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  1. Article ; Online: Spinal Cord Herniation into a Pseudomeningocele—A Delayed Presentation following a Traumatic Cervical Root Avulsion Injury

    Jay Patel / James Stewart / Shubhabrata Biswas / Sarsam Zaid

    Indian Journal of Radiology and Imaging, Vol 33, Iss 02, Pp 264-

    2023  Volume 266

    Abstract: Background Spinal cord herniation into a traumatic pseudomeningocele is a rare clinical entity. We present the sixth known case and describe surgical management. Case Presentation A 44-year-old male presented with Brown-Sequard syndrome three decades ... ...

    Abstract Background Spinal cord herniation into a traumatic pseudomeningocele is a rare clinical entity. We present the sixth known case and describe surgical management. Case Presentation A 44-year-old male presented with Brown-Sequard syndrome three decades after a cervical nerve root avulsion injury. Imaging revealed hemicord herniation into a C7/T1 pseudomeningocele in addition to extra-axial cord compression from further pseudomeningoceles. Significant clinical improvement was achieved following surgical repair. The radiological findings and technique for operative repair are described. Conclusion The case highlights this rare pathology and presentation, describes the surgical measures for repair of cord herniation, and provides evidence for the favorable outcome that can be achieved by surgical intervention.
    Keywords pseudomeningocele ; herniation ; spinal cord ; trauma ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Subject code 616
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Protocol for an observational cohort study investigating biomarkers predicting seizure recurrence following a first unprovoked seizure in adults

    Christophe de Bézenac / Laura Bonnett / Tony Marson / Mark P Richardson / Kumar Das / Shubhabrata Biswas / Simon S Keller / Michael Pridgeon / Guleed H Adan / Petroula Laiou

    BMJ Open, Vol 12, Iss

    2022  Volume 12

    Abstract: Introduction A first unprovoked seizure is a common presentation, reliably identifying those that will have recurrent seizures is a challenge. This study will be the first to explore the combined utility of serum biomarkers, quantitative ... ...

    Abstract Introduction A first unprovoked seizure is a common presentation, reliably identifying those that will have recurrent seizures is a challenge. This study will be the first to explore the combined utility of serum biomarkers, quantitative electroencephalogram (EEG) and quantitative MRI to predict seizure recurrence. This will inform patient stratification for counselling and the inclusion of high-risk patients in clinical trials of disease-modifying agents in early epilepsy.Methods and analysis 100 patients with first unprovoked seizure will be recruited from a tertiary neuroscience centre and baseline assessments will include structural MRI, EEG and a blood sample. As part of a nested pilot study, a subset of 40 patients will have advanced MRI sequences performed that are usually reserved for patients with refractory chronic epilepsy. The remaining 60 patients will have standard clinical MRI sequences. Patients will be followed up every 6 months for a 24-month period to assess seizure recurrence. Connectivity and network-based analyses of EEG and MRI data will be carried out and examined in relation to seizure recurrence. Patient outcomes will also be investigated with respect to analysis of high-mobility group box-1 from blood serum samples.Ethics and dissemination This study was approved by North East—Tyne & Wear South Research Ethics Committee (20/NE/0078) and funded by an Association of British Neurologists and Guarantors of Brain clinical research training fellowship. Findings will be presented at national and international meetings published in peer-reviewed journals.Trial registration number NIHR Clinical Research Network's (CRN) Central Portfolio Management System (CPMS)—44976.
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-12-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: The long-term outcomes of epilepsy surgery.

    Midhun Mohan / Simon Keller / Andrew Nicolson / Shubhabrata Biswas / David Smith / Jibril Osman Farah / Paul Eldridge / Udo Wieshmann

    PLoS ONE, Vol 13, Iss 5, p e

    2018  Volume 0196274

    Abstract: Despite modern anti-epileptic drug treatment, approximately 30% of epilepsies remain medically refractory and for these patients, epilepsy surgery may be a treatment option. There have been numerous studies demonstrating good outcome of epilepsy surgery ... ...

    Abstract Despite modern anti-epileptic drug treatment, approximately 30% of epilepsies remain medically refractory and for these patients, epilepsy surgery may be a treatment option. There have been numerous studies demonstrating good outcome of epilepsy surgery in the short to median term however, there are a limited number of studies looking at the long-term outcomes. The aim of this study was to ascertain the long-term outcome of resective epilepsy surgery in a large neurosurgery hospital in the U.K.This a retrospective analysis of prospectively collected data. We used the 2001 International League Against Epilepsy (ILAE) classification system to classify seizure freedom and Kaplan-Meier survival analysis to estimate the probability of seizure freedom.We included 284 patients who underwent epilepsy surgery (178 anterior temporal lobe resections, 37 selective amygdalohippocampectomies, 33 temporal lesionectomies, 36 extratemporal lesionectomies), and had a prospective median follow-up of 5 years (range 1-27). Kaplan-Meier estimates showed that 47% (95% CI 40-58) remained seizure free (apart from simple partial seizures) at 5 years and 38% (95% CI 31-45) at 10 years after surgery. 74% (95% CI 69-80) had a greater than 50% seizure reduction at 5 years and 70% (95% CI 64-77) at 10 years. Patients who had an amygdalohippocampectomy were more likely to have seizure recurrence than patients who had an anterior temporal lobe resection (p = 0.006) and temporal lesionectomy (p = 0.029). There was no significant difference between extra temporal and temporal lesionectomies. Hippocampal sclerosis was associated with a good outcome but declined in relative frequency over the years.The vast majority of patients who were not seizure free experienced at least a substantial and long-lasting reduction in seizure frequency. A positive long-term outcome after epilepsy surgery is possible for many patients and especially those with hippocampal sclerosis or those who had anterior temporal lobe resections.
    Keywords Medicine ; R ; Science ; Q
    Subject code 616
    Language English
    Publishing date 2018-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Steroid refractory giant cell arteritis with bilateral vertebral artery occlusion and middle cerebellar peduncle infarction

    Sarah Healy / Mark Simpson / William J Kitchen / Anu Jacob / Daniel Crooks / Nitika Rathi / Shubhabrata Biswas / Nicholas Fletcher / Saif Huda / Alakendu Sekhar

    The Journal of the Royal College of Physicians of Edinburgh, Vol 49, Iss 2, Pp 118-

    2019  Volume 121

    Abstract: Giant cell arteritis is the most common primary systemic vasculitis in adults aged ≥50 years and peaks in the eighth decade of life. Common symptoms include headache, scalp tenderness and jaw claudication. Elevated acute phase reactants (erythrocyte ... ...

    Abstract Giant cell arteritis is the most common primary systemic vasculitis in adults aged ≥50 years and peaks in the eighth decade of life. Common symptoms include headache, scalp tenderness and jaw claudication. Elevated acute phase reactants (erythrocyte sedimentation rate and C-reactive protein) are present in >90% of patients. Visual loss is a well-recognised complication, but approximately 2–4% of giant cell arteritis patients experience stroke, most frequently in the vertebrobasilar territory. We describe a 72-year-old male who developed bilateral vertebral artery occlusion and middle cerebellar peduncle infarction secondary to giant cell arteritis in spite of high-dose steroids.
    Keywords giant cell arteritis ; stroke ; vasculitis ; Medicine (General) ; R5-920
    Language English
    Publishing date 2019-06-01T00:00:00Z
    Publisher Royal College of Physicians of Edinburgh
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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