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Article ; Online: Single-level ossified ligamentum flavum causing a holocord syrinx: illustrative case.

Punia, Prashant / Chugh, Ashish / Gotecha, Sarang / Lachake, Apurva

Journal of neurosurgery. Case lessons

2023 Volume 6, Issue 10

Abstract: Background: Syringomyelia is a neurological disorder that is caused by abnormal cerebrospinal fluid flow or circulation. It is an incidental finding in most cases, predominantly presenting with sensory symptoms of insensitivity to pain and temperature. ... ...

Abstract	Background: Syringomyelia is a neurological disorder that is caused by abnormal cerebrospinal fluid flow or circulation. It is an incidental finding in most cases, predominantly presenting with sensory symptoms of insensitivity to pain and temperature. Spinal ossified ligamentum flavum (OLF) leading to syringomyelia is one of the rare causes. The authors report an unusual case of syringomyelia due to a thoracic OLF. Observations: A 54-year-old female presented with backache, difficulty walking, spasticity in the bilateral lower limbs, tingling sensation in the bilateral lower limbs, and paraparesis for 5 years. Her radiological investigations were suggestive of an OLF causing a syrinx. She underwent laminectomy, and her syrinx resolved on subsequent follow-up. Lessons: A syrinx due to a single-level OLF is rare, and this uncommon cause should be kept in mind while formulating treatment plans.
Language	English
Publishing date	2023-09-04
Publishing country	United States
Document type	Journal Article
ISSN	2694-1902
ISSN (online)	2694-1902
DOI	10.3171/CASE23340
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Article: Endoscopic Transnasal Navigation Guided Treatment of Clivus Abscess in Adult with Mucormycosis: A Rare Report.

Gotecha, Sarang / Chugh, Ashish / Punia, Prashant / Lachake, Apurva

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India

2023 Volume 76, Issue 1, Page(s) 1066–1070

Abstract: Osteomyelitis and abscess of the clivus are rare conditions thought to arise from contiguous spread of infection from the paranasal sinuses. Clival osteomyelitis is a rare potentially life-threatening skull base infection which is generally challenging ... ...

Abstract	Osteomyelitis and abscess of the clivus are rare conditions thought to arise from contiguous spread of infection from the paranasal sinuses. Clival osteomyelitis is a rare potentially life-threatening skull base infection which is generally challenging to diagnose and treat. It is typically seen in the pediatric population and is very rare in the adult population. The exact pathophysiology of osteomyelitis of the clivus is relatively uncertain. Here, we describe a case of a 32-year-old immunocompetent female with a primary complaint of headache, with no significant medical history of diabetes, hypertension or rhinosinusitis or SARS COV-2 for the past 18 months. This case report demonstrates an image-guided and endoscopic approach to surgical localization and treatment of abscesses in the clival area.
Language	English
Publishing date	2023-07-27
Publishing country	India
Document type	Journal Article
ZDB-ID	1471137-0
ISSN	0973-7707 ; 2231-3796 ; 0019-5421
ISSN (online)	0973-7707
ISSN	2231-3796 ; 0019-5421
DOI	10.1007/s12070-023-04117-1
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Article: Immediate postoperative resolution of syrinx post-C1/C2 fixation in an operated case of foramen magnum decompression for Chiari malformation: Is Goel's procedure a rescue surgery or a gold standard?

Chugh, Ashish / Punia, Prashant / Gotecha, Sarang / Gaud, Jayant Arun / Reddy, Rajeev / Aziz, Ramis Abdul

Journal of craniovertebral junction & spine

2024 Volume 15, Issue 1, Page(s) 105–109

Abstract: Chiari malformation (CM) is a common neurological disorder with foramen magnum decompression (FMD) as a commonly accepted treatment. The authors present a case of CM-1 wherein there was no radiological instability preoperatively and FMD was done as a ... ...

