bluuebunny/crossref_metadata_2025_split huggingface dataset:
Un capitel de lesena marmóreo con decoración figurada de temática mitológica procedente del complejo termal monumental de la ciudad hispanorromana de Valeria (Las Valeras, Cuenca)
Authors: Atienza Fuente Javier 
Published: August 2023

Durante la intervención arqueológica llevada a cabo en el complejo termal monumental de Valeria a lo largo del año 2019 se recuperaron numerosos elementos marmóreos pertenecientes a la decoración del edificio en su última etapa de uso. Entre estos objetos destaca un capitel de lesena elaborado en un marmor hispano que presenta la particularidad de contener decoración figurada, labrada en relieve, de temática mitológica. En este trabajo se aborda el estudio de esta pieza tanto en lo que respecta a sus aspectos técnicos y morfológicos como también a la temática e iconografía de la escena representada.
Sobre las dificultades de Foucault en su interpretación de la tesis de la ruptura cartesiana entre método y espiritualidad, filosofía y forma de vida
Authors: Álvarez Yágüez Jorge 
Published: August 2023

La posición de Foucault acerca de la ruptura que Descartes había representado respecto de la relación entre acceso a la verdad y transformación de sí, entre método y espiritualidad no fue unívoca. Sus formulaciones variaron, a veces de manera sorprendente. Foucault veía que el autor de las Meditaciones metafísicas mantenía una compleja relación con la tradición de la espiritualidad, lo que exigía precisar en más de un aspecto la conocida tesis de la ruptura. Aquí trataremos de examinar esa dificultad en la que se encontró Foucault.
Transcallosal Suprachoroidal Approach for a Small Third Ventricular Colloid Cyst
Authors: Rai Hitesh I. S. , Mishra Shashwat , Sahu Roshan , Katiyar Varidh 
Published: August 2023

Background and Introduction:
The interhemispheric transcallosal approach provides an elegant pathway to access the lesions of the third ventricle. However, every step of this approach is fraught with hazards which must be negotiated delicately. A comprehensive knowledge of surgical anatomy coupled with technical skill is necessary for optimum surgical results.

Objective:
This video aims to address the surgical nuances of the suprachoroidal transcallosal approach while accessing the lesions around the foramen of Monro in the anterior and middle part of the third ventricle.

Surgical Technique:
A 16-year-old boy presented with worsening headaches with episodes of speech arrest and blank stare for 6 years, which had become more frequent over the past 4–5 months. Radiology showed a subcentimeteric colloid cyst at the foramen of monro. A transcallosal corridor was used to reach the foramen of monro, and the suprachoroidal access was adopted to uncover the colloid cyst and excise it completely preserving the deep veins.

Results:
The patient had uneventful recovery and radiology showed complete excision of the cyst.

Conclusion:
Transcallosal approach, being minimally invasive, exploits the natural extra-axial corridor (interhemispheric) obviating the need for a cortical incision. The suprachoroidal approach mitigates the risks of thalamostriate vein injury, basal ganglia stroke, and hemiparesis.
Hybrid Anterior Clinoidectomy in the Clipping of Paraclinoid Aneurysms
Authors: Das Kuntal Kanti , Srivastava Arun Kumar , Bhaisora Kamlesh Singh , Balachandar  , Jaiswal Awadhesh Kumar , Behari Sanjay 
Published: August 2023

Background:
Anterior clinoidectomy for aneurysm clipping is generally performed intradurally. Despite obvious advantages, accidental drill slippage or indirect damage from heat and bone dust remain major drawbacks.

Objective:
To demonstrate the surgical technique and utility of a combined extra- and intra-dural clinoidectomy in the clipping of dorsal wall paraclinoid internal carotid artery aneurysm.

Material and Methods:
A case of dorsal wall paraclinoid aneurysm which was stuck to the anterior clinoid process on preoperative angiogram is presented. The surgical technique is shown stepwise, and the intricacies of the technique are described.

Results:
The hybrid clinoidectomy allowed for proper delineation of the aneurysm, mobilization of the optic nerve and intracranial proximal control on the clinoidal segment by dint of “apparent” intracranial ICA lengthening. This allowed the aneurysm to be clipped successfully and the patient made an uneventful recovery.

