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Deopujari CE, Karmarkar VS, Shaikh ST, Mohanty CB, Sharma V, Tadghare J, Thareja V. Neuroendoscopy in the Surgical Management of Lateral and Third Ventricular Tumors: Looking Beyond Microneurosurgery. Neurol India 2021; 69:1571-1578. [PMID: 34979645 DOI: 10.4103/0028-3886.333458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Intraventricular tumors pose a surgical challenge because of the difficulty in reaching their deep location through safe corridors and their adherence or proximity to vital neurovascular structures. Although microneurosurgery is the mainstay of surgical management, neuroendoscopy aided by adjuncts, namely, navigation and ultrasonic aspirators, has made a great contribution to improving surgical results. Objective This article reviews the experience of a neurosurgical unit with endoscopic procedures for intraventricular tumors. The current indications, benefits, and complications of neuroendoscopy are described. Materials and Methods This is a retrospective, observational study of lateral and third ventricular tumors tackled either purely with an endoscope or with its assistance over 19 years in a single unit at Bombay Hospital Institute of Medical Sciences, Mumbai. Results Of a total of 247 operated patients with intraventricular tumors, 85 cases operated using an endoscope were included. The majority of the patients had a tumor in the third ventricle (n = 62), whereas 23 patients had tumor in the lateral ventricle. The most common pathologies were colloid cyst and arachnoid cyst (n = 18). An endoscope was used for microsurgical assisted excision of tumors in 31 cases, biopsy in 24, cyst fenestration in 23, and pure endoscopic excision in seven cases. Conclusion Microsurgery remains the gold standard for the removal of giant, vascular intraventricular tumors. However, endoscopic fenestration or excision of cysts and biopsy have become better alternatives in many cases. Endoscope-assisted microsurgery affords safety and helps in achieving a more complete excision.
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Affiliation(s)
| | - Vikram S Karmarkar
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Salman T Shaikh
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Vikas Sharma
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Jitendra Tadghare
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Varun Thareja
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
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Shaikh ST, Gupta GS, Mohanty CB, Deopujari CE. Spinal Nerve Root Extradural Melanocytoma Progressing to Malignant Melanoma: A Case Report with Review of Literature. Asian J Neurosurg 2021; 16:394-397. [PMID: 34268173 PMCID: PMC8244717 DOI: 10.4103/ajns.ajns_416_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/15/2021] [Indexed: 11/17/2022] Open
Abstract
Melanocytomas are rare benign pigmented tumors arising from the leptomeninges with a very remote chance of progressing to malignant melanoma. They have a predilection for occurring in the posterior fossa or in the intradural extramedullary region of the cervical spine. We report the first case of malignant transformation of a nerve root (extradural) melanocytoma wherein immunotherapy has been added for its treatment. Only four such cases of malignant transformation of central nervous system melanocytoma have been reported in the literature. Definite diagnosis in such cases is based on immunohistochemistry evaluation. Surgical resection with adjuvant radiotherapy and immunotherapy is the recommended treatment.
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Affiliation(s)
- Salman T Shaikh
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Gaurav S Gupta
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Chadrashekhar E Deopujari
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
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Shaikh ST, Thareja V, Mohanty CB, Deopujari CE. Giant extradural spinal schwannoma in a non-neurofibromatosis child-case report and review of literature. Childs Nerv Syst 2021; 37:1327-1331. [PMID: 32671532 DOI: 10.1007/s00381-020-04801-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/09/2020] [Indexed: 11/26/2022]
Abstract
Spinal schwannoma is a rare occurrence in non-neurofibromatosis (NF) pediatric patients, especially in the extradural space extending beyond two vertebral levels. Within this age group, the common extradural tumors are either soft tissue sarcomas or metastasis, often with vertebral bony involvement. Spinal schwannomas are usually benign, slowly progressive, well-defined, intradural extramedullary lesion showing homogenous contrast enhancement on imaging. Though its clinical presentation may be with marked neurological involvement, timely surgical excision usually leads to a quick recovery of the deficits in the young age.This case report describes a giant, spinal, benign schwannoma in a 6-year-old boy which was extradural in location. The lesion was resected completely, and since then, he has been asymptomatic, tumor-free for over 3 years.
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Affiliation(s)
- Salman T Shaikh
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Room No. 114, 1st Floor, MRC Building, 12, New Marine Lines, Mumbai, 400020, India
| | - Varun Thareja
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Room No. 114, 1st Floor, MRC Building, 12, New Marine Lines, Mumbai, 400020, India
| | - Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Room No. 114, 1st Floor, MRC Building, 12, New Marine Lines, Mumbai, 400020, India
| | - Chandrashekhar E Deopujari
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Room No. 114, 1st Floor, MRC Building, 12, New Marine Lines, Mumbai, 400020, India.
