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Bajaj J, Verma S, Chaudhary V, Khandelwal N, Patidar J, Hedaoo K, Sinha M, Sharma M, Kukrele R, Bajaj D, Yadav N, Ratre S, Parihar VS, Yadav P, Agarwal P, Swamy MN, Yadav YR. Hyperselective Tibial Neurotomy for Relieving Spasticity and Restoring Motor Functions. Neurol India 2023; 71:1142-1145. [PMID: 38174447 DOI: 10.4103/0028-3886.391363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
- Jitin Bajaj
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Shashikant Verma
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Vivek Chaudhary
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Namrata Khandelwal
- Department of Neurology, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Jayant Patidar
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Ketan Hedaoo
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Mallika Sinha
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Mukesh Sharma
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Rajeev Kukrele
- Department of Plastic Surgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Diya Bajaj
- Department of Neuropathology, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Nishtha Yadav
- Department of Neuroradiology, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Shailendra Ratre
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Vijay S Parihar
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Prashant Yadav
- Department of Plastic Surgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Pawan Agarwal
- Department of Plastic Surgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - M N Swamy
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Y R Yadav
- Department of Neurosciences, Apex Hospital and Research Center, Jabalpur, Madhya Pradesh, India
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Yadav YR, Bajaj J. Precision Neurosurgery with 3D Printing. Neurol India 2023; 71:207-208. [PMID: 37148040 DOI: 10.4103/0028-3886.375410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Affiliation(s)
- Y R Yadav
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - J Bajaj
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
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Yadav YR, Bajaj J, Ratre S, Yadav N, Parihar V. A Novel Brain Retractor for Endoscopic Evacuation of Chronic Subdural Hematoma. Neurol India 2023; 71:122-128. [PMID: 36861585 DOI: 10.4103/0028-3886.370434] [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: 03/03/2023]
Abstract
Background Endoscopic chronic subdural hematoma (CSDH) evacuation is a safe and effective alternative to the conventional burr hole technique. Although a rigid endoscope has the advantage of good visualization, there are risks of brain damage due to limited space to accommodate the scope and frequent lens soiling. Objective This technical note describes a novel brain retractor to overcome the limitations of rigid endoscopy. Methods The novel brain retractor (by senior author) was made by dividing a silicon tube longitudinally into two halves, and tapered for easy introduction in the operative cavity. Sutures were placed at the outer end of the retractor to prevent migration and to assist in angulation. Results The novel retractor along with endoscopic assistance was used in 362 CSDH procedures. Endoscopy combined with this retractor provided additional help in complete removal of hematoma in organized/solid clots, septa, bridging vessels, and rapid expansion of brain in 83, 23, 21, and 24 patients, respectively (n = 151, 44%). Although there were three deaths (due to poor preoperative status), and two recurrences, there were no retractor-induced complications. Conclusions The novel brain retractor assists endoscope in proper visualization of complete hematoma cavity by gentle and dynamic brain retraction, helps in thorough irrigation of hematoma cavity, protects the brain, and prevents lens soiling. It allows easy insertion of the endoscope and instruments using bimanual technique even in patients with a small width of hematoma cavity.
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Affiliation(s)
- Yad R Yadav
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Jitin Bajaj
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Shailendra Ratre
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Nishtha Yadav
- Department of Neuroradiology and Imaging, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Vijay Parihar
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
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Bajaj J, Soni P, Khandelwal N, Hedaoo K, Kumar A, Sinha M, Ratre S, Parihar V, Swamy MN, Yadav YR. Epilepsy-Related Injuries in Children: An Institution-Based Study. Neurol India 2022; 70:1091-1094. [PMID: 35864644 DOI: 10.4103/0028-3886.349663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Epilepsy carries a lifetime risk of seizure-related accidents. The risk varies according to the socioeconomic profile of a place. Sufficient data is lacking for epilepsy-related accidents in the pediatric population. OBJECTIVE We aimed to identify the proportion of pediatric epileptic patients who met with accidents and their associated factors. METHODS A prospective study was done. Patients of less than 18 years with epilepsy of more than 1-year duration were included and were given a questionnaire modified for the pediatric population. The demography of accidents during seizures and drugs taken were recorded. RESULTS 135 epileptic children were included. 70.4% of patients suffered seizure-related accidents ranging from 1-10 accidents in their epilepsy duration. Falls (83.15%) were the most common, 25.26% of them required hospitalization. Accidents due to missing of drug dosage were observed in 23% patients. CONCLUSION Seizure-related accidents are common in the pediatric population, and may lead to major accidents. Better epilepsy management with extra care for high-risk epilepsy patients may decrease their incidents.