Conclusion:
Hybrid clinoidectomy is a useful technique and must be learnt.
Trans-Oesophageal Migration of Pulled-Out Locking Screw (Zero-Profile Implant System) and its Retrieval Using Suction Catheter
Authors: Meena Rajesh K , Mishra Shashwat , Singh Pankaj K , Kanasani Suresh , Jena Bhagyaranjan , Chandra Sarat P , Kale Shashank S 
Published: August 2023

Background:
Intraoperative trans-esophageal migration of pulled-out screws, especially while using the zero-profile implant system, has been rarely reported in the literature.

Objective:
In this technical note, we are describing a simple technique to retrieve a trans-esophageally migrated pulled-out screw using a suction catheter.

Material and Methods:
A 32-year-old female presented with spastic quadriparesis. She underwent C5-C6 anterior cervical discectomy and fusion (ACDF). Nine months following the surgery, X-ray cervical spine showed implant loosening and failure of fusion across the instrumented disc space. However, during revision surgery, the loosened screw could not be located visually in the initial attempts, though it could be felt by probing the prevertebral space with the index finger. Intraoperative X-rays showed that the screw migrated curiously in the cranial direction as the surgical field was probed further manually. The screw was then finally retrieved using Magill's forceps assisted by video laryngoscopy assisted by intermittent negative pressure application via a blunt-tipped suction catheter.

Results:
She was discharged home on a Philadelphia collar, and at 1 year of follow-up, she was completely asymptomatic.

Conclusion:
Perforation of the aerodigestive tract by a displaced cervical spine implant is an uncommon complication. Manipulation during surgery may cause the implants embedded into the wall of the aerodigestive tract to become dislodged and then migrate into the pharyngeal lumen. In resource-constrained situations or when intraoperative endoscopy is not available, a trial of screw retrieval using a suction catheter may be attempted.
Transopercular Approach to Resection of Dominant Hemisphere Diffuse Insular Glioma Using Multimodal Intraoperative Strategy with Awake Mapping
Authors: Pathiyil Rajesh Krishna , Moiyadi Aliasgar V , Shetty Prakash , Singh Vikas , Velayutham Parthiban 
Published: August 2023

Background:
Deep location as well as relation to major vascular structures and eloquent brain areas make insular glioma resection challenging. Transsylvian and transopercular approaches have been described for resection of these tumors.

Objective:
We illustrate the anatomical relations of a dominant hemisphere insular glioma and present the video demonstrating the step-wise resection of the same via frontal transopercular approach.

Surgical Procedure:
A 27-year-old lady with dominant hemisphere insular glioma underwent awake surgery through a transopercular approach with cortical and subcortical mapping using direct electrical stimulation for resection of the same.

Result:
Gross total resection of left insular glioma was achieved without any fresh postoperative deficits.

Conclusion:
Awake transopercular approach with intraoperative motor, language, and neuropsychological monitoring helps achieve maximum safe resection of insular glioma in the dominant cerebral hemisphere.
Brain Death Diagnosis in Primary Posterior Fossa Lesions
Authors: Machado Calixto 
Published: August 2023

Background:
New controversies have raised on brain death (BD) diagnosis when lesions are localized in the posterior fossa.

Objective:
The aim of this study was to discuss the particularities of BD diagnosis in patients with posterior fossa lesions.

Materials and Methods:
The author made a systematic review of literature on this topic.

Results and Conclusions:
A supratentorial brain lesion usually produces a rostrocaudal transtentorial brain herniation, resulting in forebrain and brainstem loss of function. In secondary brain lesions (i.e., cerebral hypoxia), the brainstem is also affected like the forebrain. Nevertheless, some cases complaining posterior fossa lesions (i.e., basilar artery thrombotic infarcts, or hemorrhages of the brainstem and/or cerebellum) may retain intracranial blood flow and EEG activity. In this article, I discuss that if a posterior fossa lesion does not produce an enormous increment of intracranial pressure, a complete intracranial circulatory arrest does not occur, explaining the preservation of EEG activity, evoked potentials, and autonomic function. I also addressed Jahi McMath, who was declared braindead, but ancillary tests, performed 9 months after initial brain insult, showed conservation of intracranial structures, EEG activity, and autonomic reactivity to “Mother Talks” stimulus, rejecting the diagnosis of BD. Jahi McMath's MRI study demonstrated a huge lesion in the pons. Some authors have argued that in patients with primary brainstem lesions it might be possible to find in some cases partial recovery of consciousness, even fulfilling clinical BD criteria. This was the case in Jahi McMath.
Is Acute Ischemic Stroke Really Associated with Left Ventricular Systolic Dysfunction? A Case-Control Study
Authors: Manea Mirabela M , Drago[Latin Small Letter s with comma below] Dorin , Tu[Latin Small Letter t with comma below]ă Sorin 
Published: August 2023

Context:
Heart failure and acute ischemic stroke (AIS) are frequently associated, due to similar risk factors and intertwined pathophysiologic mechanisms, and both result in a high mortality rate.

