Manjul Tripathi

Manjul Tripathi
Postgraduate Institute of Medical Education and Research | PGIMER · Department of NeuroSurgery

MCh Neurosurgery

About

314
Publications
95,181
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Introduction
Currently, I am working as an associate professor in the Department of Neurosurgery at the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. My main focus is on functional neurosurgery, Gamma knife radiosurgery, neuro-oncology, and neurotrauma. At present, I am closely working on functional radiosurgery (pain procedures, movement disorders, and psychosurgery), stereotactic radiofrequency lesioning, DBS, and peripheral nerve surgeries. I am a close collaborator with the University of Cambridge for various projects on neuro-trauma including RESCUE-ASDH. I strive for quality care in a strict protocol based manner. I believe in capacity building and collaborative efforts with researchers delivering on the same principles.
Additional affiliations
July 2019 - present
Postgraduate Institute of Medical Education and Research
Position
  • Professor (Associate)
November 2015 - June 2019
Post Graduate Institute of Medical Education and Research, Chandigarh
Position
  • Professor (Assistant)
September 2014 - November 2015
National Institute of Mental Health and Neuro Sciences
Position
  • Professor (Assistant)
Education
May 2018 - July 2020
Oxford University Hospitals NHS Trust
Field of study
  • Functional Neurosurgery (DBS, Spinal Cord Stimulation, Dorsal Root Ganglion Stimulation)

Publications

Publications (314)
Article
Study design: Global Cross Sectional Survey. Objective: To determine the classification accuracy, interobserver reliability, and intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on an international group of AO Spine members. Summary of background data: Previous upper cervical spine injury classificat...
Preprint
Purpose Surgery is the treatment of choice for large vestibular schwannomas (VS). Stereotactic radiosurgery (SRS) has been suggested as an alternative to resection in selected patients. However, the safety and efficacy of SRS in Koos grade IV patients ≤45 years old has not been evaluated. The aim of this study is to describe the clinical and radiol...
Article
Full-text available
Background: The Penn Acoustic Neuroma Quality-of-life Scale (PANQOL) was specifically developed for assessing the quality of life (QOL) in patients with vestibular schwannoma (VS). Its utility has been established in many populations, but it has not been validated for use in India. Objective: The objective of this study was to translate PANQOL i...
Article
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Background: Management strategies for petroclival menigiomas remain controversial Objectives: We share our experience in management of large and giant true petroclival meniongiomas with special emphasis on patient reported quality of life parameters. Methods: This is a single center study of 47 patients between 2008 and 2018. All patients were chec...
Article
Bevacizumab-induced rash is a rarely reported complication with very few insights into its epidemiology, pathophysiology, management and relationship with therapeutic efficacy. We report a case of ruptured occipital arteriovenous malformation treated with stereotactic radiosurgery. The patient developed steroid-resistant radiosurgery-induced brain...
Article
OBJECTIVE Though stereotactic radiosurgery (SRS) is an established safe treatment for small- and medium-sized vestibular schwannomas (VSs), its role in the management of Koos grade IV VS is still unclear. In this retrospective multicenter study, the authors evaluated tumor control and the patient outcomes of primary, single-session SRS treatment fo...
Article
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Background: The surgical skill practice in neurosurgery is being compromised in the recent past owing to the duty time constraint, patient safety concerns, and medico-legal issues. Surgical practice outside the operating 􀁔􀁑􀁑􀁏􀀂􀁋􀁕􀀂􀁇􀁕􀁕􀁇􀁐􀁖􀁋􀁃􀁎􀀂􀁖􀁑􀀂􀁇􀁐􀁊􀁃􀁐􀁅􀁇􀀂􀁃􀀂􀁔􀁇􀁕􀁋􀁆􀁇􀁐􀁖􀅏􀁕􀀂􀁑􀁒􀁇􀁔􀁃􀁖􀁋􀁘􀁇􀀂􀁕􀁍􀁋􀁎􀁎􀁕􀀂􀁃􀁐􀁆􀀂􀁖􀁑􀀂􀁉􀁃􀁋􀁐􀀂􀁅􀁑􀁐􀅿􀁆􀁇􀁐􀁅􀁇􀀐 Objective: To discuss the experience of establi...