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Affiliation(s)
- Jitin Bajaj
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Pawan Soni
- Neurology, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | | | - Ketan Hedaoo
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Ambuj Kumar
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Mallika Sinha
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Shailendra Ratre
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Vijay Parihar
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - M N Swamy
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Y R Yadav
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
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Bajaj J, Agarwal P, Sinha PM, Patidar J, Hedaoo K, Yadav YR. Rotational Occipital Scalp Flap for Occipital Pressure Ulcer. Neurol India 2022; 70:876-878. [PMID: 35864612 DOI: 10.4103/0028-3886.349590] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Occipital pressure ulcers and wound gaping may occur in unconscious and malnourished patients. Most of the time, a large defect requires wound coverage by scalp flaps. This video describes a rotational occipital scalp flap for occipital pressure ulcer and wound gaping in a patient of operated midline posterior fossa mass & ventriculoperitoneal shunt. The defect measured 2.25 × 2.5 cm with exposed inion. The wound was included in an imaginary triangle, and the horizontal and vertical incision lengths were about four times the base of the triangle. The flap was based on the left occipital artery and raised in an avascular plane above the periosteum. The wound margins were freshened and undermined. The flap was rotated to bring it over the defect, and suturing was done in the standard manner. The flap had good healing, and the patient continued to be under care for his cerebellar medulloblastoma.
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Affiliation(s)
- Jitin Bajaj
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Pawan Agarwal
- Department of Surgery, Plastic Surgery Unit, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Pranjal M Sinha
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Jayant Patidar
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Ketan Hedaoo
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Yad R Yadav
- Department of Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
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Sinha M, Bajaj J, Kumar A, Hedaoo K, Sharma S, Konchada K, Ratre S, Parihar VS, Swamy NM, Yadav YR. Lumboperitoneal Shunts - Patient Selection, Technique, and Complication Avoidance: An Experience of 426 Cases. Neurol India 2021; 69:S481-S487. [PMID: 35103006 DOI: 10.4103/0028-3886.332265] [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 Lumboperitoneal shunt is a known procedure for communicating hydrocephalus. Being an extracranial procedure, it can also be utilized in normal-sized ventricles. Objective To report our experience of lumboperitoneal shunt done with a minimal follow-up of 12 months with an emphasis on patient selection, technique, and complication avoidance. Methods This was a retrospective analysis of patients who underwent LP shunt during October 2014-October 2019 at the authors' institute. Inclusion criteria were patients with communicating hydrocephalus due to tubercular meningitis, normal pressure hydrocephalus, idiopathic intracranial hypertension, and postoperative refractory cerebrospinal fluid leaks. Data were collected for demographics, Glasgow coma scale and Glasgow outcome scale, vision, gait, memory, urinary incontinence, failed attempts, and complications. Results A total of 426 patients underwent the LP shunt procedure. The commonest indication was tubercular meningitis followed by idiopathic intracranial hypertension and normal pressure hydrocephalus. Age ranged from 16 to 72 years. There were 255 male and 171 female patients. The mean follow-up was 41 ± 8 months. Overall, 301 patients (70.6%) had neurological improvement. Shunt-related complications occurred in 112 (26.29%) patients, of which shunt block was the commonest. Other complications were infection in 17 (3.9%) patients and extrusion in four (0.9%) patients. Transient postural headache was seen in 46 (10.7%) patients, which gradually improved. Conclusion Lumboperitoneal shunt was found to be a safe and effective treatment in appropriately selected communicating hydrocephalus patients. A meticulous technique reduces the complication rate.
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Affiliation(s)
- Mallika Sinha
- Department Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Jitin Bajaj
- Department Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Ambuj Kumar
- Department Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Ketan Hedaoo
- Department Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Sandeep Sharma
- Department Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Kamesh Konchada
- Department Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Shailendra Ratre
- Department Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Vijay S Parihar
- Department Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Narayan M Swamy
- Department Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Yad R Yadav
- Department Neurosurgery, Superspeciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh, India
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Abstract
Background and Introduction Endoscopic anterior cervical approach has several advantages compared to conventional anterior cervical discectomy and fusion (ACDF). Objective This video demonstrates a step-by-step procedure for endoscopic anterior cervical discectomy. Procedure The patient is placed supine with the neck extended. A standard anterior cervical approach using about 3 cm skin incision is made and under "Easy Go" (Karl Storz, Tuttlingen, Germany) endoscopic vision, the uncinate process and uncus are drilled. Only a small portion of the normal disc, posterior longitudinal ligament (PLL), and compressing disc is removed. The closure is done in a standard manner. Results In 240 patients, the average postoperative reduction in disc height, operating time, and blood loss were 1.1 ± 0.2 mm, 110 ± 17 min, and 30 ± 11 mL, respectively. The average postoperative VAS score and Nurick grading improved significantly. There were no permanent complications or any mortality. Conclusion Endoscopic technique is an effective and safe alternative to ACDF after attaining the learning curve.
