Pseudoprogression on 68Ga-Prostate-Specific Membrane Antigen-11 PET/CT in a Treated Glioblastoma.

After standard treatment of glioblastoma, pseudoprogression versus true progression is a clinical challenge. Indeed, to differentiate these 2 on contrast MRI (cMRI) is problematic. In recent time, Ga-prostate-specific membrane antigen-11 (Ga-PSMA) PET/CT has been suggested to have high accuracy in glioblastoma recurrence. We present a case of a 40-year-old man with right frontotemporal glioblastoma underwent surgery and radiotherapy. One month posttreatment cMRI showed a new enhancing lesion in the right hippocampal region, which was also positive on Ga-PSMA-11 PET/CT. On follow-up with conservative management, both cMRI and Ga-PSMA-11 PET/CT showed regression in new lesion, hence suggest pseudoprogression.

Role of 68Ga-Prostate-Specific Membrane Antigen PET/CT in Disease Assessment in Glioblastoma Within 48 Hours of Surgery.

Within 48 hours after surgery, disease assessment in glioblastoma is a challenge for both the clinician and the radiologist. Certain technical and logistical issues prevail in this period. Ga-prostate-specific membrane antigen PET/CT is a known molecular imaging marker in prostate cancer. Its role in high-grade gliomas has been recently discussed. We present a case of a 39-year-old man with recurrence glioblastoma of the right frontal lobe and underwent resurgery. After surgery, Ga-prostate-specific membrane antigen PET/CT showed residual disease along the posterior and inferior margin of the postoperative cavity.

An epidemiological study of traumatic brain injury cases in a trauma centre of New Delhi (India).

BACKGROUND: Trauma is one of the leading causes of death and disability in Indian population. AIM: To correlate various variables like epidemiology, clinical status, severity of TBI & associated co-morbid conditions and its outcome. SETTINGS AND DESIGN: This study involved retrospective collection, prospective management and follow up of 796 cases of TBI admitted to the neurosurgery department of a tertiary care hospital in New Delhi during one year study duration. MATERIALS AND METHODS: All the relevant variables recorded and analyzed with Glasgow Outcome Scale (GOS) in 6 months into 3 groups i.e. group 1 (GOS-1/Dead), group 2 (GOS-2&3/Bad) and group 3- (GOS-3&4/good). STATISTICAL ANALYSIS: Compiled data collected, analyzed and difference between two proportions was analyzed using Chi Square test. RESULTS: This study included 791 cases with 569 (72%) males and 222 (28%) females with average age of 24 years. Fall from height was the main cause of TBI (56%) followed by road traffic injury (RTI) (36%). Majority (61%) patients reached the hospital within 6 hours of injury out of which 27% patients were unconscious. As per Glasgow coma scale mild, moderate & severe grade of TBI was seen in 62%, 22% &16% cases respectively. Radiological examination of other body parts revealed injuries in 11% cases. Only 11% cases required surgical management, rest was managed conservatively. Good outcome noted in 80% cases and 20% cases expired. Average duration of hospital stay was 5 days. According to multivariate analysis, the factors which correlated with poor prognosis are presence of radiological injuries to other body parts, GCS, abnormal cranial nerve examination, abnormal plantar and abnormal pupillary reflex. (P < 0.05). CONCLUSION: TBI predominantly affects young male population and most of these are preventable. Early transportation to the hospital and first aid results in good outcome. Mortality increases with the severity of TBI and associated injuries therefore multimodality approach in polytrauma is essential.

Chiari malformation type III treated with primary closure.

Chiari malformations represent various clinical and anatomic processes that entail varying degrees of involvement of the rhombencephalon (hindbrain). The type III Chiari malformation is distinctly rare. Chiari described only one case of his type III deformity, which is indicative of its rarity. We report a case of Chiari malformation type III, a female child who presented to us at the age of 1 month with a swelling at the back of the neck since birth. MRI revealed a Chiari type III malformation with a high cervical meningoencephalocele along with herniation of cerebellar tissue through the bony defect in the posterior elements of the C2 vertebra. At surgery, the meningoencephalocele was excised along with the gliotic cerebellar tissue, and a posterior fossa decompression along with augmentation duraplasty was done. The postoperative period was uneventful. The case and relevant literature is reviewed.