone cyst of dorsal spine presenting with paraparesis in a pediatric patient: a case report

Ukrainian Neurosurgical Journal

Introduction: Aneurysmal bone cyst (ABC) are rare benign tumours of spine. They most commonly pre... more Introduction: Aneurysmal bone cyst (ABC) are rare benign tumours of spine. They most commonly presents with backache. However neurological deficit in spinal ABCs are not uncommon. Magnetic resonance imaging of ABC may sometimes be confused with osteosarcoma or Giant cell tumours. Treatment options are varied but complete excision of tumour with spine stabilisation should be the goal. Clinical case: Here we presented the case of a 13 year old girl presenting with spastic paraparesis and bladder incontinence with MRI dorsal spine suggestive of an expansile lesion of D5 body. She underwent subtotal corpectomy with fixation of spine . Biopsy was suggestive of aneurysmal bone cyst. Post operative neurological outcome was excellent and followup scans over 2 year period suggest complete remission. Discussion: ABC are non neoplastic expansile bone lesion consisting of blood filled spaces separated by connective tissue septa of bony trabeculation and osteoclastic giant cells. Similar to our ...

Research paper thumbnail of Case Series Challenges in Diagnosis and Management of Skull Base Osteomyelitis: A Case Series

The Iranian Journal of Neurosurgery (Iran. J. Neurosurg), 2022

Background and Importance: Skull Base Osteomyelitis (SBO) is a complex disease process often conf... more Background and Importance: Skull Base Osteomyelitis (SBO) is a complex disease process often confused with malignancy due to clinical and radiological masquerade. Extensive changes have recently occurred in the clinical course and management of the disease, attributed to improvements in neurosurgical procedures, diagnostic modalities, and the introduction of new antibiotics and management techniques thus reducing the associated morbidities and mortalities. However, SBO continues to pose a major challenge in the form of early diagnosis and management and can be the cause of devastating complications and high fatality associated with the disease. Case Presentation: Here we provide the clinical profile, investigation, management, and outcome of 5 cases of SBO, all of whom were thoroughly examined for neurological deficit, complete blood count, inflammatory markers, and radiographic imaging. Biopsy and microbiological culture reports were collected and patients were followed up. Conclusion: Early diagnosis and culture-specific antibiotic treatment have been shown to provide good outcomes. Due to its rarity, large case series of SBO are insufficiently found in the literature.

Research paper thumbnail of Tuberous Sclerosis: An Overview of All Aspects of the Disease Based on a Pediatric Case

The Iranian Journal of Neurosurgery (Iran. J. Neurosurg), 2022

Background and Importance: Tuberous sclerosis, also known as Bourneville's disease is a rare auto... more Background and Importance: Tuberous sclerosis, also known as Bourneville's disease is a rare autosomal dominant disease affecting multiple systems. In this case report, we emphasize the importance of clinical criteria instead of genetic analysis in diagnosing tuberous sclerosis and the need for rigorous follow-up of patientsto prevent complications. Case Presentation: Here we present a case of a 10-year-old boy presenting with intractable seizure and hypo-pigmented patches on his face and back of trunk. In neuroimaging evaluation, subependymal giant cell astrocytoma was diagnosed. Further, hisabdominal ultrasound showed multiple hamartomatous lesions in the liver and bilateral kidney. His cardiology and dental evaluation were normal. The dermatologist diagnosed a shagreen patch on the back of his trunk. Based on the latest clinical diagnostic criteria, he was diagnosed with a case of tuberous sclerosis and has been on the rigorous follow-up ever since. Conclusion: Since tuberous sclerosis is a multisystem disease, early diagnosis is necessary to prevent acute symptoms and prevent long-term complications. Here we emphasize the need to use clinical criteria instead of genetic study for early diagnosis of tuberous sclerosis.