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Deopujari CE, Shaikh ST, Karmarkar VS, Sudke AY, Mohanty CB, Biyani NK. Experience with Management of Intracranial Arachnoid Cysts. J Neurol Surg A Cent Eur Neurosurg 2021; 82:43-52. [PMID: 33157563 DOI: 10.1055/s-0040-1718522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to analyze the demographics, clinical presentation, and surgical outcome of intracranial arachnoid cysts and to review the surgical options. METHODS This is a retrospective observational study of 56 cases of symptomatic arachnoid cysts among all age groups treated between 2004 and 2020 at the Bombay Hospital, Mumbai. Endoscopic fenestration, microsurgical cyst excision, and shunt insertion were the interventions performed. Clinical presentation, cyst reduction post-intervention, and complications were studied. The follow-up period varied from 1 month to 16 years. Statistical analysis was done for 43 patients with a minimum of 3 years' follow-up. RESULTS In all, 75% of patients were <18 years of age. Of these, the majority were between the age of 1 and 10 years. There were 14 cases of temporal, 13 cases of retrocerebellar, 10 cases of quadrigeminal cistern, and 7 cases each of interhemispheric and suprasellar arachnoid cysts. The most common clinical presentation was headache and vomiting. Concomitant hydrocephalus was seen on imaging in 24 cases. Endoscopic fenestration of cyst was the most routinely performed procedure (35 cases). Four patients of endoscopic fenestration underwent a redo endoscopic procedure on follow-up. Post-operative reduction in cyst size was found to be significantly better after endoscopic fenestration (p < 0.05). CONCLUSION Though the best available treatment for arachnoid cysts remains controversial, surgery has been found to be beneficial in symptomatic cases. Endoscopic fenestration is considered the first-line surgical option and it may be followed by shunt, if necessary. Shunts may be preferred in very young children where there is associated hydrocephalus/macrocephaly.
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Affiliation(s)
| | - Salman T Shaikh
- Department of Neurosurgery, Bombay Hospital, Mumbai, Maharashtra, India
| | | | - Amol Y Sudke
- Department of Neurosciences, Bai Jerbai Wadia Hospital, Mumbai, Maharashtra, India
| | - Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital, Mumbai, Maharashtra, India
| | - Naresh K Biyani
- Department of Neurosurgery, Bombay Hospital, Mumbai, Maharashtra, India
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Mohanty CB, Muley KD, Deopujari CE. Primary Suprasellar Hypothalamic CNS Lymphoma in an Immunocompetent Adult: A Case Report and Review of Literature. Neurol India 2020; 68:1435-1438. [PMID: 33342884 DOI: 10.4103/0028-3886.304120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Primary suprasellar central nervous system lymphoma (PCNSL) of the hypothalamus is a rare entity. Material and Methods We report a case of a 49-year-old, healthy male presented with features of diabetes insipidus. Imaging features showed a mass in the suprasellar region involving the hypothalamus mainly tuber cinereum and infundibulum. Results Preoperative fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) showed increased uptake in the mass. Biopsy revealed a diffuse type-B PCNSL. The present case emphasizes the importance of considering the diagnosis of hypothalamic lymphoma and the utility of FDG PET-CT in such situations. Conclusion To our knowledge, only eight cases of suprasellar hypothalamic PCNSL have been reported in the literature.
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Affiliation(s)
- Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital and Medical Research Centre, 12, New Marine Lines, Mumbai, Maharashtra, India
| | - Kapil D Muley
- Department of Neurosurgery, Bombay Hospital and Medical Research Centre, 12, New Marine Lines, Mumbai, Maharashtra, India
| | - Chandrasekhar E Deopujari
- Department of Neurosurgery, Bombay Hospital and Medical Research Centre, 12, New Marine Lines, Mumbai, Maharashtra, India
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Abstract
Animal models are widely used in research of peripheral nerve injury and regeneration, since there are only minor differences in the anatomy of peripheral nerves and the physiology of nerve regeneration between the humans and animals. Animal models, especially rodents, are widely used for this purpose. This narrative review provides a brief overview of the role of animal models in peripheral nerve surgery and research.
