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Item Item Item Review of types of csf diversion and their outcome in patients with posterior fossa tumour and hydrocephalus(SCTIMST, 2022) Darshan, H RItem Clinical outcome after electrophysiologically and anatomically preserved 7th nerve in vestibular schwannoma patient(SCTIMST, 2021) Arvind Kumar SinghItem Assessment of neuronal plasticity in arteriovenous malformations (avm) with overlap on eloquent areas correlation between location on mri and pre and postoperative neurological deficit(SCTIMST, 2021) Harshavardhan PrabhugoudabiradarItem A single institutional experience with pineal region tumor(SCTIMST, 2020-12-31) Patel Biren KhimjiItem A Retrospective Study of Visual Outcome and Factors Affecting it in Suprasellar Tumors in a Tertiary Care Centre(SCTIMST, 2020-12-31) Shah Shreykumar PravinchandraItem Prospective study of transforaminal lumbar interbody fusion(SCTIMST, 2020-12-31) Sawant Ninad AnandItem Study of the predictors of rupture of a specific aneurysm in a patient diagnosed with multiple aneurysms - a prospective exploratory observational study(SCTIMST, 2019-12) Yogesh Madhukar SawakareCerebral aneurysms rupture leads to subarachnoid hemorrhage which leads to significant morbidity and mortality. The outcome after subarachnoid hemorrhage due to aneurysmal rupture is still poor; mortality rates ranges from 40-50%, severe disability in 10-20% and only 40% reach independent status1,2 . Contributing causes to mortality and morbidity is bleed, rebleed, vasospasm and cerebral ischemia. Thereby “prevention is better than cure” can be applied for cerebral aneurysms if causative factors are known and will result in effective treatment of this patients. Predictive factors for bleeding in aneurysm are studied well in literature series. Multiple intracranial aneurysms occur in approximately one third (15–45%) of patients presenting with Subarachnoid hemmorhage. 3,4,9 The exact mechanism of intracranial aneurysm formation per se remains obscured; however, congenital and/or acquired degenerative changes in the arterial wall have been implicated.5,6,7 The presence of multiple aneurysms is sometimes associated with poor outcome because of the complex management issues that are involved and the higher incidence of complications arising from both the hemorrhage and any treatment 6 . It follows, therefore, that the identification of modifiable risk factors for formation of multiple aneurysms is important and has implications both for the prevention of SAH and a more detailed understanding of the pathogenesis of multiple cerebral aneurysms. It is also important to know which aneurysm has bled so as to deal with it at first. Consideration of radiological and clinical parameters is necessary for the assessment of the rupture. Many criteria on the basis of radiology i.e angiographic studies has been taken into account such as shape, size, location . neck, aspect ratio, etc have been evaluated in various studies. 6,7,8 Clinical assessment is also carried out in many studies for the same such as age, gender, cigarette smoking, alcohol, familial, hypertension, collagen vascular diseases, etc.3,4 ,5 Cerebrovascular disease risk factors such as hypertension, cigarette smoking, and alcohol consumption have been shown to increase the risk of SAH and spontaneous intracerebral hematoma.5 However, the role of these risk factors in the formation of multiple, as opposed to single, aneurysms is less well defined. To have an insight of this factors determining rupture of specific aneurysm we carried out a prospective exploratory study of multiple aneurysm in our institute.Item Prospective observational study of patients undergoing anterior petrosectomy(SCTIMST, 2019-12) Mohamed Amad JamaluddinThe anterior petrous apex has been considered as a gateway to the posterior cranial fossa. The anterior petrosectomy as described by Kawase converts this deep narrow operative corridors into wider shallower exposures, improves manoeuvrability and minimizes retraction. It comprises of a sub-temporal craniotomy followed by extradural drilling of the petrous apex to reach the posterior fossa. The traditional Kawase approach provides a 10×5 mm fenestration at the petrous apex of the temporal bone between the 5th cranial nerve and internal auditory canal and the greater superficial petrosal nerve. Complications of this approach include palsies of facial, trigeminal and abducent nerve, CSF leak, hearing loss, injury to the vein of Labbe, etc. This study aims to calculate the amount of bone resected in an anterior petrosectomy done in this institute and with this knowledge, quantify the differential variations used in each surgery while achieving adequate exposure with respect to the local complications will provide a better understanding of this approach. The study ought to define minimal safe resection for a lesion with the best local outcome while preserving