Browsing by Author "Bhattacharya, RN"

Now showing 1 - 20 of 26
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    Acoustic neurinomas during pregnancy: Report of two cases and review of literature
    (ACTA NEUROCHIRURGICA, 2001)
    Though infrequent, acoustic neurinomas have been described during pregnancy and represent a therapeutic challenge for excision without producing any problem for the mother and the foetus. First Author experienced two cases of acoustic neurinomas presenting during pregnancy. One patient presented in the terminal stages of the third trimester of pregnancy and underwent caesarean section, followed by retromastoid craniectomy and excision of the rumour. Operative management of the pregnancy and tumour in the same sitting has not been reported in the literature. Second patient who presented during 2nd trimester of pregnancy, was operated on for the tumour and had a successful continuance of pregnancy. Details of the management are discussed and the relevant literature reviewed. In addition to causing aggravation of symptoms, the larger size and increased vascularity of these rumours during pregnancy, makes them more vulnerable to acute bleeding, which in turn may initiate new or exacerbate pre-existing symptoms, as noted in one of the cases presented in this report.
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    Carotid artery injury during transsphenoidal resection of pituitary tumor: Anesthesia perspective
    (JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2003)
    The authors describe two patients who suffered carotid artery injury during transsphenoidal resection of a pituitary tumor. Anesthesiologists were involved in resuscitation after initial hemorrhage, in securing the airway, in initiating cerebral protection strategies, and in transporting these patients. Anesthesia was provided for resection of the tumors, removal of packs from the pituitary fossae, and diagnostic and therapeutic radiologic procedures. In each case hemostasis was achieved by packing the sella turcica, sphenoid sinus, and nostrils. Both patients were electively ventilated. In one patient, a pseudoaneurysm of the carotid artery was detected by angiography in the operating room. It was treated by trapping the internal carotid artery. The other patient developed a carotid-cavernous fistula, which was treated by balloon embolization. Both patients were discharged after dealing with these complications.
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    Cerebellar hemisphere, an uncommon location for pleomorphic xanthoastrocytoma and lipidized glioblastoma multiformis
    (NEUROLOGY INDIA, 2003)
    Lipidized glioblastoma multiformis (LGB) and pleomorphic xanthoastrocytoma (PXA) are often supratentorial in location and occur in the second to fourth decade. This report presents two young patients, one having LGB and the other having PXA in the cerebellum. Histological differentiation between LGB and PXA is discussed.
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    Coil embolization for intracranial aneurysms - An Indian experience
    (RIVISTA DI NEURORADIOLOGIA, 2003) Gupta, AK; Joseph, S; Bhattacharya, RN; Kapilamoorhty, TR; Kesavadas, C; Thomas, B
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    Dissecting intracranial vertebral artery aneurysms
    (NEUROLOGY INDIA, 2001)
    Dissecting aneurysms of the intracranial arteries are exceedingly rare vascular lesions that can produce acute cerebral or brain stem infarction in young healthy adults. They carry a high mortality rate. Two cases of dissecting vertebral artery aneurysms that presented with bleed, were successfully operated by trapping and excision of the dissecting segment. Both dissecting aneurysms were located distal to PICA origin. Both the patients developed post operative lower cranial nerve paresis and one developed lateral medullary syndrome, which improved subsequently. Dissecting aneurysms presenting with bleed should be surgically managed by trapping and excising the involved segment sparing the PICA origin or by interventional radiological techniques. Revascularisation procedures should be considered in addition to trapping of the main vertebral segment if PICA is involved in the trapped segment. The diagnostic and therapeutic difficulties associated with dissecting vertebral artery aneurysms and the controversies regarding their management have been reviewed.
