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Amit Agrawal

Open access

Amit Agrawal

Abstract

Cervical spine injuries are the major cause of morbidity and mortality in trauma victims. Upper cervical spine injuries account for about 24% of acute fractures and dislocations and one third of fractures occur at the level of C2, while one half of injuries occur at the C6 or C7 levels. In contrast to this approach we used the transverse cervical, platysma splitting incision at a lower (C3-C4 disc) to expose the upper cervical spine particularly lower border of C3 (entry point for the screw).

Open access

Amit Agrawal

Abstract

Meningiomas arising from the falcotentorial junction are the rarest subgroup of tentorial menigiomas. Because of the distance from the brain surface and the surrounding deep cerebral veins these lesions are difficult and dangerous to treat surgically. A 45-year-old female presented with the history of progressive headache, disorientation, unsteadiness, and urinary incontinence for over 6 months. The patient developed difficulty in swallowing, and weakness of all four limbs for the last 7 days. CT scan brain plain and contrast showed a large well defined, homogenously enhancing mass lesion in the peineal region with compression of the upper brain stem and obstructive hydrocephalus. Inspite of the good surgical decompression the patient did not do well. As described in the literature, the compression of the midbrain can cause severe respiratory disturbances with fatal outcome; probably the similar mechanism resulted in poor outcome in present case. As we noticed the diffuse hypodensity in midbrain on CT scan, similar findings have been described in literature in cases of transtentorial herniation with poorer outcome.

Open access

Amit Agrawal

Abstract

Intracranial epidermoid tumors are rare (0.2-1.8%), histologically benign, slow-growing, congenital neoplasms of the central nervous system arising from the retained ectodermal implants. We report an unusual case of intra third ventricular epidermoid in an adult presenting with the Bobble-head doll syndrome and review the relevant literature.

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Amit Agrawal

Abstract

Post-traumatic acute subdural haematomas are rare in children and associated with significant cerebral oedema. There is need to understand pathophysiology in a better way to improve the outcome. We report a case of traumatic acute subdural haematoma in five year old male child because of its rarity and difficulty confronted in the management of this lesion.

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Amit Agrawal

Abstract

The falx cerebelli is a small sickle-shaped fold of dura mater below the tentorium cerebelli, which projects forward into the posterior cerebellar notch. We report a rare case of 28 year female presented with the history of headache of six months duration off and it increased in severity and frequency over last 15 days. Imaging findings were suggestive of meningiona arising from the falx cerebelli. The lesion could be excised totally and safely.

Open access

Dhaval Shukla and Amit Agrawal

Abstract

Large hemispheric infarctions have malignant course and constitute a major cause of severe morbidity and mortality after stroke. The medical management is usually not effective in these cases. Decompressive craniectomy is a salvage therapy for medically refractory ICP. This paper discusses the merits and demerits of decompressive craniectomy for large hemispheric infarctions. Hemicraniectomy is a life-saving but non-restorative surgery. Surgery should be done before clinical signs of brain herniation to obtain maximum benefit. The relatives of the patient should be explained clearly about possibility of survival with disability before offering the surgery.