International Journal of Neurology and Neurosurgery

Palliative care has emerged as a critical component in the holistic care of patients grappling with advanced or life-limiting illnesses like neuro-oncological conditions. It holds profound significance for both the medical community and patients and their families, as it addresses the pressing need to enhance patient well-being in the face of debilitating symptoms and offers potential for improved comfort during the challenging journey. Neuro-oncological disorders, including brain tumours, pose distinct challenges due to their intricate impact on cognitive and physical functioning. Despite the availability of treatments that may temporarily alleviate symptoms and extend life expectancy, brain tumours often culminate tragically, necessitating specialized palliative care Physical immobility, cognitive changes, motor function impairments, seizures, and delirium pose significant hurdles and are intricately influenced by the characteristics and progression of the underlying tumour. This comprehensive review aims to systematically examine the existing literature to illuminate the multifaceted dimensions of palliative care tailored to neuro-oncology patients.it also intends to provides an insightful overview of pivotal themes in palliative care such as symptomatic management, psychosocial support, advance care planning, and end-of-life care. It highlights the importance of embracing a multidisciplinary approach and early integration of palliative care into the patient’s journey. It also ventures into unexplored territories within the realm of neuro-oncology, exploring critical aspects like effectiveness of interventions, advance care planning, and often-overlooked needs of caregivers who play an indispensable role in the patient’s care trajectory. In conclusion, this review amplifies the vital significance of a comprehensive palliative care approach, emphasizing the need for sustained research endeavours and collaborative partnerships among healthcare providers, researchers, and stakeholders. Through these collective efforts, the aim is to substantially enhance the quality of care and support extended to patients and their families, offering a glimmer of hope, comfort, and dignity amid the challenges posed by these complex conditions.

Background: Traumatic brain injury (TBI) often leads to changes in body composition, including the loss of lean body mass, which increases the risk of adverse clinical outcomes such as infections, prolonged ICU stays, and higher mortality rates. These complications may be exacerbated if there is a deficiency of crucial micronutrients and macronutrients. Methods: This prospective observational study was performed in the Department of Neurosurgery, SMS Medical College, Jaipur, between July 2021 and March 2022. We recruited 200 TBI patients aged 15 to 80 years who had a post-resuscitation Glasgow Coma Scale (GCS) score of 3–8 (severe TBI). The “Malnutrition Universal Screening Tool” (MUST) was used to categorize nutritional status, while serum levels of electrolytes (sodium, potassium, calcium, phosphate, and vitamin B12) were measured. Data were collected at admission and at various intervals (24 hours, weekly) based on the study protocol. Statistical analysis was performed using SPSS 22.00. Results: Among the 200 participants, 68.5% were male. Age distribution showed that 62% were 31–45 years old, with a predominant etiology of road traffic accidents (69.5%). TBI severity categorization yielded mild in 26%, moderate in 30.5%, and severe in 43.5% of cases. Daily energy, protein, carbohydrate, and fat intake were significantly lower than recommended dietary allowances (p < 0.05). Macronutrient inadequacy for energy, protein, carbohydrates, and fiber was reported in 93.5%, 69%, 4.5%, and 71.5% of patients, respectively. Sodium levels were significantly associated with TBI severity, and mean calcium levels were lower in severe TBI cases, whereas potassium and phosphate showed no significant correlation with severity (p > 0.05). Conclusion: Identifying and correcting malnutrition (including both macroand micronutrient deficiencies) upon admission may reduce complications in TBI. Appropriate nutritional interventions, coupled with close monitoring of electrolytes, have the potential to improve outcomes in this population.

Background: Peripheral neuropathies are group of disorder which affects nerves due to various etiologies. Diagnostic imaging helps and play a major role in diagnosing the peripheral neuropathies. Early timely diagnosis of nerve injury is very important in taking treatment decisions. Imaging main role is to diagnose nerve Injury/involvement, cause of compression and pathologies mimicking nerve involvement. Aims & Methods: This case series aims to discuss various entrapment peripheral neuropathies & Role of imaging with different modalities. Result & Interpretation: Ultrasound is emerging as a great tool in diagnosing nerve pathologies. It is easily available, cheap, cost effective and best screening tool. Magnetic resonance neurotrophy (MRN) studies help in deeper nerve pathologies, and affected muscle details.

Background: Cerebral venous thrombosis (CVT) is a rare but potentially life-threatening condition that can lead to significant neurological deficits. While medical management with anticoagulation is the standard treatment, some cases of CVT are resistant to medical therapy. In such situations, mechanical thrombectomy (MT) has emerged as a potential alternative. We present a case series highlighting the role of MT in patients with medically refractory CVT. Methods: This is a retrospective case series of patients diagnosed with CVT who underwent mechanical thrombectomy due to failure of medical management. Clinical, imaging, and procedural data were reviewed to assess the safety and effectiveness of the intervention. Results: A total of six patients, ranging from 29 to 81 years old, were included. All patients had failed conventional anticoagulation therapy and presented with worsening symptoms, including increased intracranial pressure, progressive neurological deficits, and impaired consciousness. Mechanical thrombectomy was successfully performed in all patients. Post-procedural outcomes showed significant improvements in neurological status, with four out of six patients achieving a modified Rankin Scale (mRS) score of 0 at three months. Two patients had a mRS score of 3, but their symptoms were markedly improved. Conclusion: Mechanical thrombectomy can be an effective treatment for patients with medically refractory CVT. Early identification of patients at risk of poor outcomes despite medical therapy and timely intervention with thrombectomy may significantly improve functional outcomes.

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Background: Since few decade stem cell research is being more crucial as it has the ability to renew their own population and to differentiate into specialized population of cells. To overcome the immune rejection, ethical issue of embryonic stem cells, and for more practical point of view, patients own body cells be reprogrammed to assume a stem cell like state called induced pluripotent cells (iPSCs) which maintain all the essential properties of embryonic stem cells. Aim: The use of iPS cells for differentiating into various cell type of body and derived differentiate cells to provide personalized cells for cell based therapy is the great aim and it opened the new avenue for regenerative medicine. Objectives: The capability of induced pluripotent stem cells (iPSC) is tremendous as it infinitely divided and differentiated into many different cell types. Hence objective is to use iPSCs to model several diseases to unravel the mechanism of alterations in these diseases. Material: Various approaches were used to induce iPSCs such as delivering reprogramming factors (Oct4, Sox2, Klf4 & c-Myc) into somatic cells or by using a cocktail of small-molecule compounds that modulate various signaling pathways. Result: The tissue of patients are used to generate immune-matched supply of pluripotent stem cells to test or screen the drug and study the specific cause for that disease in patient specific way. The stem cell research including iPS cells has received a significant amount of public attention for neurodegenerative diseases, diabetics and other tissue specific diseases. Conclusion: Great benefits are expected in this field as researchers take advantage of the tremendous potential regenerative properties of induced pluripotent stem cells for promising therapeutic applications, which is described in this article. DOI: 10.21088/ijnns.0975.0223.17125.5 Author’