Research paper thumbnail of Challenges in Diagnosis and Management of Skull Base Osteomyelitis: A Case Series

Iranian journal of neurosurgery, Dec 25, 2022

Research paper thumbnail of Tuberous Sclerosis: An Overview of All Aspects of the Disease Based On a Pediatric Case

The Iranian Journal of Neurosurgery

Background and Importance:Tuberous sclerosis, also known as Bourneville's disease is a rare a... more Background and Importance:Tuberous sclerosis, also known as Bourneville's disease is a rare autosomal dominant disease affecting multiple systems. In this case report, we emphasize the importance of clinical criteria instead of genetic analysis in diagnosing tuberous sclerosis and the need for rigorous follow-up of patientsto prevent complications. Case Presentation: Here we present a case of a 10-year-old boy presenting with intractable seizure and hypo-pigmented patches on his face and back of trunk. In neuroimaging evaluation, subependymal giant cell astrocytoma was diagnosed. Further, hisabdominal ultrasound showed multiple hamartomatous lesions in the liver and bilateral kidney. His cardiology and dental evaluation were normal. The dermatologist diagnosed a shagreen patch on the back of his trunk. Based on the latest clinical diagnostic criteria, he was diagnosed with a case of tuberous sclerosis and has been on the rigorous follow-up ever since. Conclusion: Since tuberous ...

Research paper thumbnail of Correlation between neutrophil lymphocyte count ratio and outcomes of severe traumatic head injury

International Journal of Advances in Medicine

Background: Raised peripheral neutrophil lymphocyte ratio is associated with poorer outcomes in c... more Background: Raised peripheral neutrophil lymphocyte ratio is associated with poorer outcomes in conditions such as severe brain injury, ICH, cardiovascular conditions, cancer.Methods: Retrospective analysis of 96 severe Traumatic Brain injury data treated at our institute over a period of 1 year. The patients were followed up for a period of at least 1 month. The primary outcome of the study was 1 month GOS and the various variables which may be associated with the poor GOS at 1 month follow up. Model based analysis was done for NLCR <24 hrs at 48 hrs and GCS at the time of presentation and discriminative ability of the models were studied by the Area under the curve.Results: Univariate analysis were done of 96 patients of severe traumatic brain injury for various variables such as age, sex, mode of head injury, type of head injury, presenting GCS and NLCR at 24 hrs and 48 hrs to that of GOS at 1 month follow up. Initial GCS <7 (p=0.0138) with AUC=0.6689 and peak NLCR (<24 ...

Research paper thumbnail of Third Ventricle Anaplastic Oligodendroglioma: A Case Report

Iranian Journal of Neurosurgery

Background and Importance: Anaplastic Oligodendroglioma (ODG) constitutes 24% of all pediatric OD... more Background and Importance: Anaplastic Oligodendroglioma (ODG) constitutes 24% of all pediatric ODG. The mean age of presentation of ODG is 12±6 years. They are most common in frontal and temporal lobes; however, rare cases of intraventricular ODGs are reported. Most commonly they arise from the anterior part of lateral ventricles. Third ventricle ODG is extremely rare and only a few cases of lateral and third ventricle anaplastic ODG are reported. ODGs infiltrate locally to meninges and rarely have leptomeningeal spread. Thus, ODG forms a differential diagnosis of pediatric intraventricular tumor. Case Presentation: Here we present a case of a 15-month-old male child with raised intracranial pressure due to obstructive hydrocephalus. The patient was detected to be COVID-19 RT–PCR (Reverse Transcriptase Polymerase Chain Reaction) positive in the preoperative period and underwent emergency Right-sided Ventriculo Peritoneal (VP) shunt. His contrast MRI (Magnetic Resonance Imaging) Brai...

Research paper thumbnail of Dorsal spine intradural extramedullary hemangiopericytoma: a case report

Ukrainian Neurosurgical Journal

Introduction: Hemangiopericytomas are rare CNS Neoplasms constituting <1% of CNS tumours. They... more Introduction: Hemangiopericytomas are rare CNS Neoplasms constituting <1% of CNS tumours. They are more commonly seen in cranium than in spine where they present as Intradural extramedullary in location. They rarely metastasize to Lung and Bone.World Health Organization Classification of Tumors of the Central Nervous System (CNS WHO) assigned the combined term solitary fibrous tumor/ hemangiopericytoma (SFT/HPC) to such lesions in 2016 due to their same genetic makeup. Case report: Our case is about a 61-year-old diabetic male who presented with insidious onset, gradually progressive thoracic backache and asymmetric weakness with tightness and numbness of both lower limbs for last 6 months with no sphincter incontinence and bed bound for last 15 days. Clinically he had asymmetric spastic paraparesis of lower limb. His MRI Dorsal spine showed a 1.5 ґ 2 cm heterogeneously contrast enhancing Intradural lesion at D6-D7 compressing the cord from dorsolaterally with extensive cord edem...

