Anuj Kumar Tripathi

Tuberculosis (TB) is endemic in India, alone contributing for two thirds of total cases worldwide. Spinal tuberculosis accounts for 1-2% of all cases of tuberculosis. However, spinal intramedullary tuberculoma occurs in as few as 2 out of 1000 cases of tuberculosis involving central nervous system. This may present in form of meningitis, tubercular spondylitis, arachnoididtis or tuberculomas mostly. The most common site of involvement is found to be the thoracic region of spine affecting relatively younger age groups and often seen in association with extraspinal tuberculosis disease. The source of intramedullary tuberculosis is mostly hematogenous spread from a site of primary TB elsewhere in the body which is usually the lungs.Due to rarity of the disease misdiagnosis is frequent.Magnetic Resonance Imaging is the investigation of choice and histopathological examination and culture are confirmatory methods for diagnosis of tuberculosis.Microsurgical resection is better option for rapidly progressing intramedullary tuberculosis cases. Here we report a rare case of isolated spinal intramedullary tuberculoma of thoracic spinal region. Keywords: Intramedullary Tuberculoma, Thoracic Spine, Endemic

Spinal epidermoid cyst is a rare entity. It may be congenital with associated spinal dysraphism such asspina bifida ,dermal sinus tract and other neural tube defects or acquired due to repeated lumbar puncture and trauma. Congenital spinal epidermoid cysts without spinal dysraphism are rare. Here we are reporting a rare and interesting case of thoracic extramedullary intradural epidermoid cyst with no associated features of spinal dysraphism or history of iatrogenic trauma in a young male patient.   Keywords: Epidermoid, Cyst, Spinal dysraphism, Extramedullary, Thoracic

Hydatid cyst is a very significant health problem in India. As recorded in the literature, majority of hydatid cysts are found in the liver followed by the lungs with an incidence rate of 60-70% and 10-15% respectively. Cystic hydatid disease in bones is seen in less than 4% of cases, with majority presenting in the spine. In this case report we have discussed primary intraspinal extradural hydatid cyst with paravertebral extension (dumbbell shaped) in lumbar vertebra which is a rarity. The diagnosis was established intraoperatively based on the findings with a follow up and review of literatures, along with its management.   Keywords: Hydatid cyst, Spine, Dumbbell shape.

Headache, an almost universal human experience, is one of the most common complaints encountered in medicine and neurology. In recent years, there has been a lot of focus on the impact of both physical and mental illness in terms of their impact on quality of life. The idea of quality of life is undoubtedly a multidimensional concept, which emphasizes the self-perception of an individual’s current state of mind.1 The quality of life scale is based on many things, including: Mental and physical well-being. Relationships with other people. Social, community, and civic activities. Personal development and fulfillment. Recreation and fun. Keywords: Headache, Quality of life, Descriptive study.

Extradural haematomas of the posterior fossa are a rare in comparison to supratentorial epidural hematomas and much less common. Because of the limited size of the posterior fossa early identification and intervention can save the lives of these patients. Keywords: Road side accident, Posterior fossa haematoma, Extradural haematoma.

Pineal region tumors are rare comprising 0.4% to 0.1% of all primary tumors of the central nervous system1,2 and constitute 3% to 11% of childhood brain tumors.3-5 These tumors are classified into tumors of germ cell origin, which clearly account for the majority of tumors in this region and those originating from pineal parenchymal cells.1 The latter include pineoblastomas, pineocytomas, and tumors of glial origin. These retain the potential for neuronal or glial differentiation.1,6 Approximately three-fourths of tumors in this area are malignant with the propensity for seeding(3,7,8,9,10). Retrospectively we have analyzed 47 cases of pineal region tumors and have discussed the clinical features, histopathology, management and outcome. Keywords: Pineal tumors, Central nervous system, Tumors of glial origin.

"Unknown" head injury patients are a major burden for our country. Government has provided road side aid for such victims throughout the country. A retrospective analysis was done on 52 head injury patients admitted in the department of Neurosurgery as 'unknown' closed head injury cases between September 30th 2018 to 31st December 2019. The paper also emphasises on the treatment aspect of such patients. Keywords: Unknown, Head injury, Highway.

The use of surgical treatment for depressed skull fractures that are located over major venous sinuses is a matter of controversy. However, if clinical and radiological findings of sinus obliteration and related intracranial hypertension are present, surgical decompression is indicated. Depressed skull fracture over superior sagittal sinus (SSS) is most common type of dural venous sinus injury with significant morbidity and mortality. Depressed skull fractures over SSS occasionally lead to occlusion of SSS, resulting in secondary intracranial hypertension and neurological deficit. The use of surgical management in these cases is a matter of controversy. Here, we are reporting surgically treated twelve cases of SSS injury due to depressed skull fracture with good outcome. Keywords: Head injury, Skull fracture, Superior sagittal sinus.