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Affiliation(s)
- Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences and BJ Wadia Children's Hospital, Mumbai, Maharashtra, India
| | - Dhananjaya I Bhat
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - B Indira Devi
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Deopujari CE, Shah NJ, Shaikh ST, Karmarkar VS, Mohanty CB. Endonasal endoscopic skullbase surgery in children. Childs Nerv Syst 2019; 35:2091-2098. [PMID: 31079184 DOI: 10.1007/s00381-019-04167-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 04/17/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The role of endonasal endoscopic approach for pathologies in the paediatric population is evolving and has still not been accepted as standard of care in neurosurgery. It represents a challenge in terms of narrow access, instrument manipulation and adequate reconstruction of defects. We have described our experience in 49 cases from a single neurosurgical unit in paediatric skull base surgeries through this approach over the last 12 years. MATERIAL AND METHODS A case series of 59 paediatric skull base surgeries in 49 children through endoscopic endonasal route over the last 12 years is presented. The age ranges from 4 months to 18 years. Out of 49 cases, 22 cases were of craniopharyngiomas, 8 cases of pituitary adenomas, 5 cases with CSF rhinorrhea, 5 cases with meningoencephalocele, 3 cases of Rathke's cleft cysts, 2 cases of odontoidectomy and 4 miscellaneous cases viz. mucocele, hypothalamic glioma, esthesioneuroblastoma and epidermoid. CSF leaks were repaired with free graft in the initial years and by vascularized flap more recently. RESULTS The goal of surgery was achieved in all but two cases in whom the tumour excision was unsatisfactory due to failure of the cyst wall to collapse after decompression. Extent of tumour excision was not compromised by the choice of this approach. Revision surgery for CSF leak was required in three patients. Local vascularized nasoseptal flap has been possible even in very young patients and has now become the standard for reconstruction. CONCLUSION In spite of the challenges posed by small nostrils and ill-developed sinuses in the paediatric age group, surgery from endoscopic endonasal corridor is possible to be carried out successfully in selected cases.
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Affiliation(s)
| | - Nishit J Shah
- Department of ENT, Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - Salman T Shaikh
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - Vikram S Karmarkar
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, India
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Abstract
Pediatric spinal infection includes spinal epidural abscess, spondylodiscitis and intradural (extramedullary and intramedullary) spinal infections. However, these entities are extremely rare and no clear guidelines exist for their management. Pertinent literature was searched and a detailed narrative review of this topic is presented.
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Affiliation(s)
| | - Graham Fieggen
- Division of Neurosurgery, Red Cross War memorial Children's Hospital and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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Abstract
Intraspinal bronchogenic cyst (SBC) is a rare but important cause of spinal cord compression, commonly seen in the cervicothoracic spine. We report a case of a 43-year-old male, presenting with complaints of neck pain, radiating to right shoulder, with numbness of right hand and fingers. Magnetic resonance imaging of the cervical spine revealed an intradural extramedullary, ventral cystic lesion extending from C2 to C4 vertebral levels. Complete surgical excision was performed, and the patient had a complete relief of symptoms postoperatively. Only 11 cases of SBCs have been reported in literature. We discuss the peculiar location of this lesion, possible embryological reasons and the overall surgical outcome of SBC.
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Affiliation(s)
- Ranjeet Kumar Jha
- Department of Neurosurgery, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | | | - Salman Tehran Shaikh
- Department of Neurosurgery, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India
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Shaikh ST, Chawda MD, Mohanty CB, Deopujari CE. Primary sphenoid wing meningioma in contiguity with a glioblastoma. Neurol India 2018; 66:245-248. [PMID: 29322998 DOI: 10.4103/0028-3886.222854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Salman T Shaikh
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Mihir D Chawda
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
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Deopujari CE, Mohanty CB. Anatomic variations of the fornix and its clinical implications. Neurol India 2016; 64:947-9. [PMID: 27625235 DOI: 10.4103/0028-3886.190282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Chandrashekhar E Deopujari
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, 12, New Marine Lines, Mumbai, Maharashtra, India
| | - Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, 12, New Marine Lines, Mumbai, Maharashtra, India
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Abstract
The optimal refinement in nerve repair techniques has reached a plateau, making it imperative to continually explore newer avenues for improving the clinical outcome of peripheral nerve regeneration. The aim of this short review is to discuss the role and mechanism of brain plasticity in nerve regeneration, as well as to explore the possible application of this knowledge for improving the clinical outcome following nerve repair.