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    Endovascular treatment of carotido-cavernous fistula
    (RIVISTA DI NEURORADIOLOGIA, 2003) Gupta, AK; Rao, VRK; Kapilamoorthy, TR; Bhattacharya, RN; Joseph, S; Krishnamoorthy, T
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    Endovascular treatment of ruptured intracranial aneurysms: Immediate result and long term follow up - An Indian experience
    (JOURNAL OF NEURORADIOLOGY, 2006) Gupta, AK; Purkayastha, S; Bhattacharya, RN; Bodhey, NK
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    Epidermoid cyst involving the brain stem
    (ACTA NEUROCHIRURGICA, 2000)
    Brain stem epidermoid cysts are extremely rare. We describe an unusual case of prepontine epidermoid cyst with a large part of the tumour insinuating itself into the pens. Microsurgical total excision of tumour was done without producing any new neurological deficits. Cases reported in the literature either had high mortality/morbidity or were only subtotally removed. Relevant literature is reviewed.
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    False aneurysm of cavernous carotid artery and carotid cavernous fistula: Complications following transsphenoidal surgery
    (NEUROLOGY INDIA, 2003)
    We present two cases of carotid-injury during transsphenoidal surgery for pituitary adenoma. While in one of the cases it resulted in the formation of a false aneurysm of cavernous carotid artery, in the other patient, a carotid cavernous fistula (CCF) formed. The false aneurysm was managed by surgical trapping- and the patient had an uneventful recovery. The CCF was initially managed with balloon embolization. The balloon got deflated and resulted in a false aneurysm with persistent CCF. This was occluded with Guglielmi Detachable Coils (GDC). The management options are discussed and relevant literature is reviewed. We emphasize the importance of an early cerebral angiography to know the status of the injured carotid artery and formation of false aneurysm / fistula.
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    Fibrous dysplasia of the orbit in an infant
    (PEDIATRIC NEUROSURGERY, 2000) Joseph, E; Kachhara, R; Bhattacharya, RN; Radhakrishnan, VV; Balachandran, K
    Fibrous dysplasia is an idiopathic fibro-osseous lesion of the skeletal bones. These uncommon osseous lesions usually manifest within the first two decades of life. Its occurrence during infancy is extremely uncommon, and we describe here a case of fibrous dysplasia involving the orbit in a 9-month-old male child, Copyright (C) 2000 S. Karger AG. Basel.
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    Germinoma of the basal ganglia: A case report and review of literature
    (NEUROLOGY INDIA, 2002) Elizabeth, J; Menon, G; Nair, S; Bhattacharya, RN; Radhakrishnan, VV
    Germ cell tumors of extrapineal region are extremely uncommon. The clinicopathological features of germinoma in the left basal ganglia, in a 21 year old male are presented in this report. Post-operative radiotherapy is advocated, in view of the good radiosensitivity of these tumors.
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    Infrasellar craniopharyngioma mimicking a clival chordoma: A case report
    (NEUROLOGY INDIA, 2002)
    An unusual case of entirely infrasellar craniopharyngioma mimicking a clival chordoma is described. Only 22 cases of craniopharyngioma with nasopharyngeal extension have been reported in the literature. Of the reported cases, most were primarily intracranial with secondary downward extension; only two were thought to originate from an infrasellar location. The present case is another example of an entirely infrasellar craniopharyngioma, with extensive clival destruction, mimicking a clival chordoma. Relevant literature on the subject is reviewed.
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    Intracranial aneurysmal bone cyst manifesting as a cerebellar mass
    (NEUROLOGY INDIA, 2003)
    A 17-year-old boy presented with symptoms of raised intracranial pressure for a month. Investigations revealed a large extra-cerebellar mass. The lesion was radically resected. It arose from the petrous bone. Histology revealed the lesion was an aneurysmal bone cyst [ABC].