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Affiliation(s)
- Shailendra Ratre
- Department of Neurosurgery, Superspeciality Hospital, N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India
| | - Yad R Yadav
- Department of Neurosurgery, Superspeciality Hospital, N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India
| | - M N Swamy
- Department of Neurosurgery, Superspeciality Hospital, N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India
| | - Vijay Parihar
- Department of Neurosurgery, Superspeciality Hospital, N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India
| | - Jitin Bajaj
- Department of Neurosurgery, Superspeciality Hospital, N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India
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Shrivastava A, Bajaj J, Yadav YR, Swamy NM, Parihar V, Ratre S, Sinha M, Hedaoo K, Kumar A, Chauhan PS. Colloid Cyst Presenting as Head Injury. Indian Journal of Neurosurgery 2021. [DOI: 10.1055/s-0041-1729516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
AbstractColloid cysts are mucous- or hyaloid-filled lesions with an outer fibrous layer. These are rare developmental and nonneoplastic malformation. They may be found incidentally, while some cases may present with intermittent headache, rapid neurologic deterioration, drop attacks, and even sudden death. Early recognition of this disease may result in lesser mortality. Here, we present a 22-year-old male with a history of fall while driving his two-wheeler. A diagnosis of colloid cyst of the third ventricle with a head injury was made. Colloid cyst presenting with a head injury is exceedingly rare with only five case reports in the literature. This report may help to support surgical intervention in an asymptomatic patient, as the cyst can predispose head injury with serious consequences. It also stresses the importance of a high degree of suspicion when there is any well-defined radiological abnormality in the region of the third ventricle. A colloid cyst may easily be confused with intracranial hemorrhage due to hyperdensity in head trauma. It can be distinguished by the presence of an accompanying traumatic lesion. The cyst usually has well-defined round margins, and the morphologic appearance and density do not change on a follow-up computed tomography (CT) scan, whereas in hemorrhage the density usually regresses with clinical improvement on serial imaging.
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Affiliation(s)
- Ankur Shrivastava
- Department of Neurosurgery, Super Speciality Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | - Jitin Bajaj
- Department of Neurosurgery, Super Speciality Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | - Yad R. Yadav
- Department of Neurosurgery, Super Speciality Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | - Narayan M. Swamy
- Department of Neurosurgery, Super Speciality Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | - Vijay Parihar
- Department of Neurosurgery, Super Speciality Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | - Shailendra Ratre
- Department of Neurosurgery, Super Speciality Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | - Mallika Sinha
- Department of Neurosurgery, Super Speciality Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | - Ketan Hedaoo
- Department of Neurosurgery, Super Speciality Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | - Ambuj Kumar
- Department of Neurosurgery, Super Speciality Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | - Pankaj Singh Chauhan
- Department of Neurosurgery, Super Speciality Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
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Yadav YR, Parihar VS, Ratre S, Dubey A, Jindel S, Dubey MN. Endoscopic single stage trans-oral decompression and anterior C1 lateral mass and C2 pedicle stabilization for atlanto-axial dislocation. Neurol India 2019; 67:510-515. [PMID: 31085869 DOI: 10.4103/0028-3886.257989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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
Although most of the cases of atlanto-axial dislocation (AAD) and basilar invasion can be managed by posterior approaches in the recent times, anterior decompression with stabilization is required in selected patients who persist with irreducible AAD even after manipulation of the C1-C2 facet joint under general anesthesia. A single stage endoscopic trans-oral decompression and stabilization can be used in such patients. It has not been described so far to the best of authors' knowledge. This is indicated in irreducible AAD with the mandibular angle lying below the C2-C3 disc space. It is not a proper choice when the mandibular angle is above the C2-C3 disc space, there is involvement of the facet joint by trauma or any other pathologies, and if a posterior compression at the cervicomedullary junction persists. All patients should undergo pre-operative radiographs, computed tomography (CT) scan and magnetic resonance imaging with angiogram of the cranio-vertebral region. Utilizing this technique, an intra-operative satisfactory reduction of the dislocation with C1-C2 stabilization could be achieved in 3 patients, and 7 required an additional odontoid excision. Post- operative plain radiographs should be performed to assess for C1- C2 alignment and fusion at 3 and 12 months after surgery. All 10 patients of our series had an irreducible AAD and two had an additional basilar invasion. All patients improved from the pre-operative Ranawat grade 3A (n = 8) and 3B (n = 2) to post-operative grade 1 (n = 9) and 2 (n = 1) at a 3-12- month follow-up assessment. The average duration of the procedure and blood loss was 145 minutes and 75 ml, respectively. Endoscopic trans-oral single stage decompression and stabilization seems to be an effective and safe alternative in selected patients with AAD and basilar invasion.
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Affiliation(s)
- Yad R Yadav
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Vijay S Parihar
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Shailendra Ratre
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Amitesh Dubey
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Sonpal Jindel
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Mashoo N Dubey
- Department of Radiology, MP MRI Centre, Jabalpur, Madhya Pradesh, India
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Yadav YR, Parihar VS, Ratre S. Letter to the Editor Regarding "Endoscopic Submandibular Retropharyngeal Approach to the Craniocervical Junction and Clivus: An Anatomic Study". World Neurosurg 2018; 111:420. [PMID: 29499591 DOI: 10.1016/j.wneu.2017.10.084] [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] [Received: 10/13/2017] [Accepted: 10/14/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Y R Yadav
- Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India.