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Affiliation(s)
- Chandan B Mohanty
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
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Abstract
Vein of Galen malformation (VOGM) is a rare congenital vascular anomaly, comprising about 1% of all intracranial vascular anomalies, predominantly affecting the children less than 1 year of age. A 6-month-old infant presented with complaints of increasing head size of 3 months duration and multiple episodes of vomiting associated with refusal to feed since 7 days. He was a known case of VOGM who had initially refused treatment. Investigations revealed a spontaneously thrombosed VOGM with obstructive hydrocephalous. Child improved uneventfully with ventriculoperitoneal shunt. Spontaneous thrombosis of a VOGM is a rare occurrence and carries a better prognosis. The relevant literature is discussed with emphasis on etiopathogenesis, mechanism, and management of spontaneous thrombosis of the malformation.
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Affiliation(s)
- Chandan B Mohanty
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, India
| | - Dwarakanath Srinivas
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, India
| | - Somanna Sampath
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, India
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14
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Affiliation(s)
- Chandan B Mohanty
- Consultant Neurosurgeon, Bombay Hospital and Medical Research Centre, Mumbai, India.
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Nouri A, Tetreault L, Zamorano JJ, Mohanty CB, Fehlings MG. Prevalence of Klippel-Feil Syndrome in a Surgical Series of Patients with Cervical Spondylotic Myelopathy: Analysis of the Prospective, Multicenter AOSpine North America Study. Global Spine J 2015. [PMID: 26225278 PMCID: PMC4516751 DOI: 10.1055/s-0035-1546817] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Study Design Prospective study. Objective To evaluate the prevalence of Klippel-Feil syndrome (KFS) in a prospective data set of patients undergoing surgical treatment for cervical spondylotic myelopathy (CSM) and to evaluate if magnetic resonance imaging (MRI) features in patients with KFS are more pronounced than those of non-KFS patients with CSM. Methods A retrospective analysis of baseline MRI data from the AOSpine prospective and multicenter CSM-North American study was conducted. All the patients presented with at least one clinical sign of myelopathy and underwent decompression surgery. The MRIs and radiographs were reviewed by three investigators. The clinical and imaging findings were compared with patients without KFS but with CSM. Results Imaging analysis discovered 5 of 131 patients with CSM (∼3.82%) had single-level congenital fusion of the cervical spine. The site of fusion differed for all the patients. One patient underwent posterior surgery and four patients received anterior surgery. Postoperative follow-up was available for four of the five patients with KFS and indicated stable or improved functional status. All five patients demonstrated pathologic changes of adjacent segments and hyperintensity signal changes in the spinal cord on T2-weighted MRI. Multiple MRI features, most notably maximum canal compromise (p = 0.05) and T2 signal hyperintensity area (p = 0.05), were worse in patients with CSM and KFS. Conclusions The high prevalence of KFS in our surgical series of patients with CSM may serve as an indication that these patients are prone to increased biomechanical use of segments adjacent to fused vertebra. This supposition is supported by a tendency of patients with KFS to present with more extensive MRI evidence of degeneration than non-KFS patients with CSM.
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Affiliation(s)
- Aria Nouri
- Division of Neurosurgery and Spine Program, Toronto Western Hospital, Toronto, Ontario, Canada,Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Tetreault
- Division of Neurosurgery and Spine Program, Toronto Western Hospital, Toronto, Ontario, Canada,Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Juan J. Zamorano
- Division of Neurosurgery and Spine Program, Toronto Western Hospital, Toronto, Ontario, Canada,Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Chandan B. Mohanty
- Division of Neurosurgery and Spine Program, Toronto Western Hospital, Toronto, Ontario, Canada,Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Michael G. Fehlings
- Division of Neurosurgery and Spine Program, Toronto Western Hospital, Toronto, Ontario, Canada,Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada,Address for correspondence Michael G. Fehlings, MD, PhD, FRCSC, FACS Professor of Neurosurgery, Halbert Chair in Neural Repair and RegenerationUniversity of Toronto, 399 Bathurst Street, Toronto Western Hospital, Toronto, OntarioCanada
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Affiliation(s)
- Chandan B Mohanty
- Spine Program, Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Rajiv Midha
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
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Mohanty CB, Pandey P. Hemorrhage and ischemia in different hemispheres in a child with moyamoya disease: Case report and review of literature. Ann Indian Acad Neurol 2013; 16:525-9. [PMID: 24339572 PMCID: PMC3841593 DOI: 10.4103/0972-2327.120452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/11/2013] [Accepted: 04/21/2013] [Indexed: 11/13/2022] Open
Abstract
Hemorrhagic type of moyamoya disease (MMD) is extremely rare in children. Ischemia following hemorrhage is very rare in MMD. There are only 11 reports of mixed-type of MMD, with the patient having both hemorrhage and ischemia in the same hemisphere at the time of presentation, or at different time periods. The ischemia is usually secondary to a precipitating cause. However, there are no reports of a child presenting with both ischemia and hemorrhage in different hemispheres. We present a previously unreported phenomenon of MMD, presenting as hemorrhage and ischemia in opposite hemispheres and review the relevant literature.