Abstract	Chiari malformation (CM) is a common neurological disorder with foramen magnum decompression (FMD) as a commonly accepted treatment. The authors present a case of CM-1 wherein there was no radiological instability preoperatively and FMD was done as a treatment, after which the patient improved transiently only to deteriorate further. Atlantoaxial fixation was done as a second-stage procedure, after which the patient improved clinically and radiologically. The knowledge of this case and surgical entity should be borne in mind before the formulation of a treatment plan. It is important that the solution is to identify and treat the underlying pathology rather than to decompress and directly manipulate the tonsils.
Language	English
Publishing date	2024-03-13
Publishing country	India
Document type	Case Reports
ZDB-ID	2573344-8
ISSN	0976-9285 ; 0974-8237
ISSN (online)	0976-9285
ISSN	0974-8237
DOI	10.4103/jcvjs.jcvjs_182_23
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Article ; Online: A rare case of subependymal giant cell astrocytoma presenting with spontaneous intratumoral hemorrhage.

Gotecha, Sarang / Punia, Prashant / Shobhit, Chhabra / Chugh, Ashish / Kotecha, Megha

Journal of cancer research and therapeutics

2023

Abstract: Abstract: Subependymal giant cell astrocytomas (SEGAs) are low-grade gliomas usually arising in the periventricular regions near the foramen of Monro seen exclusively with tuberous sclerosis complex. Incidence of hemorrhage in SEGA is less than 1% with ... ...

Abstract	Abstract: Subependymal giant cell astrocytomas (SEGAs) are low-grade gliomas usually arising in the periventricular regions near the foramen of Monro seen exclusively with tuberous sclerosis complex. Incidence of hemorrhage in SEGA is less than 1% with only 10 cases reported in English literature. We present a similar case of SEGA with spontaneous intratumoral hemorrhage in a 35-year-old male with cutaneous manifestations of tuberous sclerosis complex and acute onset headache with convulsion.
Language	English
Publishing date	2023-12-15
Publishing country	India
Document type	Journal Article
ZDB-ID	2187633-2
ISSN	1998-4138 ; 0973-1482
ISSN (online)	1998-4138
ISSN	0973-1482
DOI	10.4103/jcrt.JCRT_1288_20
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Article: Contrecoup Extradural Hematoma: When Hematomas Do Not Follow Rules.

Punia, Prashant / Chugh, Ashish / Gotecha, Sarang

Journal of emergencies, trauma, and shock

2022 Volume 15, Issue 1, Page(s) 53–55

Abstract: Extradural hematoma (EDH) is a fairly common entity in neurosurgical practice but EDHt at a contrecoup site and crossing a cranial suture is rare. The authors present a case of EDH due to contrecoup injury in whom sutural diastases was noted and hematoma ...

Abstract	Extradural hematoma (EDH) is a fairly common entity in neurosurgical practice but EDHt at a contrecoup site and crossing a cranial suture is rare. The authors present a case of EDH due to contrecoup injury in whom sutural diastases was noted and hematoma was seen to be crossing the adjacent suture. This was accompanied with subdural hematoma (SDH) at the coup site. According to the best of our knowledge, it makes the case only the 13
Language	English
Publishing date	2022-04-04
Publishing country	India
Document type	Case Reports
ZDB-ID	2461111-6
ISSN	0974-519X ; 0974-2700
ISSN (online)	0974-519X
ISSN	0974-2700
DOI	10.4103/JETS.JETS_64_21
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Article ; Online: Post Mucormycosis Frontal Bone Osteonecrosis: "A Road Less Traveled During the Pandemic".

Chugh, Ashish / Punia, Prashant / Gotecha, Sarang / Rege, Ishant / Shinde, Vinod

World neurosurgery

2023 Volume 172, Page(s) e335–e342

Abstract: Background: Osteonecrosis in mucormycosis is a rare phenomenon and has been reported usually following trauma or in immunocompromised individuals. Osteonecrosis of skull as a complication of mucormycosis is a rare presentation, which makes the study ... ...

