Browsing by Author "Rao, MB"

Now showing 1 - 12 of 12
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    Atypical meningioma: A clinicopathological analysis
    (NEUROLOGY INDIA, 2000) Joseph, E; Sandhyamani, S; Rao, MB; Nair, S; Radhakrishnan, VV
    In this retrospective study, 382 operated cases of meningiomas were reviewed, 32 cases (8.3%) were histopathologically classified as atypical meningioma, The anatomical locations and histological features in all the thirty-two cases were correlated with their recurrence rates and biological behaviour. The overall recurrence rate for atypical meningioma within two years was 28% as compared to 9.3% in benign meningiomas. It is being emphasized that an accurate histopathological interpretation of atypical meningioma is essential for predicting the recurrence, biological behavior as well as postoperative management modalities.
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    Craniospinal and spinal enterogenous cysts - Report of three cases
    (CLINICAL NEUROLOGY AND NEUROSURGERY, 1996)
    We report three cases of enterogenous cyst, one craniospinal and two spinal manifesting with features of spinal cord compression. In one the cyst was intramedullary in location and in the other two it was intradural, extramedullary. The unusual clinical presentation, location and magnetic resonance imaging (MRI) characteristics are discussed. None of the three patients had any vertebral anomaly or other congenital malformation. All patients had excellent outcome following surgery.
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    Epilepsy surgery in a developing country
    (11TH INTERNATIONAL CONGRESS OF NEUROLOGICAL SURGERY, VOLS 1 AND 2, 1997) Rao, MB; Radhakrishnan, K; Thomas, SV; Nayak, SD; Santoshkumar, B
    We performed a prospective study of 55 consecutive patients who underwent anterior temporal lobectomy and amygdalo-hippocampectomy (ATL) for intractable complex partial seizures (CPS) of temporal lobe origin. Presurgical evaluation included detailed clinical history and examination, scalp EEG, video-EEG, MRI, intracarotid amytal test, neuropsychological, psyche-social and psychiatric evaluation. Three-months and 1-year post-ATL assessment revealed a remarkable improvement in outcome scores; nearly 96% patients are either totally free or almost free of seizures (Engel class I and II). Utilizing non-invasive evaluation, patients with intractable temporal lobe epilepsy can be selected for cost-effective surgical treatment to provide good seizure control and improved quality of life.
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    Expanding cyst following temporal lobectomy: an unusual complication of epilepsy surgery
    (CLINICAL NEUROLOGY AND NEUROSURGERY, 1999) Rao, MB; Radhakrishnan, K; Radhakrishnan, VV; Gupta, AK
    Following anterior temporal lobectomy performed to control intractable complex partial seizures (CPS), it is rare to find a symptomatic cyst at the lobectomy site causing increased intracranial pressure and neurological deterioration. We report a 24-year-old lady who underwent anterior temporal lobectomy with extended amygdalohippocampectomy for CPS of temporal lobe origin. Ten months following the procedure, she developed a large expanding cyst at the temporal lobectomy site manifesting with recurrence of CPS, progressive focal neurological deficit and increased intracranial pressure. The patient underwent a repeat craniotomy, decompression of the cyst along with wide excision of the wall and fenestration of the arachnoid membrane into the basal cisterns. Following the procedure, the features of increased intracranial pressure and focal neurological deficit promptly improved and her seizures became better controlled. Craniotomy and fenestration of a symptomatic iatrogenic cyst following temporal lobectomy results in clinical improvement, obviating the need for a permanent cystoperitoneal shunt. (C) 1999 Elsevier Science B.V. All rights reserved.
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    Is epilepsy surgery possible in countries with limited resources?
    (EPILEPSIA, 2000)
    This study illustrates the outcome and cost-effectiveness of anterior temporal lobectomy (ATL) among patients with medically refractory temporal lobe epilepsy (TLE) treated in an epilepsy center in Kerala, South India. Patients for ATL were selected on the basis of a noninvasive protocol comprising clinical, interictal scalp electroencephalogram (EEG), magnetic resonance imaging, and ictal video-EEG data. The authors compared the outcome and direct cost of 119 patients (mean age, 25.6 years; mean duration of epilepsy before ATL, 16.1 years) who have completed at least 1 year follow-up after ATL with 71 refractory TLE patients (mean age, 27.1 years; mean duration of epilepsy, 15.4 years) who did not undergo ATL. Patients in the study who underwent ATL had a 70% likelihood of becoming seizure-free after ATL and a 30% chance of being completely off of antiepileptic drug treatment within 3 years after ATL. The out-of-pocket one-time payment for ATL (including presurgical evaluation) in this setup is Indian Rupees (INR) 47,000 (US$ 1,200). The total direct medical cost of caring for TLE patients aged 26 to 60 years would be INR 200,000 (US$ 5,000). Patients freed from seizures often can be better employed and achieve an improved quality of life. It is concluded that ATL for refractory TLE is a more cost-effective option than continued medical treatment. Epilepsy surgery is not only possible in a developing country but can also be undertaken in a cost-effective way.