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    Intramedullary spinal cord glial tumours: Management philosophy and surgical outcome
    (MINIMALLY INVASIVE NEUROSURGERY AND MULTIDISCIPLINARY NEUROTRAUMATOLOGY, 2006) Nair, S; Menon, G; Rao, BRM; Rajesh, BJ; Muthurethinam, T; Mathew, A; Easwer, HV; Bhattacharya, RN
    A retrospective analysis of 88 consecutive cases of intramedullary glial tumours, which constituted 58% of 149 cases of intramedullary lesions surgically managed over a 22-year period, is presented. Fifty-six astrocytomas and 32 ependymomas formed the group, which comprised 55 males and 33 females. While majority of the astrocytomas were in the cervical or cervicodorsal location (70%), it was almost equally distributed between the cervical and conus regions in 23 cases of ependymomas. The management philosophy has changed over the years from biopsy to total removal for ependymomas and a generous inside out decompression in case of astrocytomas. While only a biopsy or decompression was done in 35 of the earlier patients of astrocytomas a radical removal (subtotal in 18 and total in 3) could be achieved in 21 of our recent patients. We could achieve total resection in all the last 17 patients of ependymomas. Low grade astrocytomas radically removed and all ependymomas were not given radiotherapy. Out of the 39 patients of astrocytomas who are in follow up, 13 have improved, 19 remaining static and 7 have deteriorated. While only three of the 25 patients of ependymomas on long term follow up have deteriorated 18 have improved and 6 are remaining static. Conclusion: Although total resection of ependymomas have become a procedure with good functional results in most hands, a radical resection can be achieved with long term stabilisation of neurological deficits in majority of astrocytomas.
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    Lack of association of Lysyl oxidase (LOX) gene polymorphisms with intracranial aneurysm in a south Indian population
    (MOLECULAR BIOLOGY REPORTS, 2013) Sathyan, S; Koshy, L; Lekshmi, KRS; Easwer, HV; Premkumar, S; Alapatt, JP; Nair, S; Bhattacharya, RN; Banerjee, M
    Intracranial aneurysm (IA) accounts for 85 % of haemorrhagic stroke and is mainly caused due to weakening of arterial wall. Lysyl oxidase (LOX) is a cuproenzyme involved in cross linking structural proteins collagen and elastin, thus providing structural stability to artery. Using a case-control study design, we tested the hypothesis whether the variants in LOX gene flanking the two LD block, can increase risk of aSAH among South Indian patients, either independently, or by interacting with other risk factors of the disease. SNPs were genotyped by fluorescence-based competitive allele-specific PCR (KASPar) chemistry. We selected 200 radiologically confirmed aneurysmal cases and 235 ethnically and age and gender matched controls from the Dravidian Malayalam speaking population of South India. We observed marked interethnic differences in the genotype distribution of LOX variants when compared to Japanese and African populations. However, there was no significant association with any of the LOX variants with IA. This study also could not observe any significant role of LOX polymorphisms in influencing IA either directly or indirectly through its confounding factors such as hypertension and gender in South Indian population.
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    Liponeurocytoma of the cerebellum - A case report
    (NEUROLOGY INDIA, 2003)
    We report the characteristic neuropathological features of a rare case of cerebellar liponeurocytoma in a 62-year-old female. The tumor has a low proliferative potential and carries a favorable prognosis.
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    Middle Cerebral Artery Aneurysms An Institutional Experience in a South Indian Population
    (NEUROSURGERY QUARTERLY, 2008) Khursheed, N; Bhattacharya, RN; Nair, S; Menon, G; Rao, RM
    Background: Middle cerebral artery aneurysms (MCAAs) account for about 20% of intracranial aneurysms. These are commoner in females and have various other special features. Aim: To study the demographic features in a subset of South Indian Population and to assess the clinical and radiologic parameters of outcome. Patients and Methods: Retrospective analysis of 99 patients with diagnosis of symptomatic MCAAs admitted to Sri Chitra Tirunal Institute for Medical Sciences find Technology, Trivandrum, India from 2000 to 2004 was performed. Clinical features and radiologic parameters were analyzed and correlation with outcome was evaluated. Fishers exact test and Pearson analysis was used for statistical analysis. Results: Seizures and hemiparesis were common clinical findings. Hydrocephalus was less often seen and aneurysms pointing laterally had high incidence of parenchymal hematomas. Mirror, giant, and multiple aneurysms were often seen. Conclusions: MCAAs have higher association of multiple aneurysms, incidence of angiographic vasospasm is very high. and it si significantly influences outcome besides preoperative World Federation of Neurological Surgeon and future directions to improve the Surgical results should be aimed to better deal with the vasospasm and its sequelae.