Abstract	Background: Osteonecrosis in mucormycosis is a rare phenomenon and has been reported usually following trauma or in immunocompromised individuals. Osteonecrosis of skull as a complication of mucormycosis is a rare presentation, which makes the study ever so rare and interesting. Methods: Within 6 months, a total of 114 patients presented with mucormycosis as COVID-19 sequel, 60 of whom underwent form of endoscopic sinus debridement. Six of these 60 patients presented with frontal bone osteonecrosis and were included in the study. All 6 patients presented within a time period of 2-4 months' post FESS. Results: One of the 6 patients succumbed to her illness. Another patient presented with local recurrence after 3 months, for which she underwent resurgery and debridement. The other 4 patients showed gradual recovery and are without symptoms or radiologic progression at 6-month follow-up. Conclusions: Osteonecrosis in mucormycosis is a rare phenomenon, and the 2 entities have rarely been reported together. The disease usually limits itself to the frontal bone only, and pathogenesis for spread is due to a vicious cycle of infection and ischemia. Prompt diagnosis via imaging, aggressive surgical debridement with a good antifungal cover, good patient compliance, and regular follow-up form the mainstay of treatment.
MeSH term(s)	Humans ; Female ; Mucormycosis/complications ; Mucormycosis/surgery ; Mucormycosis/diagnosis ; Frontal Bone ; Pandemics ; COVID-19/complications ; Antifungal Agents/therapeutic use ; Osteonecrosis/diagnostic imaging ; Osteonecrosis/etiology ; Osteonecrosis/surgery
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2023-01-11
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2023.01.023
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Article: Unusual Presentation of Osteoid Osteoma of the Cervical Spine with Dysphagia: A Case Report.

Punia, Prashant / Chugh, Ashish / Gotecha, Sarang / Patil, Smita S / Lachake, Apurva / Shinde, Vinod

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India

2023 Volume 75, Issue 3, Page(s) 2581–2584

Abstract: It is uncommon for bony cervical spine lesions to cause dysphagia. Middle-aged female presented in the outpatient clinic with complaints of dysphagia of insidious onset. Patient's medical history, clinical manifestation and imaging studies guided the ... ...

Abstract	It is uncommon for bony cervical spine lesions to cause dysphagia. Middle-aged female presented in the outpatient clinic with complaints of dysphagia of insidious onset. Patient's medical history, clinical manifestation and imaging studies guided the diagnosis of spinal osteoid osteoma. The presentation and surgical management are discussed in this report. Supplementary information: The online version contains supplementary material available at 10.1007/s12070-023-03835-w.
Language	English
Publishing date	2023-05-02
Publishing country	India
Document type	Journal Article
ZDB-ID	1471137-0
ISSN	0973-7707 ; 2231-3796 ; 0019-5421
ISSN (online)	0973-7707
ISSN	2231-3796 ; 0019-5421
DOI	10.1007/s12070-023-03835-w
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Article: Pituitary Apoplexy Presenting with Isolated Third Nerve Palsy: A Rare Case Report.

Punia, Prashant / Patel, Ankit / Gotecha, Sarang / Lachake, Apurva / Shinde, Vinod / Chugh, Ashish

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India

2023 Volume 76, Issue 1, Page(s) 1203–1207

Abstract: A 46-year-old female came to neurosurgery outpatient department with sudden onset of drooping of RE upper eyelid and restriction of movements in adduction, depression and elevation in right eye. Patient was a known case of diabetes mellitus whose blood ... ...

Abstract	A 46-year-old female came to neurosurgery outpatient department with sudden onset of drooping of RE upper eyelid and restriction of movements in adduction, depression and elevation in right eye. Patient was a known case of diabetes mellitus whose blood sugar levels were deranged. On examination, patient was diagnosed pituitary macroadenoma. Patient was treated for her uncontrolled diabetes mellitus following which she had underwent transsphenoidal pituitary macroadenoma removal. On treatment, patient's ptosis had subsided and restriction of movement has resolved.
Language	English
Publishing date	2023-09-22
Publishing country	India
Document type	Journal Article
ZDB-ID	1471137-0
ISSN	0973-7707 ; 2231-3796 ; 0019-5421
ISSN (online)	0973-7707
ISSN	2231-3796 ; 0019-5421
DOI	10.1007/s12070-023-04221-2
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Article: Epidermoid Cyst of the Brainstem in 3-Year-Old Child: A Rare Case Report.