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    Mesial temporal sclerosis
    (NEUROLOGY INDIA, 1999)
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    National epilepsy surgery program: Realistic goals and pragmatic solutions
    (NEUROLOGY INDIA, 2014) Rathore, C; Rao, MB; Radhakrishnan, K
    There are multiple social, economic, and medical challenges in establishing successful epilepsy surgery programs in India and in other low- and middle-income countries (LAMIC). These can be overcome by reproducing pragmatic and proven epilepsy surgery models throughout the country with a larger aim of developing a national epilepsy surgery program so as to provide affordable and quality surgical care to all the deserving patients. An organized national epilepsy surgery support activity can help interested centers in India and in neighboring countries in developing epilepsy surgery programs.
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    National Epilepsy Surgery Support Activity
    (ANNALS OF INDIAN ACADEMY OF NEUROLOGY, 2014) Radhakrishnan, K; Rathore, C; Rao, MB
    While there are over one million people with drug-resistant epilepsy in India, today, there are only a handful of centers equipped to undertake presurgical evaluation and epilepsy surgery. The only solution to overcome this large surgical treatment gap is to establish comprehensive epilepsy care centers across the country that are capable of evaluating and selecting the patients for epilepsy surgery with the locally available technology and in a cost-effective manner. The National Epilepsy Surgery Support Activity (NESSA) aims to provide proper guidance and support in establishing epilepsy surgery programs across India and in neighboring resource-poor countries, and in sustaining them.
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    Natural history of seizures after temporal lobectomy: An actuarial approach
    (EPILEPSIA, 2005) Panda, S; Radhakrishnan, K; Sylaja, PN; Cherian, J; Rao, MB; Rao, BRM; Radhakrishnan, VV; Sarma, PS
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    Pathology of temporal lobe epilepsy: An analysis of 100 consecutive surgical specimens from patients with medically refractory epilepsy
    (NEUROLOGY INDIA, 1999) Radhakrishnan, VV; Rao, MB; Radhakrishnan, K; Thomas, SV; Nayak, DS; Santoshkumar, B; Joseph, E; Raghunath, B
    The neuropathological features of temporal lobe epilepsy were studied utilising 100 consecutive surgical specimens from patients with medically refractory complex partial seizures. A wide spectrum of neuropathological changes was recorded in 98 specimens. Fifty-eight specimens showed features of Ammon's horn sclerosis, Diffuse accumulation of corpora amylacea were demonstrated in the resected temporal lobes from 54 patients. Six patients had neoplastic lesions of temporal lobe. One unique case of dysembryoplastic neuroepithelial tumour showed a melanotic component within the tumour. The neuropathological features were regarded as nonspecific in 31% of cases. Our results indicate that a majority of patients with medically intractable epilepsy of temporal lobe origin reveal significant neuropathological features. Careful documentation of the neuropathological features and its correlation with radiological, electrophysiological and pre- and post-surgical clinical features will help in predicting the seizure outcome after temporal lobectomy for medically refractory epilepsy.
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    Spinal subdural abscess
    (NEUROLOGY INDIA, 1997) Rao, MB; Misra, BK; Rout, D
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    Suprasellar meningioma subsequent to treatment for a pituitary adenoma: Case report
    (SURGICAL NEUROLOGY, 1997)
    The authors report a case of suprasellar meningioma that developed 16 years after surgery and radiation therapy for a pituitary adenoma. The patient had significant recovery of visual loss following excision of the meningioma. We believe that this tumor was induced by radiation received by the patient previously and we stress that tissue diagnosis should be obtained in patients who develop a recurrent tumor after a long period following initial radiotherapy. Radiation induced meningioma has to be considered in the differential diagnosis of any patient who has a recurrence after therapeutic radiation. This is especially essential in the absence of biochemical and clinical signs of a previously functioning pituitary adenoma and before the initiation of medical therapy for recurrent pituitary adenomas. (C) 1997 by Elsevier Science Inc.