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Article ; Online: Primary intracranial sarcoma masquerading as a chronic subdural haematoma: illustrative case and review of an unusual phenomenon.

Vasoya, Pavan / Raj, Vivek / Khan, Khurram / Thakar, Sumit / Aryan, Saritha

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2023 Volume 39, Issue 7, Page(s) 1957–1962

Abstract: It is very unusual for a primary intracranial malignancy to present as a chronic subdural hematoma. This case report describes one such case in a 3-year-old girl who presented with raised intracranial pressure following a mild head injury. Imaging of her ...

Abstract	It is very unusual for a primary intracranial malignancy to present as a chronic subdural hematoma. This case report describes one such case in a 3-year-old girl who presented with raised intracranial pressure following a mild head injury. Imaging of her brain revealed bilateral chronic subdural hematomas with an enhancing subdural mass and multiple nodular lesions infiltrating the brain parenchyma. She underwent a craniotomy, drainage of the subdural collections and resection of the subdural mass. Histopathology revealed an undifferentiated sarcoma, and she was referred for adjuvant therapy. This case underlines the importance of evaluating paediatric subdural collections for a possible underlying malignancy, even in the background of a preceding head injury. The cause-effect relationship of sarcomas with subdural collections remains unclear because of the scarcity of available literature on the subject.
MeSH term(s)	Humans ; Child ; Female ; Child, Preschool ; Hematoma, Subdural, Chronic/diagnostic imaging ; Hematoma, Subdural, Chronic/surgery ; Sarcoma/surgery ; Craniotomy ; Brain Neoplasms/complications ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/surgery ; Tomography, X-Ray Computed
Language	English
Publishing date	2023-03-18
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-023-05919-y
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Article: Prospective Study to Evaluate the Role of Multidetector Computed Tomography in Evaluation of Paranasal Sinus Pathologies.

Usmani, Tarim / Fatima, Eram / Raj, Vivek / Aggarwal, Kashish

Cureus

2022 Volume 14, Issue 4, Page(s) e24011

Abstract: Background: The use of computed tomography (CT) combined with functional endoscopic sinus surgery (FESS) has empowered the modern sinus surgeon to treat patients more effectively, facilitating reduced morbidity and complications. This study aimed to ... ...

Abstract	Background: The use of computed tomography (CT) combined with functional endoscopic sinus surgery (FESS) has empowered the modern sinus surgeon to treat patients more effectively, facilitating reduced morbidity and complications. This study aimed to evaluate the role of multidetector computed tomography (MDCT) in the evaluation of paranasal sinus pathologies. Materials & methods: This cross-sectional study was conducted among the adult subjects attending the department of radiology at a tertiary care center in Lucknow for CT scan of paranasal sinuses for suspected paranasal sinus pathology from August 2018 to January 2020. The study included subjects above 12 years of age visiting the facility for CT of paranasal sinuses with a suspected paranasal sinus pathology and were also undergoing FESS. Results: A total of 74 patients falling in the sampling frame were enrolled in the study. Majority of cases were aged <40 years (n=41; 55.4%). Age group of 21-30 years was most affected (24.3%). Mean age of patients was 38.39±14.48 years. Inflammatory pathologies diagnosed on MDCT-included sinusitis (n=25), sinonasal polyps (n=17), sinusitis with polyps (n=15), and mucocele (n=2), respectively. FESS/histopathological diagnosis was done in 73 cases and revealed inflammatory pathology in 59/73 (80.8%) and neoplastic pathology in 14 (19.2%) cases. FESS/histopathological break up of inflammatory pathologies included 22 cases of sinusitis, 20 cases of sinonasal polyps, 14 cases of sinusitis with polyps, and three cases of mucocele. Agreement between MDCT and final diagnosis was seen in 67/74 (90.5%) cases assessed. Conclusion: The findings of the present study showed that MDCT is a useful modality for preoperative assessment of paranasal sinuses. With its high precision in diagnosis, it can help in further treatment planning and management in patients with paranasal sinus pathologies.
Language	English
Publishing date	2022-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.24011
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Article: Clinical Associations of Liver Injury in COVID-19.