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Affiliation(s)
- Chandan B Mohanty
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Mohanty CB, Midha R. Retractor-assisted endoscopic nerve decompression in entrapment neuropathy. World Neurosurg 2013; 82:e149-50. [PMID: 24172048 DOI: 10.1016/j.wneu.2013.10.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 10/23/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Chandan B Mohanty
- Division of Neurosurgery and Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Rajiv Midha
- Division of Neurosurgery and Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
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Mohanty CB, Shukla DP, Devi BI. Brain tumors of infancy--an institutional experience and review of the literature. Pediatr Neurosurg 2013; 49:145-54. [PMID: 24662246 DOI: 10.1159/000358308] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 12/31/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Brain tumors in infants are rare and form a distinct subgroup of pediatric brain tumors. These tumors differ from tumors in older children with respect to histology and management and tend to have a poorer outcome. METHODS We analyzed 31 consecutive cases of brain tumors in infancy managed in our institute in the last 15 years and reviewed the published literature since 1990. RESULTS Only 2 of these patients had congenital tumors. Choroid plexus tumors were the most common histological subtype, followed by medulloblastoma; 62% of patients underwent a gross total or near-total excision of the tumor with 1 perioperative mortality; 68% of patients had a good outcome. CONCLUSION Choroid plexus tumors were the most common histological type. Safe resection should be the goal of surgery. Surgeries for tumors in this age group were associated with lower rates of total excision and higher morbidity. Low-grade lesions as expected are associated with longer survival; however, long-term outcomes are far from satisfactory.
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Affiliation(s)
- Chandan B Mohanty
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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21
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Mohanty CB, Narasinga Rao KVL. Brainstem hemangioblastoma and sellar mass. J Neurosci Rural Pract 2012. [PMID: 23189026 PMCID: PMC3505365 DOI: 10.4103/0976-3147.102654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Chandan B. Mohanty
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - KV L Narasinga Rao
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
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Abstract
OBJECTIVE To establish predisposing factors of high cervical disc degeneration (HCDD) with an emphasis on the presence or absence of craniovertebral junction (CVJ) pathology by a retrospective analysis of clinical and radiologic parameters of patients operated at our institute. METHODS Thirty-seven patients of C3-4 prolapsed intervertebral disc (PIVD) were compared with 45 patients of C5-6 PIVD. Nurick's grade was used for clinical assessment. Radiological parameters like congenital and osteoarthritic changes at CVJ along with measurement of stress levels in flexion and extension on X-rays were done. RESULTS Mean age of C3-4 PIVD patients (48.16 years, range 26-65 years) was significantly higher than C5-6 PIVD patients (38.13 years, range 21-55 years) (p < 0.001). CVJ pathology was seen in significantly higher proportion in patients with C3-4 PIVD (18/37) in comparison to C5-6 PIVD (4/45) (p < 0.001). C3-4 PIVD patients presented with a poorer pre-op and post-op Nurick's grade. T2 hyperintense intramedullary signal change was seen in 91.8% (34/37) of C3-4 PIVD patients as compared to 66.67% (30/45) of C5-6 PIVD patients (p < 0.001). CONCLUSION CVJ pathology is a predisposing factor for HCDD. HCDD presents in a poorer Nurick's grade compared to lower cervical PIVD and majority of the patients have T2 hyperintense intramedullary signal changes in MRI. Presence of T2 hyperintense intramedullary signal changes is associated with poorer pre-op clinical status and poorer post-op outcome.
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Affiliation(s)
- Chandan B Mohanty
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
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Abstract
Intraosseous schwannoma of the spine is an extremely rare tumor, with only 18 cases reported so far in the literature. We describe the 1st case of intraosseous schwannoma in the pediatric age group, which was treated successfully, and we review the pertinent literature.
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Affiliation(s)
- Chandan B Mohanty
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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Mohanty CB, Indira Devi B, Somanna S, Bhat DI, Dawn R. Corpus callosum arteriovenous malformation with persistent trigeminal artery. Br J Neurosurg 2011; 25:736-40. [DOI: 10.3109/02688697.2011.554583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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