Article
Background: The surgical skill practice in neurosurgery is being compromised in the recent past owing to the duty time constraint, patient safety concerns, and medico-legal issues. Surgical practice outside the operating room is essential to enhance a resident's operative skills and to gain confidence. Objective: To discuss the experience of establ...
Article
Background The pseudoaneurysms of the internal carotid artery (ICA) at the skull base form a unique subset of craniofacial pseudoaneurysms with varied diagnostic and therapeutic challenges. Recurrence in a surgically treated pseudoaneurysm may become a nightmare due to very limited number of open and endovascular options. Report We report a rare c...
Article
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Background: Primary hypophysitis (PH) is most commonly treated with glucocorticoids. But there is considerable variation in the treatment regimens. Aims and Objectives: We aimed to compare the outcomes of therapeutic versus replacement glucocorticoid regimens in PH. Therapeutic regimen (TR) comprised oral prednisolone (1mg/kg/d) for 6-12 weeks fol...
Article
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Background Surgical removal has been performed as the first line treatment for symptomatic or enlarging hypoglossal schwannomas (HS). Stereotactic radiosurgery (SRS) offers a minimally invasive approach that may afford long-term tumor control for patients with HS particularly those who refuse or are unfit for surgery. This study evaluates outcomes...
Article
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Martin Luther King, in his famous speech, mentioned that “Blood alone moves the wheels of history. Stereotactic radiosurgery (SRS) moved the wheel of neurosurgery in the absence of bloodshed. Over the last five decades, SRS has made a phenomenal stride in the pursuit of being minimally invasive but equally effective. Though literature testifies for...
Article
Background: The optimal management of asymptomatic, presumed WHO grade I meningiomas remains controversial. Objective: To define the safety and efficacy of stereotactic radiosurgery (SRS) compared with active surveillance for the management of patients with asymptomatic parafalcine/parasagittal (PFPS) meningiomas. Methods: Data from SRS-treate...
Article
Full-text available
Background Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise di!erences in...
Article
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Background: Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise differences...
Article
Full-text available
Background Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise differences i...
Article
Full-text available
Meningioma is a common incidental finding, and clinical course varies based on anatomical location. The aim of this sub-analysis of the IMPASSE study was to compare the outcomes of patients with an incidental frontobasal meningioma who underwent active surveillance to those who underwent upfront stereotactic radiosurgery (SRS). Data were retrospect...
Article
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Background The optimal treatment strategy of asymptomatic, convexity meningiomas, remains unclear. Objective The purpose of this study was to define the safety and efficacy of stereotactic radiosurgery (SRS) in the management of patients with asymptomatic convexity meningiomas. Methods Data of SRS-treated patients from 14 participating centers an...
Article
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Context: Paediatric pituitary adenomas (PPAs) are uncommon, with evidence confined to small cohorts. Aim: We aimed to elucidate the baseline profile and outcomes of PPAs in a large, contemporary, monocentric cohort. Settings, Design: Pituitary clinic at PGIMER over 8 years (2010‑2018). Subjects and Methods: PPAs in patients (≤20 years at diagnosi...
Article
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Background: Stellate ganglion block (SGB) causes blockage of sympathetic nerve activity, which may lead to intracerebral vessel dilatation and relieve cerebral vasospasm in patients of aneurysmal subarachnoid hemorrhage (aSAH). Objective: The aim of this study was to evaluate the efficacy and safety of SGB to relieve cerebral vasospasm on clinic...
Chapter
Full-text available
The pituitary-hypothalamus unit functions as the central regulator of multiple endocrine glands and determines several physiological functions. Disorders of the hypothalamus-pituitary unit can be secondary to congenital or developmental causes, genetic syndromes, or acquired causes. Functionally, any of these can lead to under-or overfunctioning of...