Madan, Kaushal / Bhargava, Richa / Dewan, Arun / Budhiraja, Sandeep / Aggarwal, Ritesh / Jadaun, Shekhar Singh / Raj, Vivek / Mishra, Ram Shankar / Indrayan, Abhaya

The Journal of the Association of Physicians of India

2023 Volume 70, Issue 10, Page(s) 11–12

MeSH term(s)	Humans ; COVID-19 ; Liver ; SARS-CoV-2 ; Liver Diseases/etiology
Language	English
Publishing date	2023-06-25
Publishing country	India
Document type	Journal Article
ZDB-ID	800766-4
ISSN	0004-5772
ISSN	0004-5772
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Article ; Online: Microsurgical Clipping of Eight Intracranial Aneurysms in a Patient.

Kiran, Narayanam Anantha Sai / Hegde, Vinay / Raj, Vivek / Hegde, Alangar S

Neurology India

2020 Volume 68, Issue 6, Page(s) 1481–1483

MeSH term(s)	Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Microsurgery ; Neurosurgical Procedures ; Retrospective Studies ; Surgical Instruments ; Treatment Outcome
Language	English
Publishing date	2020-09-30
Publishing country	India
Document type	Letter
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/0028-3886.304102
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Zs.A 698: Show issues

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Article ; Online: Spinal Morphometry As A Novel Predictor For Recurrent Lumbar Disc Herniation Requiring Revision Surgery: Results of A Case Control Study.

Thakar, Sumit / Raj, Vivek / Neelakantan, Sankar / Vasoya, Pavan / Aryan, Saritha / Mohan, Dilip / Hegde, Alangar S

Neurology India

2022 Volume 70, Issue Supplement, Page(s) S211–S217

Abstract: Introduction: There is conflicting data on the risk factors for recurrent lumbar disc herniation (rLDH). Most of the predictors for rLDH identified so far are acquired risk factors or radiological factors at the level of the herniation. Whole lumbar ... ...

Abstract	Introduction: There is conflicting data on the risk factors for recurrent lumbar disc herniation (rLDH). Most of the predictors for rLDH identified so far are acquired risk factors or radiological factors at the level of the herniation. Whole lumbar spine (WLS) morphometry has not been evaluated as a possible predictor of rLDH. Objectives: We aimed to evaluate if preoperative spinal morphometry can predict the occurrence of rLDH requiring revision surgery. Methods: This retrospective case-control study on 250 patients included 45 patients operated for rLDH, 180 controls without rLDH who had previously undergone microdiscectomy for a single level lumbar disc prolapse, and a holdout validation set of 25 patients. Morphometric variables related to the WLS were recorded in addition to previously identified predictors of rLDH. Logistic regression (LR) analysis was performed to identify independent predictors of rLDH. Results: LR yielded four predictors of which two were WLS morphometric variables. While increasing age and smoking positively predicted rLDH, increasing WLS interfacet distance and WLS dural-sac circumference negatively predicted rLDH. The LR model was statistically significant, χ Conclusions: Larger mean lumbar bony canals and dural sacs protect from the occurrence of symptomatic rLDH. These WLS morphometric variables should be included in future risk stratification algorithms for lumbar disc disease. In addition to the previously recognized risk factors, our study points to an underlying developmental predisposition for rLDH.
MeSH term(s)	Humans ; Case-Control Studies ; Intervertebral Disc Displacement/surgery ; Recurrence ; Reoperation/methods ; Retrospective Studies ; Diskectomy/methods ; Microsurgery ; Lumbar Vertebrae/anatomy & histology ; Lumbar Vertebrae/surgery ; Risk Assessment
Language	English
Publishing date	2022-11-22
Publishing country	India
Document type	Journal Article ; Validation Study
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/0028-3886.360932
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Article ; Online: Adenosine-Induced transient asystole during surgical treatment of basilar artery aneurysms.