| | - Vijay S Parihar
- Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | - Shailendra Ratre
- Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
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Yadav YR, Parihar V. The endoscopic trans-fourth ventricle aqueductoplasty and stent placement for the treatment of trapped fourth ventricle; stent blockage complications under estimated? Neurol India 2016; 60:455. [PMID: 22955000 DOI: 10.4103/0028-3886.100743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
- Yad R Yadav
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
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Yadav YR, Parihar VS, Todorov M, Kher Y, Chaurasia ID, Pande S, Namdev H. Role of endoscopic third ventriculostomy in tuberculous meningitis with hydrocephalus. Asian J Neurosurg 2016; 11:325-329. [PMID: 27695532 PMCID: PMC4974953 DOI: 10.4103/1793-5482.145100] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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] [Indexed: 12/21/2022] Open
Abstract
Hydrocephalus is one of the commonest complications of tuberculous meningitis (TBM). It can be purely obstructive, purely communicating, or due to combinations of obstruction in addition to defective absorption of cerebrospinal fluid (CSF). Endoscopic third ventriculostomy (ETV) as an alternative to shunt procedures is an established treatment for obstructive hydrocephalus in TBM. ETV in TBM hydrocephalus can be technically very difficult, especially in acute stage of disease due to inflamed, thick, and opaque third ventricle floor. Water jet dissection can be helpful in thick and opaque ventricular floor patients, while simple blunt perforation is possible in thin and transparent floor. Lumbar peritoneal shunt is a better option for communicating hydrocephalus as compared to VP shunt or ETV. Intraoperative Doppler or neuronavigation can help in proper planning of the perforation to prevent neurovascular complications. Choroid plexus coagulation with ETV can improve success rate in infants. Results of ETV are better in good grade patients. Poor results are observed in cisternal exudates, thick and opaque third ventricle floor, acute phase, malnourished patients as compared to patients without cisternal exudates, thin and transparent third ventricle floor, chronic phase, well-nourished patients. Some of the patients, especially in poor grade, can show delayed recovery. Failure to improve after ETV can be due to blocked stoma, complex hydrocephalus, or vascular compromise. Repeated lumbar puncture can help faster normalization of the raised intracranial pressure after ETV in patients with temporary defect in CSF absorption, whereas lumbar peritoneal shunt is required in permanent defect. Repeat ETV is recommended if the stoma is blocked. ETV should be considered as treatment of choice in chronic phase of the disease in obstructive hydrocephalus.
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Affiliation(s)
- Yad R Yadav
- Department of Neurosurgery, St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
| | - Vijay S Parihar
- Department of Surgery, St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
| | - Mina Todorov
- Department of Surgery, St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
| | - Yatin Kher
- Department of Neurosurgery, St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
| | - Ishwar D Chaurasia
- Department of Neurosurgery, Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - Sonjjay Pande
- Department of Radio Diagnosis, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Hemant Namdev
- Department of Neurosurgery, St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
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Abstract
Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. There is lack of uniformity in the treatment of CSDH amongst surgeons in terms of various treatment strategies. Clinical presentation may vary from no symptoms to unconsciousness. CSDH is usually diagnosed by contrast-enhanced computed tomography scan. Magnetic resonance imaging (MRI) scan is more sensitive in the diagnosis of bilateral isodense CSDH, multiple loculations, intrahematoma membranes, fresh bleeding, hemolysis, and the size of capsule. Contrast-enhanced CT or MRI could detect associated primary or metastatic dural diseases. Although definite history of trauma could be obtained in a majority of cases, some cases may be secondary to coagulation defect, intracranial hypotension, use of anticoagulants and antiplatelet drugs, etc., Recurrent bleeding, increased exudates from outer membrane, and cerebrospinal fluid entrapment have been implicated in the enlargement of CSDH. Burr-hole evacuation is the treatment of choice for an uncomplicated CSDH. Most of the recent trials favor the use of drain to reduce recurrence rate. Craniotomy and twist drill craniostomy also play a role in the management. Dural biopsy should be taken, especially in recurrence and thick outer membrane. Nonsurgical management is reserved for asymptomatic or high operative risk patients. The steroids and angiotensin converting enzyme inhibitors may also play a role in the management. Single management strategy is not appropriate for all the cases of CSDH. Better understanding of the nature of the pathology, rational selection of an ideal treatment strategy for an individual patient, and identification of the merits and limitations of different surgical techniques could help in improving the prognosis.
