International Journal of Neurology and Neurosurgery

Posterior fossa is the most common site for brain tumors in the first decade of life. Tumors occurring in this area are usually of either neuronal or glial origin. The common tumors include pilocytic astrocytoma, medulloblastoma, ependymoma, brainstem glioma and rarely atypical rhabdoid teratoid tumors. These account for approximately 50 to 55% of all tumors found in childhood. Less frequently, hemangioblastomas, dermoids, or arachnoid cysts are also encountered. In the Indian subcontinent, tuberculoma is an important entity and must be considered in the differential diagnosis of posterior fosss masses in children.1 

Key words: children, infratentorial, posterior fossa, surgery, tumor. D.P. Mazumdar et al. International Journal of Neurology and Neurosurgery.

Our understanding regarding the pathophysiology of migaraine has changed a lot in past few years and now it is considered as a neuro-inflammatory disorder where calcitonin gene related peptide (CGRP) plays a major role. This peptide is found in the trigemino-vascular system and its role in migraine is confirmed by a number of different evidences including- higher serum concentration during spontaneous as well as experimental migraine, decrement in serum CGRP concentration after migraine abortive therapy and termination of acute attack of migraine with CGRP antagonists. This review examines all the evidences. Migraine and tension type headache are two types of headaches that are widely prevalent. Their prevalence varies from 5% to 70% across various studies depending upon the methodological differences.1 World Health Organization recognizes migraine among the top ten disabling conditions.2 Despite a huge burden imparted by this illness and wide prevalence, we are still not able to find out the exact patho-physiological mechanisms. 

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High precision radiotherapy (RT) is exiting and has shown promise in dose escalation to target while reducing dose to adjacent critical structures and thus reducing complications while maintaining or improving survival functions. High precision RT techniques used in brain tumours are usually three dimensional conformal RT (3D-CRT), intensity modulated RT (IMRT), stereotactic conformal radiotherapy (SCRT) and radiosurgery (SRS). These high precision techniques needs expertise, time, resources and are expensive. Recent results from prospective studies have suggested favorable clinical outcome in the form of improved local control, survival and importantly minimizing later morbidity, after conformal techniques and justify their use in clinical practice.

Keywords: High precision radiotherapy, brain tumour, clinical outcome

Magnetic resonance imaging (MRI) is superior to computed tomography (CT) in terms of its capability to detect ultra-early lesions in the acute stage of cerebral infarction. However, in neurological critical care, CT is usually selected as the first-line technique of diagnostic imaging because of the reduced time necessary for imaging, fewer limitations for the patient, and higher safety and sensitivity in detection of bleeding. In January 2005, a 3.0Tesla MRI device for whole body imaging (Signa EXCITE 3.0, General Electric Company) was approved in Japan and was first installed in our hospital. Its full-scale operation was immediately started. Presently, it is often used for imaging of the head in combination with an additionally approved 8-ch coil.Compared to the currently available highest-level 1.5Tesla MRI device, the 3.0Tesla MRI device (hereinafter simply called “3.0T MRI device”) has a two-fold higher signal to noise ratio, and requires only one fourth of the time for imaging. Furthermore, its high magnetization efficiency allows improved detectability of hemorrhagic lesions (subarachnoid hemorrhage, etc.). Making use of these characteristics of this new device, we have been taking MR images and MR angiograms of patients in the acute stage of stroke for the purpose of evaluation and diagnosis. We present the usefulness of 3.0T MRI device in the neurological critical care and the prospects for 3.0T MRI  to replace the role of CT as the first-line technique of diagnostic imaging. 

Keywords: 3.0 T MRI , neurological critical care , stroke