Sai Kiran, Narayanam A / Mohan, Dilip / Sivaraju, Laxminadh / Raj, Vivek / Vidyasagar, Kanneganti / Hegde, Alangar S

Neurology India

2020 Volume 68, Issue 2, Page(s) 419–426

Abstract: Aim: To evaluate the safety and efficacy of adenosine-induced transient asystole (AITA) during surgery for basilar artery aneurysms.: Materials and methods: All the patients with basilar artery aneurysms operated using AITA at our institute during ... ...

Abstract	Aim: To evaluate the safety and efficacy of adenosine-induced transient asystole (AITA) during surgery for basilar artery aneurysms. Materials and methods: All the patients with basilar artery aneurysms operated using AITA at our institute during two years period (August 2013-July 2015) were included in this study. Results: Adenosine was used in 11 patients with 13 basilar artery aneurysms. Seven of these aneurysms were basilar bifurcation aneurysms, four were basilar-superior cerebellar artery junction aneurysms, and two were distal basilar trunk aneurysms. The indications for AITA were narrow corridor for placement of temporary clip in 11 aneurysms, intraop rupture in 1 aneurysm, and circumferential dissection of a large aneurysm in 1. The mean dose of adenosine used for inducing asystole was 19.4 mg (range: 15-30 mg) and the mean total dose of adenosine used was 40.6 mg (range: 18-90 mg). A mean of 2 (range: 1-5) AITAs were required during surgical treatment of these aneurysms. The mean duration of a systole was 27 s (range: 9-76 s). There were no complications related to AITA in these patients except for transient rebound hypertension in one patient. Check angiogram revealed complete obliteration of 11 aneurysms and small residual neck in 2 aneurysms. Modified Rankin Scale at three months of follow-up was 0 in seven patients, 1 in two patients, 4 in one patient, and 6 in one patient. Conclusion: AITA during surgical management of basilar artery aneurysms is a safe and effective technique and has an important role during surgery for these aneurysms.
MeSH term(s)	Adenosine/therapeutic use ; Adult ; Aneurysm, Dissecting/diagnostic imaging ; Aneurysm, Dissecting/surgery ; Aneurysm, Ruptured/diagnostic imaging ; Aneurysm, Ruptured/surgery ; Angiography, Digital Subtraction ; Anti-Arrhythmia Agents/therapeutic use ; Basilar Artery/diagnostic imaging ; Basilar Artery/surgery ; Cerebral Angiography ; Female ; Heart Arrest, Induced/methods ; Humans ; Imaging, Three-Dimensional ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Intraoperative Care ; Male ; Middle Aged ; Neurosurgical Procedures/methods ; Young Adult
Chemical Substances	Anti-Arrhythmia Agents ; Adenosine (K72T3FS567)
Language	English
Publishing date	2020-05-15
Publishing country	India
Document type	Journal Article
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/0028-3886.284353
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Zs.A 698: Show issues

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Article ; Online: Outcome of Microsurgical Clipping for Multiple Versus Single Intracranial Aneurysms: A Single-Institution Retrospective Comparative Cohort Study.

Sai Kiran, Narayanam Anantha / Raj, Vivek / Sivaraju, Laxminadh / Vidyasagar, Kanneganti / Mohan, Dilip / Hegde, Alangar S

World neurosurgery

2020 Volume 143, Page(s) e590–e603

Abstract: Objective: To evaluate the results of microsurgical clipping for single intracranial aneurysm (SIA) and multiple intracranial aneurysms (MIA) and compare the outcomes.: Methods: All patients who underwent surgery for intracranial aneurysm (IA) at our ...