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Affiliation(s)
- Yad R Yadav
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Vijay Parihar
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Hemant Namdev
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Jitin Bajaj
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
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Abstract
Introduction: Configuration and size of the foramen magnum and posterior fossa plays an important role in the pathophysiology of the posterior fossa and craniovertebral junction disorders. This study is aimed to find out various dimensions of the foramen magnum and posterior fossa. Materials and Methods: This is a prospective study of 100 consecutive normal computerized tomography (CT) scans of posterior fossa and 100 dry adult skulls without any bony abnormality. The posterior fossa volume was calculated by abc/2 in method 1 and by advanced work station of CT scan in method 2. Various dimensions of posterior fossa and foramen magnum were also studied. Results: Age ranged from 16 to 89 years with a mean of 51.3 years. Mean height of posterior fossa were 3.01 cm (±0.22) and 3.52 (±0.43) cm in dry skull and CT scan group, respectively (P < 0.0001). Mean volume of posterior fossa were 157.88 (±27.94) cm3 and 159.58 (±25.73) cm3 by method 1 and method 2, respectively (P > 0.05). All the dimensions of posterior fossa and foramen magnum were larger in male as compared to female. Mean anteroposterior (AP), transverse diameter and surface area of the foramen magnum were 3.31 (±0.35) cm, 2.76 (±0.31) cm, and 729.15 (±124.87) mm2, respectively, in CT scan group as compared to 3.41 (±0.29) cm, 2.75 (±0.25) cm, and 747.67 (±108.60) mm2, respectively, in dry skull group. Conclusion: Normal values of posterior fossa and foramen magnum could serve as a future reference. Dry skull dimensions could be different from CT scan measurement. More studies are needed as there could be variations in dimensions in different regions in India
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Affiliation(s)
- Gautam Kanodia
- Department of Neurosurgery, NSCB Medical College and MP MRI Jabalpur, Madhya Pradesh, India
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Agarwal M, Adhana R, Namdev H, Yadav YR, Agrawal T. Transoral extrusion of the ventriculo-peritoneal shunt: A case report and review of literature. J Pediatr Neurosci 2012; 6:149-51. [PMID: 22408670 PMCID: PMC3296415 DOI: 10.4103/1817-1745.92847] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
There are several case reports of complications of ventriculo-peritoneal shunt. Extrusion of the peritoneal end of the shunt through mouth is extremely rare. There are few case reports. We are reporting one such case. A 1-year male child was admitted with the peritoneal end of ventriculo-peritoneal shunt coming out through mouth since 6 hours after an episode of vomiting. He was conscious and had no neurological deficits. The anterior fontanelle was depressed. There was no infection. The peritoneal end of the shunt was removed through the mouth. Shunt revision was performed. The patient was discharged 10 days after the revision without any complications. At 1-year follow-up the patient is doing well. Possible mechanisms of bowel perforation are discussed. Pulling the peritoneal end through mouth is probably the best way of management as small spontaneous gut perforation seals off spontaneously. It also decreases the possibility of infection, other morbidities, and hospital stay.
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Affiliation(s)
- Moneet Agarwal
- Department of Neurosurgery, NSCB Medical College, Madhya Pradesh, India
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Yadav YR, Shenoy R, Mukerji G, Parihar V. Water jet dissection technique for endoscopic third ventriculostomy minimises the risk of bleeding and neurological complications in obstructive hydrocephalus with a thick and opaque third ventricle floor. ACTA ACUST UNITED AC 2010; 53:155-8. [PMID: 21132605 DOI: 10.1055/s-0030-1263107] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Endoscopic third ventriculostomy (ETV) is a procedure of choice in the treatment of obstructive hydrocephalus. Neurovascular injury while perforating the ventricular floor can occur when using a conventional probe, especially in patients with a thick and opaque third ventricle floor. The water jet dissection technique can be useful in such cases to perform an initial perforation. PATIENTS/MATERIAL AND METHODS The water jet dissection technique was used to perform ETV in 36 patients with obstructive hydrocephalus with a thick and opaque third ventricle floor over a 3-year period. A water jet was generated using a syringe connected to a 2-mm catheter. RESULTS The water jet dissection technique successfully created a patent ETV stoma in 31 patients. 5 patients needed a re-operation due to a blocked stoma. There were no complications related to the procedure. An improvement in clinical function was seen in 28 (83.3%) patients at a median follow-up of 29 months. CONCLUSION The water jet dissection is a useful technique while performing ETV to prevent neurovascular injury. Our improvised technique of creating a water jet is safe, inexpensive, readily available and can be practiced at any centre performing ETV.
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Affiliation(s)
- Y R Yadav
- Department of Neurosurgery, NSCB Medical College and Hospital, Jabalpur, India
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17
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Abstract
Surgical options for suprasellar arachnoid cyst are cystoperitoneal shunt, craniotomy fenestration and endoscopic fenestration. Endoscopic management has been found to be safe and effective. We report our experience with endoscopic management in 12 (male five, female seven; age range 8 months to 42 years) patients with suprasellar arachnoid cyst. The endoscopic procedure included lateral ventricle puncture by precoronal burr hole and superior and inferior wall of the cyst was communicated with the lateral ventricle and the interpeduncular cistern respectively. All patients had hydrocephalus. Four pediatric patients had macrocephaly. All adult patients had visual disturbances. One adult patient presented with psychomotor disturbance along with features of raised intracranial pressure. All cases improved following endoscopic treatment. There were no complications or death. One patient required VP shunt. Postoperative MRI showed significant reduction in cyst volume in 11 patients. Follow-up ranged from 6 months to 6 and a half years. Our study suggests that endoscopic technique is a safe and effective alternative treatment for suprasellar arachnoid cyst. It prevents complications such as subdural effusion and intracranial hematoma, which are not uncommon with craniotomy fenestration.
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Affiliation(s)
- Y R Yadav
- Neurosurgery Unit, NSCB Medical College, Jabalpur, MP, India.