Research paper thumbnail of Gallstone ileus: a rare case of distal jejunal obstruction

International Surgery Journal, 2015

Gallstone ileus as a cause of distal jejunal obstruction is rare. Herein we present a case of gal... more Gallstone ileus as a cause of distal jejunal obstruction is rare. Herein we present a case of gallstone ileus without any previous biliary symptoms and with Rigler's triad on radiological investigation. As the signs and symptoms of gallstone ileus is nonspecific high index of suspicion is necessary to make a diagnosis of gallstone ileus. One staged cholecystectomy, fistula repair and enterolithotomy was done and patient recovered uneventfully.

Research paper thumbnail of Recurrence and Functional Outcome Following Resection of Craniopharyngioma

Iran J Neurosurg, 2023

Background and Aim: Craniopharyngiomas (CP) are histologically benign tumors of the sellarsuprase... more Background and Aim: Craniopharyngiomas (CP) are histologically benign tumors of the sellarsuprasellar region and are associated with significant morbidity. Due to the lack of knowledge of the factors responsible for the recurrence of CP and the challenges in surgeries for recurrent CP studies, it is necessary to determine the predictive factors for CP patients for preoperative prognosis and also for proper planning of surgery for a better functional outcome. Using"primum non nocere" or "do no harm" rule, our study tries to find out the optimum surgical strategy to have a better functional outcome as well as to reduce recurrence. Methods and Materials/Patients: This study is a 5-year retrospective analysis of the institutes of neuropathology database and clinical and radiological data with 12 months of follow-up in such patients Results: Out of 72 patients, 33 were men and 39 were women with a mean age of 17.34 years. A total of 11 patients underwent gross total resection (GTR) and the rest 61 patients were operated by subtotal resection (STR) followed by radiotherapy (RT). The recurrence rate in GTR and STR+radiotherapy (RT)was 1% and 24%, respectively. Eighteen cases had a poor postoperative outcome with a mortality rate of 6.98. Postoperative visual loss, obesity, neurological deficit, and diabetes insipidus (DI) were more common in the GTR group, while postoperative endocrinal dysfunction was more common in the STR+RT group. Also, older age, preoperative vision loss, hypothalamus invasion, and GTR were associated with poor postoperative outcomes. Conclusion: Patient-tailored resection should be performed for better functional outcomes with acceptable recurrence rates. Preoperative risk factor analysis helps to make proper surgical decisions regarding the extent of resection.

Research paper thumbnail of Dorsal spine intradural extramedullary hemangiopericytoma: a case report