Abstract	Objective: To evaluate the results of microsurgical clipping for single intracranial aneurysm (SIA) and multiple intracranial aneurysms (MIA) and compare the outcomes. Methods: All patients who underwent surgery for intracranial aneurysm (IA) at our institution over a 3-year period (June 2013 to May 2016) were included in this study. Results: A total of 157 patients with 225 IAs were included. Forty-one of these patients had MIA (109 IAs, mean, 2.7 ± 1.2; range, 2-7), and remaining 116 had SIA. In the patients with MIA, all aneurysms were secured during the same admission whenever possible. Depending on the locations of the IAs and condition of brain during surgery (tense/lax), all aneurysms were secured on same day (in a single session, single or multiple craniotomy in 28 patients) or on different days (multiple sessions in 13 patients). Postoperative control angiography (DSA) before discharge could be done for 216 aneurysms (MIA, n = 105; SIA, n = 111). Successful occlusion of the aneurysm from circulation was noted in 96.2% (101/105) of MIA and 93.7% (104/111) of SIA. Follow-up of 6 months or longer was available for 146 patients. A modified Rankin Scale score ≤2 was considered a good outcome. Univariate analysis of the entire group revealed no significant difference in clinical outcomes between patients with SIA and MIA both at discharge (good outcome: MIA, 82.9%; SIA, 93.1%; P = 0.068) and at a final follow-up of ≥6 months (good outcome: MIA, 87.2%; SIA, 94.4%; P = 0.164). Clipping for MIA was not associated with poor outcome in multivariate analysis. Conclusions: Comparable clinical outcomes and high rates of complete aneurysm occlusion following microsurgical clipping can be expected in patients with SIA and patients with MIA.
MeSH term(s)	Adult ; Aged ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Male ; Microsurgery/methods ; Microsurgery/trends ; Middle Aged ; Retrospective Studies ; Surgical Instruments/trends ; Tertiary Care Centers/trends ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2020-08-08
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.08.019
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Zs.A 1159: Show issues

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Article ; Online: A thoracic intradural "spinal stone" causing paraparesis.

Raj, Vivek / Thakar, Sumit / Hegde, Alangar S

The spine journal : official journal of the North American Spine Society

2016 Volume 16, Issue 9, Page(s) e617–8

Language	English
Publishing date	2016-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2016.02.015
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Zs.A 5898: Show issues

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Article ; Online: Severe Disease Burden and the Mitigation Strategy in the Arsenic-Exposed Population of Kaliprasad Village in Bhagalpur District of Bihar, India.

Kumar, Arun / Kumar, Kanhaiya / Ali, Mohammad / Raj, Vivek / Srivastava, Abhinav / Kumar, Manishankar / Niraj, Pintoo Kumar / Kumar, Mukesh / Kumar, Rishav / Kumar, Dhruv / Bishwapriya, Akhouri / Kumar, Ranjit / Kumar, Suresh / Anand, Gautam / Kumar, Santosh / Sakamoto, Maiko / Ghosh, Ashok Kumar

Biological trace element research

2023 Volume 202, Issue 5, Page(s) 1948–1964

Abstract: The present study was carried out in the village Kaliprasad of Bhagalpur district of Bihar to know the arsenic exposure effect in the exposed population. A total of n = 102 households were studied, and their water and biological samples such as urine and ...