Aims:
Our objective was to demonstrate that left ventricular systolic dysfunction (LVSD) is associated with AIS.

Settings and Design:
Prospective matched, case-control study on 110 patients with AIS.

Methods and Material:
The patients in the control group (CG) without history of AIS and the same inclusion criteria were matched for age, sex, and atrial fibrillation (AF) prevalence.

Statistical Analysis Used:
Fisher's exact test was used for statistical analysis.

Results:
LVSD of any degree was not statistically more or less frequent in AIS patients than in the CG. The same was true if only the patients with AF were considered (the prevalence of LVSD was not significantly different in patients with AIS and AF than in controls with AF). However, among the patients without AF the proportion of patients with normal systolic function was significantly higher in the controls than in the AIS group (P = 0.036). There was no significant difference regarding LVSD either between the patients with cardioembolic AIS and those with noncardioembolic AIS or between the AIS patients with AF and AIS patients without AF.

Conclusions:
Our study concluded that the prevalence of LVSD was the same in AIS patients and controls matched for age, sex, and AF prevalence, although the prevalence of LVSD was indeed higher in AIS patients without AF than in controls without AF.
Mini Temporal Craniotomy Using Anatomical Surface Landmarks for Temporal Lobe Epilepsy
Authors: Doddamani Ramesh Sharanappa , Subianto Heri , Bajaj Jitin , Girishan Shabari , Samala Raghu , Agrawal Mohit , Ramanujam Bhargavi , Tripathi Manjari , Chandra Poodipedi Sarat 
Published: August 2023

Background:
Patients with temporal lobe epilepsy are subjected to standard temporal lobectomy wherever indicated. This is performed using a reverse question mark flap and a standard frontotemporal craniotomy. We describe the technique of minitemporal craniotomy (3 × 3cms) for temporal lobe epilepsy (TLE) and analyze the clinical outcomes of patients operated using this approach.

Objectives:
To describe the technique of minitemporal craniotomy for TLE without navigation guidance and to analyze the clinical outcomes of patients operated using this approach.

Materials and Method:
This was a retrospective analysis of all consecutive TLE cases operated at our institute from 2014 to 2019, via minitemporal craniotomy, using surface landmarks only without navigation guidance. The surgical technique, indications for surgery, and their clinical outcomes were analyzed.

Results:
A total number of 48 patients underwent surgery for TLE. There were no complications except three patients who had transient hemiparesis. The average duration of hospital stay was 4 days following surgery. Out of 28 patients with mesial temporal sclerosis, 22 (82%) had international league against epilepsy, Class I seizure outcome, 4 (12.5%) had Class II outcome and 2 (5.5%) had Class III outcome. 9 patients with dysembryoplastic neurectodermal tumor (DNET), 4 gangliogliomas, 2 neurocystecercosis (NCC), all had Class I outcome. Out of the five patients with MTS and associated anterior temporal focal cortical dysplasia (FCD), four (80%) had a Class I outcome, whereas one (20%) had Class II outcome.

Conclusion:
Utilizing surface anatomical landmarks, minitemporal craniotomy can be performed in even peripheral centers without neuronavigation, with good cosmesis, seizure outcomes.
Trans-Thoracic Extra-Pleural Percutaneous Spinal Fixation—A Technical Note
Authors: Krishnan Shyam S. , Nigam Pulak , Vasudevan Madabhushi C. 
Published: August 2023

Study Design:
Cross-sectional analysis of defined parameters of patients who underwent the presented technique.

Patients undergoing thoracic spine fixation for various pathologies.

Objective:
This technique attempts to limit the incision size in extrapleural thoracotomy for multi-level spinal fixation.

Summary of Background Data:
Dorsal spine is traditionally approached by either transpleural or extrapleural approach. The extrapleural approach carries a limitation of being restricted in number of levels it can address. By incrementally modifying the present technique, we were able to employ the approach in greater number of levels with lesser morbidities.

Method:
Classical extrapleural thoracotomy approach is employed with incision size limited to the levels of pathology (~5 cm). Thereafter, proper exposure using Kittner dissection and defining of screw entry points follows. Stab incision is made and screws placed percutaneously through a K-wire-defined trajectory.