Ukrainian neurosurgical journal, Dec 30, 2021

Hemangiopericytomas are rare CNS Neoplasms constituting <1% of CNS tumours. They are more commonl... more Hemangiopericytomas are rare CNS Neoplasms constituting <1% of CNS tumours. They are more commonly seen in cranium than in spine where they present as Intradural extramedullary in location. They rarely metastasize to Lung and Bone.World Health Organization Classification of Tumors of the Central Nervous System (CNS WHO) assigned the combined term solitary fibrous tumor/ hemangiopericytoma (SFT/HPC) to such lesions in 2016 due to their same genetic makeup. Case report: Our case is about a 61-year-old diabetic male who presented with insidious onset, gradually progressive thoracic backache and asymmetric weakness with tightness and numbness of both lower limbs for last 6 months with no sphincter incontinence and bed bound for last 15 days. Clinically he had asymmetric spastic paraparesis of lower limb. His MRI Dorsal spine showed a 1.5 × 2 cm heterogeneously contrast enhancing Intradural lesion at D6-D7 compressing the cord from dorsolaterally with extensive cord edema from C5 to L2. Preoperative diagnosis of Meningioma/ Metastasis was made and patient underwentD5-D7 laminectomy and tumour excision. Intraoperative findings, there was no dural attachment, there were multiple tortuous blood vessels overlying greyish pink, fleshy, suckable, highly vascular, capsulated tumor posterolateral to cord. The superior aspect of tumor was adherent to cord with no clear interface. Tumor was seen separate from Left D7 nerve root. Post operatively patient improved symptomatically and neurologically. His HPE was suggestive of Hemangiopericytoma WHO Grade II (IHC markers CD34 and CD 31 was positive and KI 67% index of 10-15%). Patient has been on follow up and planned for metastatic workup. Conclusion: Spinal Hemangiopericytoma are rare disease with nonspecific radiological features making preoperative diagnosis difficult. Differential diagnosis of hemangiopericytoma should be kept in case of atypical and high-grade radiological features. Gross total resection without compromising the neurological status should be the goal to prevent local recurrence. Proper consensus regarding the follow up and adjuvant therapies of spinal Hemangiopericytoma are still lacking.

Research paper thumbnail of Aneurysmal bone cyst of dorsal spine presenting with paraparesis in a pediatric patient: a case report

Ukrainian neurosurgical journal, Jun 29, 2023

Aneurysmal bone cyst (ABC) are rare benign tumours of spine. They most commonly presents with bac... more Aneurysmal bone cyst (ABC) are rare benign tumours of spine. They most commonly presents with backache. However neurological deficit in spinal ABCs are not uncommon. Magnetic resonance imaging of ABC may sometimes be confused with osteosarcoma or Giant cell tumours. Treatment options are varied but complete excision of tumour with spine stabilisation should be the goal. Clinical case: Here we presented the case of a 13 year old girl presenting with spastic paraparesis and bladder incontinence with MRI dorsal spine suggestive of an expansile lesion of D5 body. She underwent subtotal corpectomy with fixation of spine. Biopsy was suggestive of aneurysmal bone cyst. Post operative neurological outcome was excellent and followup scans over 2 year period suggest complete remission. Discussion: ABC are non neoplastic expansile bone lesion consisting of blood filled spaces separated by connective tissue septa of bony trabeculation and osteoclastic giant cells. Similar to our case it is seen more commonly in young females. Lumbar spine has higher incidence of ABC as compared to dorsal and cervical spine. Most common presentation is backache. Surgical options for ABC include intralesional curettage, en bloc resection followed by fixation. Vertebroplasty is also a treatment option to reinforce spinal stability. Post operative radiotherapy also can be considered in partially resected cases. Although ABC have high recurrence rate of 10-44% which has been reported with 2 years following surgery. However our patients continue to have no radiological evidence of recurrence on 2 year follow up. Conclusion: ABCs are benign tumour which may present with neurological deficit. Although treatment of ABC remains controversial but early surgery with complete removal of tumour in patients with neurological deficit provides excellent recovery. However due to high recurrence rate regular follow up is necessary.

Research paper thumbnail of Aneurysmal bone cyst of dorsal spine presenting with paraparesis in a pediatric patient: a case report

Ukrainian Neurosurgical Journal

Introduction: Aneurysmal bone cyst (ABC) are rare benign tumours of spine. They most commonly pre... more Introduction: Aneurysmal bone cyst (ABC) are rare benign tumours of spine. They most commonly presents with backache. However neurological deficit in spinal ABCs are not uncommon. Magnetic resonance imaging of ABC may sometimes be confused with osteosarcoma or Giant cell tumours. Treatment options are varied but complete excision of tumour with spine stabilisation should be the goal. Clinical case: Here we presented the case of a 13 year old girl presenting with spastic paraparesis and bladder incontinence with MRI dorsal spine suggestive of an expansile lesion of D5 body. She underwent subtotal corpectomy with fixation of spine . Biopsy was suggestive of aneurysmal bone cyst. Post operative neurological outcome was excellent and followup scans over 2 year period suggest complete remission. Discussion: ABC are non neoplastic expansile bone lesion consisting of blood filled spaces separated by connective tissue septa of bony trabeculation and osteoclastic giant cells. Similar to our ...