Abstract	The present study was carried out in the village Kaliprasad of Bhagalpur district of Bihar to know the arsenic exposure effect in the exposed population. A total of n = 102 households were studied, and their water and biological samples such as urine and hair were collected and analyzed in a graphite furnace atomic absorption spectrophotometer (GF-AAS). The assessment of arsenic-exposed village population reveals that the villagers were suffering from serious health-related problems such as skin manifestations (hyperkeratosis and melanosis in their palm and soles), breathlessness, general body weakness, mental disorders, diabetes, hypertension (raised blood pressure), hormonal imbalance, neurological disorders, and few cancer cases. About 77% of household hand pump water had arsenic level more than the WHO recommended level of 10 µg/L, with highest level of 523 µg/L. Moreover, in 60% individual's urine samples, arsenic concentration was very high with maximum 374 µg/L while in hair 64% individuals had arsenic concentration above the permissible limit with maximum arsenic concentration of 11,398 µg/kg. The hazard quotient (HQ) was also calculated to know the arsenic risk percentage in children as 87.11%, in females as 83.15%, and in males as 82.27% by groundwater. This has surpassed the threshold value of
MeSH term(s)	Child ; Humans ; Male ; Female ; Arsenic/analysis ; Population Groups ; Water Pollutants, Chemical/analysis ; Arsenic Poisoning/epidemiology ; Groundwater ; India/epidemiology ; Water
Chemical Substances	Arsenic (N712M78A8G) ; Water Pollutants, Chemical ; Water (059QF0KO0R)
Language	English
Publishing date	2023-08-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	445336-0
ISSN	1559-0720 ; 0163-4984
ISSN (online)	1559-0720
ISSN	0163-4984
DOI	10.1007/s12011-023-03822-w
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Zs.B 2323: Show issues

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Article ; Online: Occipital Interhemispheric Transtentorial Approach for Tumors of Posterior Third Ventricular Region: Review of Surgical Results.

Sai Kiran, Narayanam A / Vidyasagar, Kanneganti / Srinivasa, Rakshith / Sivaraju, Laxminadh / Raj, Vivek / Furtado, Sunil V / Thakar, Sumit / Aryan, Saritha / Mohan, Dilip / Hegde, Alangar S

Neurology India

2022 Volume 70, Issue 4, Page(s) 1417–1426

Abstract: Background: Controversies exist regarding the ideal surgical approach for tumors in posterior third ventricular region (PTV).: Objective: To evaluate the results of occipital interhemispheric transtentorial (OITT) approach for tumors in PTV.: ... ...

Abstract	Background: Controversies exist regarding the ideal surgical approach for tumors in posterior third ventricular region (PTV). Objective: To evaluate the results of occipital interhemispheric transtentorial (OITT) approach for tumors in PTV. Materials and methods: Thirty-three patients underwent surgery via OITT approach for PTV tumors at Sri Sathya Sai Institute of Higher Medical Sciences during the study period of 5 years (June 2011-May 2016). Ideal trajectory for OITT approach was determined by neuronavigation. Endoscope was used for removing any residual lesion at the blind spots. Results: Postoperative magnetic resonance imaging (MRI) performed in all the patients revealed gross total or near-total (>95%) excision of tumor in 31 patients (93.9%). Preoperative neurological deficits improved either completely or significantly following excision of the tumor in 73.3% (11/15) of the patients. Outcome was good (modified Rankin scale ≤2) at discharge in 93.9% (31/33) and at a final follow-up of 3 months or more in 96.8% (30/31) of the patients. None of the patients died during the postoperative period. Complications included upgaze palsy (transient- 6.1% [2/33], persisting- 3% [1/33]), visual field defects (transient- 3% [1/33], persisting- 3% [1/33]), transient third nerve paresis (1/33-3%), transient hemiparesis (1/33-3%), operative site hematoma (1/33-3%), small posterior cerebral artery (PCA) territory infarct (1/33-3%), and small venous infarct (1/33-3%). At least one follow-up MRI could be performed in 23 patients. Final follow-up MRI revealed no recurrence or increase in the size of the residual lesion compared to postoperative images in 20 patients (20/23-87%) and large recurrence in 3 patients (3/23-13%) with high-grade lesions. Conclusion: Gross total/near-total excision can be performed in majority of the PTV tumors through OITT approach with minimal morbidity and mortality.
MeSH term(s)	Humans ; Infarction/pathology ; Meningeal Neoplasms/surgery ; Meningioma/surgery ; Neurosurgical Procedures/methods ; Pineal Gland/pathology ; Third Ventricle/surgery
Language	English
Publishing date	2022-08-16
Publishing country	India
Document type	Journal Article
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/0028-3886.355141
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