International Journal of Neurology and Neurosurgery

Chronic subdural hematomas (cSDH) are a common neurological condition that can cause significant morbidity in the elderly population. Traditionally, surgical options such as burr hole drainage and craniotomy are employed for treatment; however, a novel and minimally invasive intervention has emerged in recent years: middle meningeal artery (MMA) embolization. This technique offers a promising alternative for patients with recurrent cSDH or those who are not candidates for conventional surgery. MMA embolization targets the vascular supply of the hematoma by selectively embolizing the middle meningeal artery, which contributes to abnormal neovascularization within the hematoma capsule. This approach reduces the blood flow to the hematoma, leading to its stabilization and potential resolution without the need for surgical intervention. We present a case of 63-year-old patient with a recurrent cSDH treated successfully with MMA embolization, highlighting the technique’s effectiveness, safety, and potential for broader application in managing this condition.
 

The reconstruction of scalp defects remains a significant challenge in plastic surgery. External Tissue Expansion (ETE) has garnered attention for its capacity to regenerate soft tissues, including skin, subcutaneous fat, and breast tissue. As a minimally invasive and cost-effective tissue engineering approach, ETE demonstrates great potential in wound regeneration. Despite promising outcomes, several challenges must be addressed before its routine clinical application can be realized.Basic in vivo and in vitro studies have explored the mechanisms underlying ETE-mediated tissue regeneration. Findings suggest that ETE facilitates cell proliferation and migration, enhances adipogenesis, promotes angiogenesis, and provides a favorable environment for soft tissue growth. Understanding the mechanical and chemical signals involved in ETE-induced tissue regeneration could enable its broader adaptation in clinical practice.This article reviews the clinical applications of ETE, examines preclinical animal models, and evaluates the potential mechanisms by which ETE promotes tissue regeneration, offering insights into its future integration into clinical settings.
 

Neuropsychiatric disorders encompass a wide range of complex disorders where not only the brain of an affected individual but also their behaviour is poorly affected. These disorders include attention deficit hyperactivity disorder (ADHD), eating disorders, Bipolar disorder, Schizophrenia and Autism, arising from the complex interplay of different factors like environment, genetics and epigenetics. Among all genetics plays quite a significant role in the progression of these disorders. Genetic variants like SNPs, CNVs and genetic mutations are important in influencing the progression of these disorders. Several technologies such as Genome-wide association studies can be used to identify the key gene loci and pathways for the progression of neuropsychiatric disorders. This article aims to have an overview of all genetic variants of various neuropsychiatric conditions with an understanding of their pathways. Moreover, it also highlights different techniques that are used in finding these key gene variants. Also, the complexities that create challenges to genetic variant analysis for medical relevance and how upcoming technologies be used to overcome this problem.
 

Background: Postoperative peritumoral brain edema (PTBE) significantly impacts the clinical outcomes of patients undergoing meningioma resection.Objective: This study aimed to identify predictive factors of PTBE by examining various demographic, clinical, and surgical variables. Methods: A Prospective analysis was conducted on 50 patients who underwent meningioma resection. Data collected included age, sex, chief complaints, duration of symptoms, presence of preoperative seizures, tumor characteristics (location, origin, shape, MRI T2 intensity, maximum diameter, volume), edema volume, edema index, midline shift, and preoperative treatments (mannitol, steroids, anti-epileptic drugs). Surgical details such as tumor consistency, Simpson grade of resection, sinus violation, operative time, intraoperative blood loss, and histopathological features including WHO grade and prominent nucleoli were also analyzed. Postoperative edema was assessed on day 7 after surgery. Results: Preliminary analysis indicated that 21 patients (42%) diagnosed having postoperative PTBE. Preoperative seizures, Sinus violation during surgery, Prominent nucleoli, mixed tumor consistency (soft+ firm) were the independent risk factors for postoperative PTBE,whereas Preoperative Mannitol use and Steroid usewere independent protective factors for postoperative PTBE. It was also found that sphenoid wing meningioma resection was associated with significant postoperative PTBE as compared to all other tumour locations. Tumor size, Tumor shape, Tumor MRI T2 intensity, midline shift, surgical simpsons grade and histopathological grade did not significantly increase complication rate. Detailed statistical analysis is ongoing to further elucidate these relationships. Conclusion: This study identifies several predictive factors of PTBE following meningioma resection. Use of Mannitol and Steroid in preoperative period is protective in developing postoperative PTBE. Factors like preoperative seizures, sinus violation, prominent nucleoli, mixed tumor consistency should warrant surgeon’s attention and needs comprehensive perioperative management to mitigate the risks. Further studies with larger sample sizes are necessary to validate these findings

Background: Thecoperitoneal shunt (TPS) is a method of diverting cerebrospinal fluid (CSF), similar to the ventriculoperitoneal shunt (VPS). While VPS is a common and widely used procedure for hydrocephalus, TPS is less frequently practiced due to limited data on its indications and complications. Patients and Methods: In this study, we retrospectively reviewed our experience with TPS and its indications and complications, in 17 patients operated on from January 2021 to December 2023, with at least six months of follow-up. We analyzed the patients’ clinical data, indications, imaging studies, and complications. Results: Seventeen patients underwent TPS in our institute. The common indications were idiopathic intracranial hypertension (IIH), normal pressure hydrocephalus (NPH), cerebral venous thrombosis (CVT) with vision loss, pseudomeningocele, and CSF leak from the surgical site. The mean follow-up period was 1.2 years. Common complications included shunt overdrainage with subdural collection, shunt infection, shunt blockage, and shunt disconnection. A literature review revealed various other indications and complications. Conclusion: TPS is an effective and favorable treatment modality for various conditions and demonstrates good clinical outcomes. The encountered complications can be managed effectively and may be reduced with additional precautions and strategies