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18
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Parihar V, Yadav YR, Sharma D. Pituitary apoplexy in a pregnant woman. Ann Indian Acad Neurol 2010; 12:54-5. [PMID: 20151014 PMCID: PMC2811983 DOI: 10.4103/0972-2327.48861] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2008] [Revised: 08/22/2008] [Accepted: 11/09/2008] [Indexed: 11/29/2022] Open
Affiliation(s)
- Vijay Parihar
- Neurosurgery Unit, Department of General Surgery, NSCB Government Medical College and Hospital, Jabalpur, Madhya Pradesh - 482 002, India
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Yadav YR, Basoor A, Todorov M, Parihar V. Endoscopic management of large multicompartmental intraventricular arachnoid cyst extending from foramen magnum to foramen of Monro. Neurol India 2010; 58:481-4. [DOI: 10.4103/0028-3886.65894] [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: 11/04/2022]
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Yadav YR, Parihar V, Sinha M, Jain N. Simple depressed skull fracture causing posterior third superior sagittal sinus occlusion and elevated intracranial pressure. Neurol India 2009; 57:830-1. [DOI: 10.4103/0028-3886.59500] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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23
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Jain G, Mukerji G, Dixit A, Manshani N, Yadav YR. The impact of nutritional status on the outcome of Indian patients undergoing neurosurgical shunt surgery. Br J Nutr 2007; 98:944-9. [PMID: 17761009 DOI: 10.1017/s0007114507749218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 11/06/2022]
Abstract
Undernutrition is common in surgical patients, is frequently unrecognised and is strongly associated with adverse outcomes such as high rates of complications and mortality, worsening functional status and prolonged hospitalisation. Owing to the associated infection and symptoms such as repeated vomiting, a high prevalence of undernutrition is expected in hydrocephalus patients, which may contribute to their poor surgical outcomes. The aim of this study was to evaluate the influence of preoperative nutritional status on the outcome of Indian patients with hydrocephalus undergoing neurosurgical shunt surgery. One hundred and twenty-four consecutive patients undergoing scheduled hydrocephalus shunt surgery were studied prospectively. All patients underwent nutritional screening according to different parameters prior to surgery. The patients were classified into normally nourished and undernourished groups. The undernourished group was further subdivided into moderately and severely undernourished. The surgical outcome was compared between these groups. A high prevalence (53 %) of undernutrition was observed in these patients. Postoperative complications such as shunt infection (P = 0·0023), shunt revision (P = 0·0074) and mortality (P = 0·0003) were significantly more common in undernourished patients compared with normally nourished patients. Serum albumin emerged as the most significant independent predictor of postoperative mortality. The present study demonstrated a high prevalence of undernutrition in hydrocephalus patients in India and its adverse influence on the outcome of shunt surgery. Early preoperative nutritional status screening and its optimisation may decrease the morbidity and mortality of shunt surgery for hydrocephalus.
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Affiliation(s)
- Gaurav Jain
- Department of Surgery, NSCB Medical College, Jabalpur, India.
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24
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Yadav YR, Basoor A, Jain G, Nelson A. Authors′ reply. Neurol India 2007. [DOI: 10.4103/0028-3886.30437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Yadav YR, Jaiswal S, Adam N, Basoor A, Jain G. Endoscopic third ventriculostomy in infants. Neurol India 2006; 54:161-3. [PMID: 16804260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Endoscopic third Ventriculostomy (ETV) is one of the surgical options for obstructive hydrocephalus. There are varying opinions about results of ETV in infants. We are therefore presenting the results of ETV in 54 infants. MATERIALS AND METHODS A prospective study of 54 infants undergoing ETV in our institution in the last 2 years was carried out. There were 48 cases of congenital hydrocephalus with aqueductal stenosis, 6 of post tubercular meningitis hydrocephalus. Average follow up was 18 months. RESULTS There was 83.3% (45 cases) clinical success rate in our study. Infection, persistent cerebro-spinal fluid (CSF) leak and bleeding occurred in 4 (8%) cases each while blockage of stoma was observed in 8 (14.8%) patients. Majority of ETV stoma closure (6 out of total 8) occurred following infection (4) or bleeding during surgery (2). One patient (2%) had transient diabetes insipidus. Overall failure rate in our study was 16.7% (8 stoma blocks and 1 procedure abandoned). Low birth weight pre mature infants had higher failure rate (3 out of 5 infants 60%) compared to full term infants with normal birth weight (12.3%). Age did not have any impact on the success rate (P>0.05). Success rates were not significanlty different in patients with aqueductal stenosis (85.4%) and TBM (66.6%) (Fisher's exact test, P=0.3). CONCLUSION ETV was fairly safe and effective in full term normal birth weight infants while the results in low birth weight pre mature infants were poor.
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Affiliation(s)
- Y R Yadav
- Neurosurgery Unit, NSCB Medical College, Jabalpur, MP, India.
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26
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Abstract
We report about a 7-year-old female child with cyanotic heart disease whose thalamic abscess was successfully treated by endoscope-assisted abscess drainage. Endoscopic aspiration of thalamic abscess appears to be a safe and effective method of treatment for deep-seated abscesses, as direct visualization of the abscess cavity is possible and the completeness of evacuation can be assessed.