Research paper thumbnail of Case Series Challenges in Diagnosis and Management of Skull Base Osteomyelitis: A Case Series

The Iranian Journal of Neurosurgery (Iran. J. Neurosurg), 2022

Background and Importance: Skull Base Osteomyelitis (SBO) is a complex disease process often conf... more Background and Importance: Skull Base Osteomyelitis (SBO) is a complex disease process often confused with malignancy due to clinical and radiological masquerade. Extensive changes have recently occurred in the clinical course and management of the disease, attributed to improvements in neurosurgical procedures, diagnostic modalities, and the introduction of new antibiotics and management techniques thus reducing the associated morbidities and mortalities. However, SBO continues to pose a major challenge in the form of early diagnosis and management and can be the cause of devastating complications and high fatality associated with the disease. Case Presentation: Here we provide the clinical profile, investigation, management, and outcome of 5 cases of SBO, all of whom were thoroughly examined for neurological deficit, complete blood count, inflammatory markers, and radiographic imaging. Biopsy and microbiological culture reports were collected and patients were followed up. Conclusion: Early diagnosis and culture-specific antibiotic treatment have been shown to provide good outcomes. Due to its rarity, large case series of SBO are insufficiently found in the literature.

Research paper thumbnail of Tuberous Sclerosis: An Overview of All Aspects of the Disease Based on a Pediatric Case

The Iranian Journal of Neurosurgery (Iran. J. Neurosurg), 2022

Background and Importance: Tuberous sclerosis, also known as Bourneville's disease is a rare auto... more Background and Importance: Tuberous sclerosis, also known as Bourneville's disease is a rare autosomal dominant disease affecting multiple systems. In this case report, we emphasize the importance of clinical criteria instead of genetic analysis in diagnosing tuberous sclerosis and the need for rigorous follow-up of patientsto prevent complications. Case Presentation: Here we present a case of a 10-year-old boy presenting with intractable seizure and hypo-pigmented patches on his face and back of trunk. In neuroimaging evaluation, subependymal giant cell astrocytoma was diagnosed. Further, hisabdominal ultrasound showed multiple hamartomatous lesions in the liver and bilateral kidney. His cardiology and dental evaluation were normal. The dermatologist diagnosed a shagreen patch on the back of his trunk. Based on the latest clinical diagnostic criteria, he was diagnosed with a case of tuberous sclerosis and has been on the rigorous follow-up ever since. Conclusion: Since tuberous sclerosis is a multisystem disease, early diagnosis is necessary to prevent acute symptoms and prevent long-term complications. Here we emphasize the need to use clinical criteria instead of genetic study for early diagnosis of tuberous sclerosis.

Research paper thumbnail of Challenges in Diagnosis and Management of Skull Base Osteomyelitis: A Case Series

Iranian journal of neurosurgery, Dec 25, 2022

Research paper thumbnail of Tuberous Sclerosis: An Overview of All Aspects of the Disease Based On a Pediatric Case

The Iranian Journal of Neurosurgery

Background and Importance:Tuberous sclerosis, also known as Bourneville's disease is a rare a... more Background and Importance:Tuberous sclerosis, also known as Bourneville's disease is a rare autosomal dominant disease affecting multiple systems. In this case report, we emphasize the importance of clinical criteria instead of genetic analysis in diagnosing tuberous sclerosis and the need for rigorous follow-up of patientsto prevent complications. Case Presentation: Here we present a case of a 10-year-old boy presenting with intractable seizure and hypo-pigmented patches on his face and back of trunk. In neuroimaging evaluation, subependymal giant cell astrocytoma was diagnosed. Further, hisabdominal ultrasound showed multiple hamartomatous lesions in the liver and bilateral kidney. His cardiology and dental evaluation were normal. The dermatologist diagnosed a shagreen patch on the back of his trunk. Based on the latest clinical diagnostic criteria, he was diagnosed with a case of tuberous sclerosis and has been on the rigorous follow-up ever since. Conclusion: Since tuberous ...