Gotecha, Sarang / Chugh, Ashish / Punia, Prashant / Lachake, Apurva / Reddy, Musuku Rajeev / Aziz, Ramis Abdul

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India

2023 Volume 76, Issue 1, Page(s) 1224–1228

Abstract: Epidermoid cysts are infrequent lesions occupying the intracranial space, comprising approximately 1-2% of all intracranial tumors. Brainstem epidermoids are exceptionally uncommon in children; up until now, only a few scattered case reports have been ... ...

Abstract	Epidermoid cysts are infrequent lesions occupying the intracranial space, comprising approximately 1-2% of all intracranial tumors. Brainstem epidermoids are exceptionally uncommon in children; up until now, only a few scattered case reports have been documented in the literature regarding this unique location. These cysts commonly arise from the inclusion of ectodermal elements during neural tube closure. Complete excision of these cysts is challenging due to their close proximity and adherence to the brainstem, which makes it difficult to achieve. As a result, recurrence of the cysts is not uncommon. We have reported a rare case of a 3-year-old with a 5-month history of progressive headache, imbalance while walking and progressive weakness in his right upper limb and lower limb along with difficulty in swallowing. On MRI Brain imaging study he had a pre-pontine epidermoid with intra-axial extension in the pons. The patient underwent retro-sigmoid/suboccipital craniotomy and microsurgical excision of the tumor, including the tumor capsule. After completing the surgery, the cavity was irrigated using a solution containing hydrocortisone and Ringer lactate to prevent the occurrence of aseptic meningitis. In the postoperative, the patient recovered without any complications, as all symptoms showed immediate improvement, and the lower cranial nerves returned to normal functioning.
Language	English
Publishing date	2023-09-20
Publishing country	India
Document type	Journal Article
ZDB-ID	1471137-0
ISSN	0973-7707 ; 2231-3796 ; 0019-5421
ISSN (online)	0973-7707
ISSN	2231-3796 ; 0019-5421
DOI	10.1007/s12070-023-04229-8
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Article: Neuroophthalmic Manifestations of Intracranial Tumours in Children.

Kotecha, Megha / Gotecha, Sarang / Chugh, Ashish / Punia, Prashant

Case reports in ophthalmological medicine

2021 Volume 2021, Page(s) 7793382

Abstract: Background: All children between 0 and 16 years presenting with brain tumours confirmed by Magnetic Resonance Imaging (MRI) and treated surgically in our institute were included in this study.: Objective: The aim of this study is to evaluate the ... ...

Abstract	Background: All children between 0 and 16 years presenting with brain tumours confirmed by Magnetic Resonance Imaging (MRI) and treated surgically in our institute were included in this study. Objective: The aim of this study is to evaluate the neuroophthalmic and clinical characteristics of intracranial space occupying lesions in children. Methods: Neuroophthalmic manifestations along with location of the tumour by contrast-enhanced MRI, type of surgical intervention, and postoperative histopathological diagnosis were evaluated. Results: In pediatric brain tumours, male preponderance was seen and supratentorial location was more common in general, while in older children, infratentorial tumours were more common than supratentorial tumours. Headache, vomiting, and cerebellar signs were the commonest neurological features. Diminution of vision, diplopia, and strabismus were the commonest ophthalmic symptoms. Papilledema, ophthalmoparesis, and nystagmus were the most frequent ophthalmological signs. Neurological manifestations of seizures, altered sensorium and motor deficits were more frequently seen in supratentorial tumours, while cranial nerve involvement and ataxia were seen in infratentorial tumours. Ophthalmological manifestations including diplopia, strabismus, ophthalmoparesis, and nystagmus were more frequently seen in infratentorial tumours. Astrocytoma was the most frequent histopathological diagnosis followed by medulloblastoma. Conclusion: Diagnosis of pediatric intracranial tumours is complex and requires a multidisciplinary approach for prompt management. An ophthalmologist should have a high index of suspicion for brain tumours especially in patients presenting with common ocular symptoms like diminution of vision, diplopia, and strabismus without any neurological symptoms.
Language	English
Publishing date	2021-05-15
Publishing country	United States
Document type	Case Reports
ZDB-ID	2659091-8
ISSN	2090-6730 ; 2090-6722
ISSN (online)	2090-6730
ISSN	2090-6722
DOI	10.1155/2021/7793382
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