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Affiliation(s)
- Mufique Gajdhar
- Department of Neurosurgery Unit, NSCB Medical College, Jabalpur, Madhya Pradesh, India
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27
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Yadav YR, Pandey S, Tiwari M, Agrawal A, Nelson A. Supratentorial to infratentorial and antigravity migration of intracranial bullet. Neurol India 2006; 54:453-4. [PMID: 17114873 DOI: 10.4103/0028-3886.28138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BACKGROUND AND AIMS Delayed traumatic hematomas and expansion of already detected hematomas are not uncommon. Only few studies are available on risk factors of expanding hematomas. A prospective study was aimed to find out risk factors associated with such traumatic lesions. MATERIALS AND METHODS Present study is based on 262 cases of intracerebral hematomas / contusions out of which 43 (16.4%) hematomas expanded in size. computerized tomography (CT) scan was done in all the patients at the time of admission and within 24 hours of injury. Repeat CT scan was done within 24 hours, 4 days and 7 days. Midline shift if any, prothrombin time, activated partial thromboplastin time, bleeding time, clotting time and platelet counts, Glasgow coma scale at admission and discharge and Glasgow outcome score at 6 months follow up were recorded. RESULTS Twenty six percent, 11.3 and 0% patients developed expanding hematoma in Glasgow Coma scale (GCS) of 8 and below, 9-12 and 13-15 respectively. The chances of expanding hematomas were higher in patients with other associated hematomas (17.4%) as compared to isolated hematoma (4.8%) (Fisher's exact results P =0.216). All the cases of expanding hematoma had some degree of midline shift and considerably higher proportion had presence of coagulopathy. The results of logistic regression analysis showed GCS, midline shift and coagulopathy as significant predictors for the expanding hematoma. Thirty nine patients (90.7%) of the total expanding hematomas developed within 24 hours of injury. CONCLUSIONS Enlargement of intracerebral hematomas is quite common and majority of them expand early after the injury. These lesions were common in patients with poor GCS, associated hematomas, associated coagulopathy and midline shift.
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Affiliation(s)
- Yad R Yadav
- Neurosurgery Unit, NSCB Medical College, Jabalpur, MP, India.
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Abstract
AIMS AND OBJECTIVES The alignment of upper and lower cervical spine is presumed to be closely interrelated and the knowledge of this is mandatory when performing occipito-cervical and upper cervical fusions. The aim of this study was to establish standard values for upper and lower cervical spine alignment in the Indian population. MATERIALS AND METHODS Five hundred eighteen asymptomatic volunteers (261 males and 257 females) between 12 and 80 years of age underwent lateral radiography with their neck in the neutral position. Angles for occipital to 2nd cervical (Oc-C2), 1st to 2nd cervical (C1-C2) and sagittal alignment of 2nd to 7th cervical vertebrae (C2-C7) were measured. Statistical analyses were performed using a statistical package SPSS 10 for windows and the students 't' test. RESULTS The mean Oc-C2, C1-C2 and C2--C7 angles were 14.66+9.5 degrees , 25.6+7.9 degrees and 16.8+12.7 degrees in male, while same angles in female were 15.59+8.26 degrees, 26.9+6.8 degrees and 9.11+10.4 degrees respectively. Weak statistically significant negative correlation was observed between the measured angles of the upper (Oc-C2 and C1-C2) and lower (C2-C7) cervical spines, which means if the lordosis of the occiput and upper cervical spine increases (if the Oc-C2 angle increases), the alignment of lower cervical spine becomes kyphotic and vice versa. This negative correlation was stronger between the Oc-C2 and C2-C7 angles than between the C1-C2 and C2-C7 angles. CONCLUSIONS Relationship between alignment of the upper and the lower cervical spine should be taken into consideration when performing cervical fusion.
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Affiliation(s)
- S K Sherekar
- Neurosurgery Unit, NSCB Medical College, Jabalpur, Madhya Pradesh, India
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Yadav YR, Pandey S, Agrawal A. Hemispheric cerebral ischemia in traumatic brain injury: A report of four cases. The Indian Journal of Neurotrauma 2005. [DOI: 10.1016/s0973-0508(05)80029-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yadav YR, Pande S, Raina VK, Singh M. Lumboperitoneal shunts: review of 409 cases. Neurol India 2004; 52:188-90. [PMID: 15269466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND AND AIMS A prospective study was carried out to evaluate the lumboperitoneal shunt procedure. MATERIAL AND METHODS Four hundred and nine patients having communicating hydrocephalus were selected for the procedure during a 10-year period from March 1992 to February 2002. The average follow-up was 45.34 months. RESULTS Tubercular meningitis (TBM)-related hydrocephalus was detected in 285 patients. Forty per cent of the patients were less than 15 years of age. Glasgow Coma Scale (GCS) of less than 8 was seen in 40% patients and 14.9% patients were in GCS 13-15. At the time of discharge 56.7% patients improved in their GCS to 13 -15 and 14.9% were in GCS 8 or less. The overall mortality was 5.13% and shunt-related mortality was seen in 2% patients. Shunt malfunction requiring revision was seen in 32 patients (7.8%) and the total number of shunt revisions was 44 (11%). Shunt infection was noted in 3.4% patients. CSF leak at the lumbar end occurred in 12 patients. Four patients required conversion of LP shunt to VP shunt. CONCLUSIONS Lumboperitoneal shunt is an effective shunting procedure in communicating hydrocephalus.