Results:
Eighteen patients underwent fixation through this technique, of which 11 were infectious, four were traumatic, and the rest were neoplastic in pathology. None except three patients had ICU stay of more than 1 day. All patients had a pain score of 6 or lower except for two.

Conclusion:
Combining the technique of percutaneous screw placement with traditional extrapleural thoracotomy reduces the size of the incision, tissue damage, and morbidity while reducing the cost and duration of hospitalization without comprising the extent of pathology that can be dealt with.
Hearing Rehabilitation After Treatment of Sporadic Vestibular Schwannomas
Authors: Kumar Sanjeev , Sahana Debabrata , Nair Anirudh , Rathore Lavlesh , Sahu Rajiv K , Jain Amit , Borde Praveen , Tawari Manish , Madhariya Satya Narayan , Nair Suresh 
Published: August 2023

Background:
Hearing preservation in vestibular schwannoma resection is a much-discussed topic in these times of functional preservation. Irrespective of the mode of treatment of large tumors, this becomes possible only in a lucky few. The overall burden of such deaf patients is on a rising trend, and therefore, it is high time neurosurgeons look into this often-neglected area of hearing rehabilitation.

Objectives:
In this review, the authors intend to provide a glimpse of available hearing rehabilitation modalities in the present era.

Materials and Methods
: This review deals with both immediate and long-term hearing outcomes following both surgery and stereotactic radiosurgery for sporadic vestibular schwannoma and the need for hearing rehabilitation in these patients. Various databases, including PubMed, Medline/Medscape, Scopus, Cochrane, and Google Scholar were searched to find available literature on hearing rehabilitation after treatment of sporadic vestibular schwannoma. The searched MeSH terms were “Hearing”, “Vestibular schwannoma”, “Rehabilitation”, and “Acoustic Neuroma”, alone and in various combinations.

Results
: The authors were surprised to find a paucity of literature. Even though neurosurgeons are at the forefront in managing vestibular schwannoma, they are not actively involved in hearing rehabilitation techniques possible for those who are rendered deaf following treatment.

Conclusions
: The authors strongly believe that this review will be a wake-up call for neurosurgeons on a relatively untouched topic.
Cerebrospinal Fluid Flow Analysis in Tuberculous Meningitis Using Phase Contrast Technique on 3 Tesla MRI
Authors: Ashta Aanchal , Prakash Anjali , Dixit Rashmi , Kumar Naresh 
Published: August 2023

Background:
Phase-contrast magnetic resonance imaging (PC-MRI) has been used for studying cerebrospinal fluid (CSF) dynamics in various CSF related disorders at aqueduct of Sylvius.

Objective:
To analyze the CSF flow dynamics qualitatively and quantitatively using PC-MRI across the aqueduct of Sylvius in diagnosed patients of tuberculous meningitis.

Methods:
Thirty patients, clinically diagnosed with tuberculous meningitis and mean age of 24 years (range: 12–60 years) were taken up to study the changes in CSF flow dynamics using PC-MRI with retrospective cardiac gating. Thirty age and sex matched healthy volunteers were also included for comparison and reference values. Flow quantification was done by through-plane scans acquired in the axial plane perpendicular to the aqueduct. For qualitative examination, in-plane phase contrast scans were acquired in the mid-sagittal plane. Encoding velocity was kept in craniocaudal direction. Calculated parameters were peak velocity (cm/s), average velocity (cm/s), average flow (mL/s), net forward volume (mL), and stroke volume (μL).

Results:
Qualitatively, loss of normal sinusoidal waveform of CSF flow was noted in two cases of hydrocephalus with exaggerated flows. Quantitatively, CSF flow parameters showed marked numerical difference in tuberculous meningitis patients with hydrocephalus on comparison with healthy volunteers and with cases without hydrocephalus.

Conclusion:
PC-MRI is a sensitive technique to analyze altered CSF flow dynamics in tuberculous meningitis patients. This is a useful adjunct in imaging these patients to extract both the qualitative and quantitative information about CSF flow for comprehensive evaluation.
Surgical Management of a Superior Orbital Fissure Cavernous Hemangioma
Authors: Padilla-Lichtenberger Fernando , Massa Daniela S , Plou Pedro , Campero Alvaro , Ajler Pablo 
Published: August 2023

Background:
Cavernous sinus hemangiomas (CSHs) are intracranial extradural benign, well-demarcated neoplasms arising within dural sinuses. The orbital apex and superior orbital fissure (SOF) are common locations for these lesions. Because of the complex anatomy of this area and potential morbidity, SOF CSH surgical management is challenging.