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    Pathogenesis of intracranial aneurysm is mediated by proinflammatory cytokine TNFA and IFNG and through stochastic regulation of IL10 and TGFB1 by comorbid factors
    (JOURNAL OF NEUROINFLAMMATION, 2015) Sathyan, S; Koshy, LV; Srinivas, L; Easwer, HV; Premkumar, S; Nair, S; Bhattacharya, RN; Alapatt, JP; Banerjee, M
    Background: Intracranial aneurysm (IA) is often asymptomatic until the time of rupture resulting in subarachnoid hemorrhage (SAH). There is no precise biochemical or phenotype marker for diagnosis of aneurysm. Environmental risk factors that associate with IA can result in modifying the effect of inherited genetic factors and thereby increase the susceptibility to SAH. In addition subsequent to aneurismal rupture, the nature and quantum of inflammatory response might be critical for repair. Therefore, genetic liability to inflammatory response caused by polymorphisms in cytokine genes might be the common denominator for gene and environment in the development of aneurysm and complications associated with rupture. Methods: Functionally relevant polymorphisms in the pro-and anti-inflammatory cytokine genes IL-1 complex (IL1A, IL1B, and IL1RN), TNFA, IFNG, IL3, IL6, IL12B, IL1RN, TGFB1, IL4, and IL10] were screened in radiologically confirmed 220 IA patients and 250 controls from genetically stratified Malayalam-speaking Dravidian ethnic population of south India. Subgroup analyses with genetic and environmental variables were also carried out. Results: Pro-inflammatory cytokines TNFA rs361525, IFNG rs2069718, and anti-inflammatory cytokine IL10 rs1800871 and rs1800872 were found to be significantly associated with IA, independent of epidemiological factors. TGFB1 rs1800469 polymorphism was observed to be associated with IA through co-modifying factors such as hypertension and gender. Functional prediction of all the associated SNPs of TNFA, IL10, and TGFB1 indicates their potential role in transcriptional regulation. Meta-analysis further reiterates that IL1 gene cluster and IL6 were not associated with IA. Conclusions: The study suggests that chronic exposure to inflammatory response mediated by genetic variants in pro-inflammatory cytokines TNFA and IFNG could be a primary event, while stochastic regulation of IL10 and TGFB1 response mediated by comorbid factors such as hypertension may augment the pathogenesis of IA through vascular matrix degradation. The implication and interaction of these genetic variants under a specific environmental background will help us identify the resultant phenotypic variation in the pathogenesis of intracranial aneurysm. Identifying genetic risk factors for inflammation might also help in understanding and addressing the posttraumatic complications following the aneurismal rupture.
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    Pathogenesis of intracranial aneurysm is mediated by proinflammatory cytokine TNFA and IFNG and through stochastic regulation of IL10 and TGFB1 by comorbid factors (vol 12, 135, 2015)
    (JOURNAL OF NEUROINFLAMMATION, 2015) Sathyan, S; Koshy, LV; Srinivas, L; Easwer, HV; Premkumar, S; Nair, S; Bhattacharya, RN; Alapatt, JP; Banerjee, M
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    Primary osteogenic sarcoma involving sella-sphenoid sinus - Case report
    (NEUROLOGIA MEDICO-CHIRURGICA, 1999)
    A 38-year-old male presented with an extremely rare primary osteogenic sarcoma, unassociated with Paget's disease or late effects of radiation, involving the sella and sphenoid sinus region. Complete excision of the tumor was achieved through an extended frontobasal approach. Postoperatively, six cycles of combination chemotherapy (adriamycin, ifosphamide, and cisplatin) followed by a total of 55 Gy local radiotherapy in 33 fractions was given. Primary osteogenic sarcoma should be considered in the differential diagnosis of the central skull base tumors. Osteogenic sarcoma, in general, has a bad prognosis, and should be managed aggressively with multimodality treatment including gross total surgical resection, combination chemotherapy, and radiotherapy.