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Affiliation(s)
- Y R Yadav
- Department of Surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, India.
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Yadav YR, Singh M, Raina VK. Sphenoid wing meningioma presenting as movement disorder: letter to editor. Neurol India 2002; 50:229-30. [PMID: 12134203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Yadav YR, Rahman HH, Tandan JK, Singh BP, Kriplani TC, Mahendra R. Primary ectopic meningioma. J Indian Med Assoc 2001; 99:102-3, 110. [PMID: 11482801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Primary ectopic meningiomas are rare. A case of a 16-year-old male who presented with a large mass in temporofrontal region is reported. X-ray skull showed soft tissue shadow with hyperostosis of frontal and temporal bone. CT scan of brain demonstrated a markedly enhancing lesion and bony hyperostosis with no intracranial component. Total excision of tumour with hyperostotic bone was done. Patient is well without any evidence of recurrence two years after surgery. Relevant literature is reviewed.
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Affiliation(s)
- Y R Yadav
- Government Medical College, Department of Neurosurgery, Jabalpur
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Yadav YR, Bhagat M, Rahman HH, Tandon JK, Kriplani TC, Shrivastava I, Singh BP. Adult diastematomyelia : a case report and review of literature. Neurol India 1998; 46:316-318. [PMID: 29508831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Adult presentation in diastematomyelia is very rare. The common location is from first to third lumbar vertebrae. Lumbosacral adult diastematomyelia is even rarer. A 42 years male with lumbosacral diastematomyelia is described. Combined myelographic-CT scan study demonstrated lumbar canal stenosis and bony spur attached to vertebral bodies of the fifth lumbar and first sacral vertebra. Surgery with decompression of neural elements and removal of bony spur resulted in complete relief of symptoms. Detailed case representation and a review of 74 cases of adult diastematomyelia is reported.
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Affiliation(s)
- Y R Yadav
- Department of Neurosurgery, Government Medical College, Jabalpur - 482 003, M.P., India
| | - M Bhagat
- Department of Neurosurgery, Government Medical College, Jabalpur - 482 003, M.P., India
| | - H H Rahman
- Department of Neurosurgery, Government Medical College, Jabalpur - 482 003, M.P., India
| | - J K Tandon
- Department of Neurosurgery, Government Medical College, Jabalpur - 482 003, M.P., India
| | - T C Kriplani
- Department of Neurosurgery, Government Medical College, Jabalpur - 482 003, M.P., India
| | - I Shrivastava
- Department of Neurosurgery, Government Medical College, Jabalpur - 482 003, M.P., India
| | - B P Singh
- Department of Neurosurgery, Government Medical College, Jabalpur - 482 003, M.P., India
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Abstract
Cranial chordomas are extremely rare in childhood with only 25 cases having been reported in the first decade of life. A 6-year-old female child with cranial chordoma is reported. Literature on the subject is reviewed, with special reference to the management, histopathological features and prognosis in childhood chordomas as compared to the adult variety.
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Affiliation(s)
- Y R Yadav
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Yadav YR, Yadav S, Kala PC. Puerperal tetanus. J Indian Med Assoc 1991; 89:336-7. [PMID: 1816313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Fifty cases of puerperal tetanus were studied. It constituted 6.66% of total cases of tetanus with overall mortality of 52% which was higher in cases with incubation period of 14 days or less, period of onset 48 hours or less, higher grades, cases with temperature more than 37.7 degrees C and patients with respiratory complications. Significantly higher mortality rate after 48 hours signifies the need of effective local control of infection to improve prognosis. Prevention, early detection and prompt treatment of respiratory complications which is the main cause of death may further reduce mortality rate in these patients.
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Affiliation(s)
- Y R Yadav
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh
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Abstract
Isolated involvement of the 5th through 10th cranial nerves, in blunt head trauma, without any other neurological deficit, is extremely rare. Two such cases are reported and relevant literature reviewed. The mechanics of trauma involved and the poor recovery is outlined.
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Affiliation(s)
- Y R Yadav
- Department of Neurosurgery, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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38
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Affiliation(s)
- Y R Yadav
- Department of Neurosurgery, PGIMER, Chandigarh, India
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39
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Yadav YR, Kala PC, Yadav S. Respiratory complication in tetanus. Indian J Med Sci 1989; 43:317-22. [PMID: 2632408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Six hundred cases of tetanus were studied to find out incidence of respiratory complications and to evaluate factors predisposing such complications in tetanus. The incidence of complications was 41 per cent. Infants, patients of more than 40 years of age, smokers, cases with grossly contaminated injuries, short incubation period and short period of onset were more vulnerable. Patients with dysphagia, spasm, associated respiratory diseases and the patients in higher grades were also found to be more susceptible to respiratory complications.
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