Iype Cherian

Iype Cherian
Krishna Institute Of Medical Sciences University | KIMS · Krishna Institute of Physiotherapy

MCh Neurosurgery

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53
Publications
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400
Citations
Citations since 2017
28 Research Items
363 Citations
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Introduction
We work on improving the new technique of Cisternostomy for head injuries that we described.We also work on updating our theory of CSF shift edema in trauma, and the cooling and cleaning theory. We proposed that the brain is cooled and cleaned by CSF through Virchow Robin spaces

Publications

Publications (53)
Book
Neurotrauma in Multiple Choice Questions is the FIRST review book to use the multiple-choice question format in neurosurgical trauma. Students of neurosurgery, the resident, the fellow, the younger neurosurgeon preparing for exams or practice, and even the later stage neurosurgeon are the target audience of this book. The information in this work i...
Chapter
The chapter covers key details on the following topics in the setting of traumatic brain injury (TBI): CSF leak, seizures, hydrocephalus, infection, nutrition, recovery, and rehabilitation with reference to key trials and advances in the area.
Chapter
In this chapter, the questions and answers are intended to cover the following topics in relation to cranial neurotrauma: epidemiology, types of head injury, raised intracranial pressure, cerebral edema, initial assessment, and examination. It will also present key facts on coma, diffuse axonal injury, concussion, herniation syndromes, the systemic...
Chapter
In this chapter, the questions and answers are intended to cover the following topics in relation to the neurocritical care and neurosurgical management of traumatic brain injuries (TBI) in the following settings: closed and penetrating TBI, traumatic hematomas, skull fractures, scalp injuries, decompressive craniectomy, cisternostomy, venous sinus...
Chapter
Image-guidance has been the mainstay for most neurosurgical procedures to aid in accuracy and precision. Developments in visualization tools have brought into existence the current microscope and even sophisticated augmented reality devices providing a human–computer interface. The current microscope poses an ergonomic challenge particularly in sce...
Article
Traumatic brain injury (TBI) represents a major public health concern worldwide, with no significant change in its epidemiology over the last 30 years. After TBI, the primary injury induces irreversible brain damage, which is untreatable. The subsequent secondary injury plays a critical role in the clinical prognosis because without effective treat...
Article
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Introduction: Traumatic brain injuries (TBI) are among the worst consequences and are the major causes of death and disability worldwide. It is considered as silent epidemics affecting individuals of all the ages and one of the major burden of neorological disease. Hence, TBIs are often overlooked and are sometimes called “the neglected disease of...
Article
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Background Cerebral venous thrombosis (CVT) is a rare cerebrovascular disorder, comprising <1% of all strokes. The incidence of CVT is higher in females but a small number of cases suggest that men have a higher risk for CVT in high elevation. The aim of this retrospective cohort study is to investigate this gender-related relationship and to descr...
Article
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Background: Spinal cord injury causes serious disability among patients. More than 40 million people worldwide suffer from Spinal cord injury every year. Most of them are young men. More than10% of trauma victims sustain spine injury and have higher mortality than other injuries. Materials and Methods: This is a prospective observational hospital b...
Article
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Background: Herein we report a rare case of acute liver failure due to levetiracetam, which has been considered to have an excellent safety profile with minimal hepatic side effects. Case presentation: A 55-year-old male patient presenting with sudden onset dizziness, slurring of speech and headache was operated for posterior fossa cerebellar hemat...
Article
Background: There is scant literature describing the management of acute spinal injury in pregnant patients. Here, we report our experience with five cases of pregnant patients including three females who suffered acute traumatic spinal cord injuries (SCIs). Methods: This retrospective study evaluated five pregnant women presenting with traumatic s...
Article
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Background: Intracerebral hemorrhage accounts for 10 to 20% of strokes. Based on the precise site and size of the hematoma, ICH can manifest a range of clinical and radiological deficits. The role of surgical removal of hematoma has by far been controversial, and despite large clinical trials, the efficacy of surgery remains controversial. In this...