Research paper thumbnail of Correlation between neutrophil lymphocyte count ratio and outcomes of severe traumatic head injury

International Journal of Advances in Medicine

Background: Raised peripheral neutrophil lymphocyte ratio is associated with poorer outcomes in c... more Background: Raised peripheral neutrophil lymphocyte ratio is associated with poorer outcomes in conditions such as severe brain injury, ICH, cardiovascular conditions, cancer.Methods: Retrospective analysis of 96 severe Traumatic Brain injury data treated at our institute over a period of 1 year. The patients were followed up for a period of at least 1 month. The primary outcome of the study was 1 month GOS and the various variables which may be associated with the poor GOS at 1 month follow up. Model based analysis was done for NLCR <24 hrs at 48 hrs and GCS at the time of presentation and discriminative ability of the models were studied by the Area under the curve.Results: Univariate analysis were done of 96 patients of severe traumatic brain injury for various variables such as age, sex, mode of head injury, type of head injury, presenting GCS and NLCR at 24 hrs and 48 hrs to that of GOS at 1 month follow up. Initial GCS <7 (p=0.0138) with AUC=0.6689 and peak NLCR (<24 ...

Research paper thumbnail of Third Ventricle Anaplastic Oligodendroglioma: A Case Report

Iranian Journal of Neurosurgery

Background and Importance: Anaplastic Oligodendroglioma (ODG) constitutes 24% of all pediatric OD... more Background and Importance: Anaplastic Oligodendroglioma (ODG) constitutes 24% of all pediatric ODG. The mean age of presentation of ODG is 12±6 years. They are most common in frontal and temporal lobes; however, rare cases of intraventricular ODGs are reported. Most commonly they arise from the anterior part of lateral ventricles. Third ventricle ODG is extremely rare and only a few cases of lateral and third ventricle anaplastic ODG are reported. ODGs infiltrate locally to meninges and rarely have leptomeningeal spread. Thus, ODG forms a differential diagnosis of pediatric intraventricular tumor. Case Presentation: Here we present a case of a 15-month-old male child with raised intracranial pressure due to obstructive hydrocephalus. The patient was detected to be COVID-19 RT–PCR (Reverse Transcriptase Polymerase Chain Reaction) positive in the preoperative period and underwent emergency Right-sided Ventriculo Peritoneal (VP) shunt. His contrast MRI (Magnetic Resonance Imaging) Brai...

Research paper thumbnail of Dorsal spine intradural extramedullary hemangiopericytoma: a case report

Ukrainian Neurosurgical Journal

Introduction: Hemangiopericytomas are rare CNS Neoplasms constituting <1% of CNS tumours. They... more Introduction: Hemangiopericytomas are rare CNS Neoplasms constituting <1% of CNS tumours. They are more commonly seen in cranium than in spine where they present as Intradural extramedullary in location. They rarely metastasize to Lung and Bone.World Health Organization Classification of Tumors of the Central Nervous System (CNS WHO) assigned the combined term solitary fibrous tumor/ hemangiopericytoma (SFT/HPC) to such lesions in 2016 due to their same genetic makeup. Case report: Our case is about a 61-year-old diabetic male who presented with insidious onset, gradually progressive thoracic backache and asymmetric weakness with tightness and numbness of both lower limbs for last 6 months with no sphincter incontinence and bed bound for last 15 days. Clinically he had asymmetric spastic paraparesis of lower limb. His MRI Dorsal spine showed a 1.5 ґ 2 cm heterogeneously contrast enhancing Intradural lesion at D6-D7 compressing the cord from dorsolaterally with extensive cord edem...

Research paper thumbnail of Gallstone ileus: a rare case of distal jejunal obstruction

International Surgery Journal, 2015

Gallstone ileus as a cause of distal jejunal obstruction is rare. Herein we present a case of gal... more Gallstone ileus as a cause of distal jejunal obstruction is rare. Herein we present a case of gallstone ileus without any previous biliary symptoms and with Rigler's triad on radiological investigation. As the signs and symptoms of gallstone ileus is nonspecific high index of suspicion is necessary to make a diagnosis of gallstone ileus. One staged cholecystectomy, fistula repair and enterolithotomy was done and patient recovered uneventfully.