Article
Full-text available
Objective The optimal management of asymptomatic, skull-based meningiomas is not well defined. The aim of this study is to compare the imaging and clinical outcomes of patients with asymptomatic, skull-based meningiomas managed either with upfront stereotactic radiosurgery (SRS) or active surveillance. Methods This retrospective, multicenter study...
Article
Background: Studies have evaluated the effects of volatile and intravenous anesthetic agents on the cerebral vasculature with inconsistent results. We used digital subtraction angiography to compare the effects of propofol and sevoflurane on the luminal diameter of cerebral vessels and on cerebral transit time in patients with aneurysmal subarachn...
Chapter
Introduction|Management Options for Intracranial AVM|Role of GKRS in the Management of Intracranial AVM in the Times of ARUBA|Patient Selection for GKRS|Technique and Radiosurgical Profile|Dose–Volume Relationship|Patient Follow-Up and Postradiosurgery Evaluation|The Pathological Rationale of GKRS|Outcomes after GKRS|Hypofractionated Radiosurgery|V...
Article
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Background The optimal management of asymptomatic, petroclival meningiomas remains incompletely defined. The purpose of this study was to evaluate the safety and efficacy of upfront stereotactic radiosurgery (SRS) for patients with asymptomatic, petroclival region meningiomas.Methods This retrospective, international, multicenter study involved pat...
Article
Full-text available
Xanthomatous meningioma is a WHO grade I metaplastic meningioma where neoplastic cells contain lipid-filled vacuolated cytoplasm. The origin of xanthomatous meningiomas is believed to be from meningothelial cells but diagnosis remains difficult because of their close resemblance with the histiocytes. Peculiar radiographic features may aid in diagno...
Article
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Background: Intramedullary schwannomas (IS) at cervicomedullary junction (CMJ) are exceedingly uncommon. There is hardly any clinicoradiological marker for preoperative diagnosis and prognostication. Case: We report a case of a 17‐year‐old boy with progressive spastic quadriparesis of six months duration. On radiology, there was a contrast‐enhancin...
Article
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Introduction: Since the landmark publication by Smith and Robinson, approaches to the cervical spine anteriorly have undergone many modifications and even additions. Nevertheless, at its core, the anterior approach remains an elegant and efficient approach to deal with majority of cervical spine pathologies including the degenerative cervical spin...
Article
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Objective Isocitrate dehydrogenase (IDH) mutation status is recommended used for diagnosis and prognostication of glioblastoma patients. We studied efficacy and safety of stereotactic radiosurgery (SRS) for patients with recurrent IDH-wt glioblastoma.Methods Consecutive patients treated with SRS for IDH-wt glioblastoma were pooled for this retrospe...
Article
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Introduction Aggressive pituitary adenomas (APA), are, by definition, resistant to optimal multimodality therapy. The challenge lies in their early recognition and timely management. Temozolomide is increasingly being used in patients with APAs, but evidence supporting a favorable response with early initiation is lacking. Methods This was a sing...
Article
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Gamma knife radiosurgery (GKRS) is a popular radiosurgical tool for various benign and malignant intracranial pathologies. Our objective was to evaluate the spectrum of complications of GKRS, the timeline of adverse events, and the outcome following the radiosurgical intervention. We systematically searched for articles related to various complicat...
Article
OBJECTIVE Molecular profiles, such as isocitrate dehydrogenase (IDH) mutation and O ⁶ -methylguanine-DNA methyltransferase (MGMT) methylation status, have important prognostic roles for glioblastoma patients. The authors studied the efficacy and safety of stereotactic radiosurgery (SRS) for glioblastoma patients with consideration of molecular tumo...
Article
Background The initial management of asymptomatic, incidentally discovered, cavernous sinus (CS) meningiomas remains incompletely defined. This study evaluated the safety and efficacy of stereotactic radiosurgery for patients presenting with an asymptomatic CS meningioma. Methods This is an international, retrospective study included patients trea...