Article
Background: The available surgical options to control increased intracranial pressure and to limit secondary brain damage in the setting of severe traumatic brain injury (TBI) include decompressive craniectomy, cisternostomy, and other methods to divert cerebrospinal fluid (CSF) such as placement of an external ventricular drain. Methods: We dis...
Article
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p class="Default"> Introduction: The major emotions such as fear, anger, joy and sadness are created through a complex mechanism in the temporal lobe combining data from all the sensory inputs to the brain. However, these emotions may turn into extreme manifestations when the hypothalamus and the autonomic nervous system transform these emotions to...
Chapter
Cerebrospinal fluid (CSF) from the basal cisterns transits into the brain through spaces that surround the vascular system of the brain; the so-called paravascular spaces (Virchow Robin Spaces), or paravascular pathway, which surround the arteries, veins, and capillaries. The passage of CSF through these paravascular spaces is driven by the cardiov...
Article
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Background: In developing nations like Nepal, spinal cord injury has multispectral consequences for both the patient and their family members. It has the tendency to cripple and handicap the patients, and burn out their caretakers, both physically and mentally. Furthermore, the centralization of health care with only a handful of dedicated rehabili...
Article
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Objective and Background To evaluate possible roles for indocyanine green (ICG)-based FLOW 800 software in surgical treatment of cerebral arteriovenous malformations (AVMs). Methods We perform ICG videoangiography several times for each step of AVM resection to elucidate feeders, drainers, and cerebral perfusion. Results Since 2010, 22 AVM surger...
Article
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Background Juvenile nasal angiofibromas (JNA) is a benign lesion with high vascularity and propensity of bone erosion leading to skull base invasion and intracranial extension. It is known to involve multiple compartments, which are often surgically difficult to access. With evolution in surgical expertise and technical innovations, endoscopic and...
Article
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Background: Cerebrospinal fluid (CSF) transport across the central nervous system (CNS) is no longer believed to be on the conventional lines. The Virchow-Robin space (VRS) that facilitates CSF transport from the basal cisterns into the brain interstitial fluid (ISF) has gained interest in a whole new array of studies. Moreover, new line of evidenc...
Article
Objective: Traumatic brain injury (TBI) is one of the major challenges in health care, representing the third most frequent cause of death. Current optimal management is based on a progressive, target-driven approach combining both medical and surgical treatment strategies. Here we describe cisternostomy, an emerging surgical treatment for TBI tre...
Article
Background: Glasgow Coma Scale has been a long sought model to classify patients with head injury. However, the major limitation of the score is its assessment in the patients who are either sedated or under the influence of drugs or intubated for airway protection. The rational approach for prognostication of such patients is the utility of scori...
Article
Full-text available
Cisternostomy is defined as opening the basal cisterns to atmospheric pressure. This technique helps to reduce the intracranial pressure in severe head trauma as well as other conditions when the so-called sudden “brain swelling” troubles the surgeon. We elaborated the surgical anatomy of this procedure as well as the proposed physiology of how cis...
Article
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In this case report, we discuss the microsurgical management of a Spetzler-Martin grade 5 arteriovenous malformation (AVM) in a young boy who presented with a hemorrhagic episode and had a high calculated risk of rebleeding. We also outline the rationale for choosing the management option.
Article
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JCMSBackground and Objectives: Tracheostomy is electively performed in critically ill patients requiring prolonged respiratory support. The risk of transporting, the increasing associated cost and operative room schedule are some of the obstacles for wider acceptance of this procedure. The use of rigid selection criteria exclude many patients who w...
Article
