Academic Day Presentations on 01.06.2024 at 8.00 AM by Department of Neurosurgery
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Item Long term surgical outcomes of Medulloblastoma – A single institution experience(SCTIMST, 2024-06-01) Lokesh, VDMedulloblastoma is the most common childhood malignant tumour of the brain and accounts for 20% of CNS tumours in children. These tumours are grouped into four morphological types viz 1. classical type, 2. desmoplastic nodular, 3. with extensive nodularity; 4. anaplastic/large cell variety. Based on molecular profile, Medulloblastoma has been reclassified into four subtypes: They are Wingless(WNT), Sonic hedgehog(SHH), Group 3 and Group 4 types. Medulloblastomas are risk stratified based on various factors into standard/average risk and high risk, according to clinical risk factors, histological features, molecular markers, age at diagnosis, extent of tumour resection and presence or absence of metastases. The main form of treatment for this condition is surgical resection followed by adjuvant therapies like chemotherapy and craniospinal radiotherapy. The main drawbacks of this treatment are significant side effects and long-term impairment due to adjuvant therapy and the morbidity related to surgery. Hence, we aimed to study this tumour in all aspects- clinico demographic profile, imaging characteristics, post operative complications, cerebellar mutism, recurrence, functional outcomes on follow up. In a small cohort of patients, we had a molecular data regarding the immunohistochemistry for small cohort of patients which was compared with Morphological type. This is one among the largest series of Medulloblastoma study in the world literature and maximum cases recorded from a single institute in India. Acknowledgement : Krishnakumar K1 , Easwer HV, George C.Vilanilam, Jayanand B Sudhir, Prakash Nair, Ganesh Divakar, Gowtham M, Deepthi N2, Rajaleksmy P2, Kesavadas C3, Bejoy Thomas3 ( 1=Department of Neurosurgery, 2= Department of Pathology, 3 = Department of IS & IR)Item The Utility of copeptin as a predictor for post operative hyponatremia and hypernatremia in endoscopic pituitary adenoma surgery patients(SCTIMST, 2024-06-01) Akhilesh, GowdaArginine vasopressin (AVP) is an important hormone responsible for maintaining sodium homeostasis after pituitary surgery. The measurement of AVP levels is difficult because of its short half-life (t1/2). Copeptin is a preprohormone of AVP, and it is a more stable peptide, which can be used as surrogate marker for AVP. This study aims to assess the role of copeptin as a predictor of postoperative hyponatremia and hypernatremia in patients undergoing endoscopic pituitary adenoma surgery. In this prospective study of patients who underwent endoscopic pituitary adenoma surgery, Serum copeptin levels were assessed preoperatively (C1), at extubation (C2), and postoperative day 4 (C3). A relative increase or decrease in early change in copeptin (C2-C1) can predict development of early hyponatremia or transient central diabetes insipidus, respectively. A relative increase in delayed change in copeptin (C3- C1) can predict development of delayed hyponatremia. Acknowledgement : Anand Binu, MCh, Easwer HV, MCh, Prakash Nair1, MCh, Antony Stanley, MD, Biren Khimji Patel, MCh, Madhusoodanan Urulangodi2, PhD, Geetha Mandagini, PhD( 1=Department of Neurosurgery, 2= Department of Biochemistry)Item Treatment of Classical Trigeminal Neuralgias – Our Experience at the Sree Chitra Tirunal Institute for Medical Sciences and Technology(SCTIMST, 2024-06-01) Easwer, HVTrigeminal Nerve is the fifth of the cranial nerves capturing sensations over face and helping us chew the food that we eat. Trigeminal Neuralgia is a condition where an aberrant neuronal activity in the nerve leads to pain over the face. This pain comes in shock-like manner lasting a minute or more in a recurrent fashion. Also called “Suicide Disease” the pain drives the sufferer to contemplate ending one’s life. Classical Trigeminal Neuralgia is due to an artery compressing the nerve. The treatment of this condition is initially using medicines which often gives relief for some time. As the frequency and intensity of the pain increases despite multiple medications. Each in increasing doses, other treatment options are contemplated. The definitive treatment of Trigeminal Neuralgia is by separating the offending artery from the nerve and positioning a piece of Teflon between the two, a. procedure called. as Microvascular Decompression (MVD). The other treatment options of Trigeminal Neuralgia includes damaging the Trigeminal Nerve partially so that pain sensation is not transmitted. This list includes – Radiofrequency Thermal Rhizotomy (RFTR) Balloon Rhizotomy and Glycerol Rhizotomy. Radiosurgery is a form of focused radiation that can be used for partially damaging the nerve using radiation This presentation details the experience of Sree Chitra Tirunal Institute for Medical Sciences and Technology in attempting to provide relief to patients with Trigeminal Neuralgia with Micro Vascular Decompression (MVD), Radiofrequency Thermal Rhizotomy (RFTR) and Balloon Compression Rhizotomy (BCR) in the last few years Acknowledgement : Easwer HV1, Krishnakumar K, George C.Vilanilam, Jayanand B Sudhir, Prakash Nair, Ganesh Divakar, Gowtham M, Subin Sukesan2 [1 Department of Neurosurgery, SCTIMST, Trivandrum, 2 Department of Cardiac Anesthesia]