Preprint
Objective: The optimal management of asymptomatic, skull-based meningiomas is not well defined. The aim of this study is to compare the imaging and clinical outcomes of patients with asymptomatic, skull-based meningiomas managed either with upfront stereotactic radiosurgery (SRS) or active surveillance. Methods: This retrospective, multicenter stud...
Article
OBJECTIVE The object of this study was to evaluate the safety, efficacy, and long-term outcomes of stereotactic radio-surgery (SRS) in the management of intracranial chordomas. METHODS This retrospective multicenter study involved consecutive patients managed with single-session SRS for an intracranial chordoma at 10 participating centers. Radiolog...
Article
Background: Brain metastases represent a major indication for stereotactic radiosurgery (SRS), but further study is needed regarding repeat SRS (SRS2) after local or marginal recurrence after prior SRS (SRS1). We report local tumor control (LC) after SRS2 and identify predictors of radiation necrosis (RN) and symptomatic RN (SRN). Methods: Patie...
Article
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Background Although head injury (HI) from low- and middle-income countries (LMIC) heavily contributes to the global disease burden, studies are disproportionately less from this part of the world. Knowing the different epidemiological characteristics from high-income nations can target appropriate prevention strategies. This study aims to provide a...
Article
OBJECTIVE As novel therapies improve survival for men with prostate cancer, intracranial metastatic disease has become more common. The purpose of this multicenter study was to evaluate the safety and efficacy of stereotactic radiosurgery (SRS) in the management of intracranial prostate cancer metastases. METHODS Demographic data, primary tumor ch...
Article
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Background Pandoraea apista is predominantly recovered from the respiratory tract of patients with cystic fibrosis (CF). Authors report first case of central nervous system infection by P. apista in the form of skull base osteomyelitis. Case Description A 67-year-old male presented with complaints of earache and hearing deficit for few months. The...
Article
Gamma angle plays a major role in Gamma Knife Radiosurgery (GKRS) treatment planning. Selecting an appropriate gamma angle may help in mitigating unnecessary radiation exposure to organs at risk (OARs). The aims in GKRS of vestibular schwannoma (VS) is to deliver sufficient radiation to the tumor extending into internal auditory canal (IAC) while k...
Conference Paper
Pinning of skull during neurosurgical procedures is one of the important steps prior to positioning. We designed silicone studs as one of non-pharmacological approach in blunting the hemodynamic response associated with the pinning. These silicone caps provide cushioning to the underlying scalp and distribute force from to a wider area.
Article
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Cerebral phaeohyphomycosis is a rare but serious fungal infection of the central nervous system caused by dematiaceous septate fungi characterized by the presence of melanin-like pigment within the cell wall that is a pale brown to black. It is associated with poor prognosis despite aggressive treatment. We report a previously well 3-year boy with...
Article
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SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism....
Article
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Objectives: To assess the reporting of study design and characteristics in multi-level degenerative cervical myelopathy (DCM) treated by posterior surgical approaches, and perform a comparison of clinical and radiographic outcomes between different approaches. Methods: A literature search was performed in Embase and MEDLINE between 1995-2019 usi...
Article
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We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which pati...
Article
BACKGROUND Stereotactic radiosurgery (SRS) is increasingly considered for selected olfactory groove meningiomas (OGMs). OBJECTIVE To investigate the safety and efficacy of SRS for OGMs. METHODS From 20 institutions participating in the International Radiosurgery Research Foundation, we pooled patients who underwent SRS for histologically confirme...
Article
Full-text available
Background and Importance Intracranial textilomas are retained surgical sponges presenting as pseudomass lesions in postoperative patients usually with surrounding inflammatory reaction. Though rare, these are commonly misdiagnosed as postoperative hemorrhagic collections, abscesses, radionecrosis, or residual/recurrent mass lesions. We describe th...