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This is a case report of a neurologically intact patient following posttraumatic cervical spondyloptosis. We discuss the disease, management protocol and some surgical nuances to prevent any damage to the cord during different stages of its treatment.
Article
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Here we present a very rare case of a woman with a bone fragment in the third ventricle of the brain following compound-depressed skull fractures due to a road traffic accident. There are only few case reports of bullets and textiloma being removed from the third ventricle. Following operative removal of the fragment, the patient was started on cor...
Article
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Primary dural lymphoma is a subentity of primary leptomeningeal lymphoma which represents 0.1% of all non-Hodgkin's lymphomas. Only five cases have been reported so far. We report a very rare case of primary dural-based lymphoma in a 14 year-old boy presenting with mass effect. The patient was managed with excision of the lesion and removal of the...
Article
Full-text available
Here we present a very rare case of a woman with a bone fragment in the third ventricle of the brain following compound-depressed skull fractures due to a road traffic accident. There are only few case reports of bullets and textiloma being removed from the third ventricle. Following operative removal of the fragment, the patient was started on cor...
Article
Full-text available
Critical illness-related cortisol insufficiency is a known entity. However, there are instances where there is a normal serum cortisol level in an unresponsive patient with low Glasgow Coma Scale (GCS), even after thorough investigations to rule out other correctable entities. In patients with lesions in the vicinity of hypothalamus, especially bas...
Article
Object: A modified World Federation of Neurosurgical Societies scale (m-WFNS scale) for aneurysmal subarachnoid hemorrhage (SAH) recently has been proposed, in which patients with Glasgow Coma Scale (GCS) scores of 14 are assigned to grade II and those with GCS scores of 13 are assigned to grade III regardless of the presence of neurologic deficit...
Article
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Arteriovenous malformation (AVM) of the scalp is an uncommon entity. Its management is difficult because of its high shunt flow, complex vascular anatomy, and possible cosmetic complications. The etiology of scalp AVMs that is, cirsoid aneurysm may be spontaneous or traumatic. Clinical symptoms frequently include pulsatile mass, headache, local pai...
Article
Full-text available
Practical scenario in trauma neurosurgery comes with multiple challenges and limitations. It accounts for the maximum mortality in neurosurgery and yet the developing countries are still ill-equipped even for an emergency set-up for primary management of traumatic brain injuries. The evolution of modern neurosurgical techniques in traumatic brain i...
Technical Report
Full-text available
The evolution of modern neurosurgical techniques in traumatic brain injury has been ongoing for the last two centuries. However, it has always been a challenge to obtain an effective clinical outcome, especially in those following severe traumatic brain injuries. Other than the well-established procedures for acute and/or chronic subdural hematomas...
Article
Full-text available
The evolution of modern neurosurgical techniques in traumatic brain injury has been ongoing for the last two centuries. However it has always been a challenge to obtain an effective clinical outcome, especially those following severe traumatic brain injuries. Other than the well established procedures for acute and/ or chronic subdural hematomas an...
Article
Full-text available
A 48-year-old man presented with proptosis of the left eye, which on excisional biopsy proved to be primary adenosquamous carcinoma of the lacrimal gland. The lesion was excised radically by a limited frontotemporo-orbitozygomatic approach and any further surgeries, such as exenteration, were avoided in view of the patient's wish to preserve the ey...
Article
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A 12-year-old girl presented to Manipal Teaching Hospital with quadriparesis of 8 months' duration. Examination revealed a hyperpigmented patch over the chest wall with overlying hypertrichosis, musculoskeletal anomalies, upper limb asymmetry and ipsilateral breast hypoplasia. MRI scan revealed cranio-vertebral junction anomaly and spina bifida occ...
Article
The health scenario of western Nepal is bleak and especially the Neurosurgical facilities are poor. We started the Department of Neurosurgery in April 2008 and has been improvising to do various cases with good success rate. Although not very well equipped, we have tried to do our best and the results have been encouraging.
Article
Full-text available
doi: 10.3126/kumj.v6i3.1727 Kathmandu University Medical Journal (2008), Vol. 6, No. 3, Issue 23, 426-427

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