International Journal of Neurology and Neurosurgery

Use of cortical screws for bony fixation is a well known phenomenon but use of same screws for softtissue fixation is a new concept. A case of necrotising fascitis of scalp was treated with repeated debridement and local flaps. In this case we had no difficulty in covering the wound as flaps were preoperatively planned but insetting tough oedematous flaps was difficult, hence we used cortical screws for fixation and they served the purpose well.

Keywords: Cortical screws; scalp reconstruction,rotation flaps; screws.

Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spinal procedures in the United States. With an excellent outcome in most of them. The complications associated with this procedure are rare but can be troublesome and life threatening. We report the case of a patient that sustained a missed, late esophageal perforation after an anterior cervical discectomy and fusion, leading to multiple abscesses in the epiduaral, paraspinal, mediastinal, parapsoas, and pleural spaces, who survived after multiple procedures and was able to ambulate after a prolonged course of care. A proposed algorithm for treatment is included.

Keywords: ACDF; Multiple epidural abscess; Esophageal perforation. 

16-years old male diagnosed six years ago as grade 2 ependymoma presented to our hospital with extracranial extension to the left side of face involving the left eye and left cheek.

Keywords: Glioma; Ependymoma; Extracranial extension. 

Brain implants, often referred to as neural implants, are technological devices that connect directly to a biological subject’s brain - usually placed on the surface of the brain, or attached to the brain’s cortex. “Brain pacemakers” are used to treat people who suffer from epilepsy, Parkinson’s disease, major depression and other diseases. Pacemakers may also be implanted outside the brain, on or near the spinal cord (spinal cord stimulation), and around cranial nerves such as the vagus nerve (vagus nerve stimulation), and on or near peripheral nerves. The deep brain stimulation system consists of three components: the implanted pulse generator (IPG), the lead, and the extension. DBS leads are placed in the brain according to the type of symptoms to be addressed. Brain implants electrically stimulate, block or record signals from single neurons or groups of neurons networks in the brain. DBS reduces tremor, rigidity, bradykinesia, gait problems, dyskinesia, motor fluctuations, dystonia. The innovative technology may also come to the next generations that may replace the 1st generation Brain Pacemakers. There are very few cons for brain pacemakers that outweigh the potential benefits. In the short amount of time brain pacemakers have progressed so far. Given more time, brain pacemakers will be a really useful and a powerful technology.  

Keywords: Brain pacemaker; Brain implants; Deep brain stimulation; Parkinson’s disease; Alzheimer’s disease.   

Background: Walking is an integrated function of neurophysiological and musculoskeletal systems which in turn depends upon cardiorespiratory and metabolic systems for energy cost and expenditure. Objective: To evaluate the abnormalities of gait in patients with diabetic peripheral neuropathy (DPN) by reviewing studies on assessment and treatment. Methods: A systematic review of PubMed was done using search terms of diabetic neuropathy and gait for articles in English with abstracts and independent blinded data extraction and synthesis was performed to identify studies on assessment and treatment. Results: Reduced gait speed, reduced double support time, reduced step length, reduced ankle range of motion, with increased ankle invertor-evertor moment; altered plantar pressures with increased load under midfoot compared to rearfoot; earlier muscle activity of soleus, tibialis anterior, vastus medialis and medial hamstrings with delayed muscle activity of vastus lateralis and lateral gastrocnemius; longer loading time with decreased mediolateral and longitudinal center of pressure excursions were reported in gait of individuals with DPN. Gait-related interventions in DPN population studied were physiotherapy including walking prescription, lower extremity strengthening and balance exercises, footwear and insoles, and visual feedback which were shown to improve balance, gait speed, muscle activity and plantar pressures in this population. Conclusion: There were alterations in temporal and spatial gait parameters, muscle activation patterns, and loading time responses which is essential for clinicians examining patients with DPN, and interventions such as physiotherapy, footwear and insoles and visual feedback were reported to be useful to improve gait in people with DPN.

Keywords: Gait; Human walking; Bipedal locomotion; Diabetic neuropathy; Functional mobility.