the adequacy of exposureItem Prospective observational study for the evaluation of clinical and radiological correlates in patients undergoing surgery for vestibular schwannoma(SCTIMST, 2019-12) Arunkumar KarthikayanCerebellopontine angle (CPA) tumours comprise 5 to 10 percent of all intracranial tumours. Around 90 % of all CPA tumours are vestibular schwannomas, which are benign tumours of the vestibular portion of the vestibulocochlear nerve, arising from the Schwann cells. They first originate in the intracanalicular part of the nerve and grow slowly out into the cisterns. They present with unilateral sensorineural hearing loss with poor speech discrimination (77 to 95 %), unilateral non pulsatile tinnitus (53 to 70%), vestibular dysfunction, trigeminal nerve symptoms, cerebellar dysfunction, headache, facial nerve dysfunction, raised intracranial pressure and lower cranial palsy. Long tract signs are a late finding in patients with vestibular schwannomas and these have become extremely rare in modern series. (1,2) Long tract involvement may present with hyperactivity of ipsilateral deep tendon reflexes, increased tone of the musculature and Babinski sign - extensor plantar response. Rarely extremity weakness and ipsilateral sensory symptoms are found in a small subset of patients. (1 - 10) Diffusion tensor imaging of the brainstem allows delineation of the white matter tracts of the brainstem. It allows subjective quantification of the directional diffusion of the water in the white matter tracts. Lui et al found that in circumscribed posterior fossa primary lesions there was a correlation between clinical weakness and higher mean diffusivity, lower fractional anisotropy and lower transverse eigenvalue values. (55)This study can assess the subset of the patients with vestibular schwannomas who present with long tract signs and their correlation with tractography findings preoperatively. The intraoperative nature of the tumour and the histopathological characteristics will be noted and the postoperative outcome with repeat imaging will be assessed. Through this study, we objectively hope to define the less commonly studied manifestation of vestibular schwannomas, the long tract signs - the size of the tumour beyond which they tend to occur - both clinically and radiologically. There is scarcity of research correlating clinical data with DTI imaging findings and the post operative follow up data, showing outcome after resection. This study hopes to assess the utility of diffusion tensor imaging to objectively quantify the involvement of long tracts in vestibular schwannomas and its usefulness in predicting post operative outcome. The Principal Investigator of this study regularly operates on vestibular schwannomas and we hope that this data will add on to the understanding of the long tract involvement in vestibular schwannomas.Item Prospective observational study of outcomes of different transcranial approaches for craniopharyngiomas(SCTIMST, 2019-12) Jaypalsinh GohilCraniopharyngioma: “One would expect these congenital epithelial tumors to be capable of enucleation like Dermoid cysts elsewhere in the body, but they so definitely adhere to the adjacent structures neighboring on their place of origin, it is rarely possible to shell them out of their bed without the production of serious secondary symptoms. To be sure, one may occasionally succeed in stripping out a thin-walled cyst, and examples of this have been reported, but when the tumor is partly solidified, and calcareous, sad experience warns the surgeon to leave it pretty much alone.” Harvey Cushing, 1932. (1) “Though this tumor is still an ominous disease, it seems fair to say, that the outlook has improved considerably.” (2) Craniopharyngiomas are rare CNS tumors defined by WHO as benign, partly cystic epithelial tumor of the sellar region presumably derived from Rathke’s pouch epithelium. While it is benign in nature, the adhesion to surrounding structures may result in damage to sellar and parasellar tissues during surgery and hence it is called “Benign Tumor in a malignant location.” (3) However due to introduction of hormonal therapy has allowed optimal correction endocrinal deficiency, and improvement in radiation and microsurgical techniques have improved survival enormously, it is the quality of survival that has become real challenges. The results of the published studies of neuropsychological outcome in children are often conflicting and controversial. However surgical approaches of craniopharyngioma need to be addressed with regards to neuropsychological outcome. This study serves the above mentioned purpose.Item Post Surgical Outcome of Long Term Epilepsy Associated Tumors (LEAT): A Retrospective Cohort Study(SCTIMST, 2018-12) Pradeepanand, VaidyaItem Item Item Retrospective Study of Outcome of Patients with Tentorial Meningioma Following Microsurgical Resection(SCTIMST, 2018-12) Gograj, Garhwal