Objective:
Describe a case of a SOF CSH and review of literature.

Material and Methods:
We present the case of a 44-year-old female with a 2-month history of right eye visual disturbances. A contrast-enhanced magnetic resonance imaging showed a right orbital apex nodular formation. A pterional craniotomy with a middle fossa mini peeling was performed.

Results:
Gross total resection was accomplished. No recurrences were observed 2 years after surgery.

Conclusion:
SOF CSH should be included in a differential diagnosis in cases of space-occupying orbital apex lesions with atypical features. Surgery is the gold standard treatment. Radiosurgery is a valid option for tumor remnants.
Disseminated Cysticercosis in Indian Scenario – Experience from a Teaching University Hospital
Authors: Ganaraja Harikrishna V , Mahadevan Anita , Saini Jitender , Nalini Atchayaram , Pal Pramod K , Satishchandra Parthasarathy , Netravathi Manjunath 
Published: August 2023

Background and Objectives:
Neurocysticercosis (NCC) due to Taenia Solium is a major public health problem. Our objective was to study patients with disseminated cysticercosis (DCC) who had NCC in the brain along with an additional site in the body and assess their clinical, radiological profile, and response to therapy.

Materials and Methods:
A chart review of DCC with a high lesion load of NCC ≥20 (DNCC) in the brain was performed.

Results:
Sixteen (M:F = 13:3) patients were diagnosed with DNCC with a mean age of presentation of 35.1 ± 14.2 years. Headache was the predominant symptom, followed by seizures (93.75%), vomiting (43.75%), behavioral disturbances (31.25%), fever (12.5%), encephalopathy (12.5%), visual disturbances (6.25%), and muscle pain and limb weakness (6.25%). CT brain showed multiple active parenchymal cysts in all, and calcifications in 68.75%. MRI brain revealed involvement of cortex and subcortical structures in all, followed by cerebellum (81.25%) and brainstem (75%). Intramedullary spinal lesion was observed in 12.5% cases. Albendazole with steroids was used in 15 patients. In 93.3% patients, there was complete improvement in seizures; 12.5% subjects had persistent memory and behavioral abnormalities. One subject required decompressive craniectomy; mortality was observed in two subjects.

Conclusions:
We hereby report one of the largest case series on disseminated cysticercosis with a high lesion load of NCC in the brain. A comprehensive clinical, imaging, therapeutic response with repeat imaging and long-term follow-up has given us a better understanding of this difficult-to-treat neurological disorder. We suggest cautious use of anti-parasitic therapy under the cover of corticosteroids to prevent irreversible neurological sequelae.
A Comparison of Treatment Options in Focal Post-Stroke Spasticity of the Upper Extremity
Authors: Sankaran Ravi , Raj Manu 
Published: August 2023

Background:
Post-stroke 20%–40% of patients develop spasticity which can quadruple total cost of care. This impact can be reduced by affordable treatment options for focal spasticity.

Objectives:
The primary objective of the study was to compare changes in Passive Range of Movements in patients with focal post-stroke spasticity from pre-treatment to end of 1 month of treatment with anti-spastic agents. The secondary objectives were to measure the changes in Modified Ashworth, and Brunnstrom Recovery Staging during the same period.

Materials and Methods:
This prospective longitudinal cohort study was conducted in a tertiary level rehabilitation center. One hundred and three adults with post-stroke spasticity participated. The patients received one of the four options: Phenol, Onabotulinum toxin, Bupivacaine and Hyaluronidase. The main outcome measures were the following: Changes in Passive Range of Movement (PRoM), Brunnstrom staging (BRS) and Modified Ashworth Scale (MAS).

Result:
Post intervention testing at 1 month was done. Each agent significantly improved BRS (1.10, 95% CI 0.8–1.4, P = 0.001) and PRoM (32.28, 95% CI 27.66- 36.89, P = 0.001), while reducing MAS (0.39, 95% CI 0.01–0.77, P = 0.05). In addition, subgroup comparisons were done with phenol as a reference for all three outcome measures. There was a significant difference in the improvement of Brunnstrom staging for Bupivacaine (0.52, 0.094–0.95, 0.02) compared to phenol. Similarly, Hyaluronidase showed better improvement in MAS (0.39, 0.01–0.77, 0.05) compared to Phenol.

Conclusion:
There was a significant difference in PRoM, MAS and Brunnstrom staging from baseline to end of 1 month long anti-spasticity treatment.