Amit Agrawal

Latest posts by Amit Agrawal (see all)

DYKE-DAVIDOFF-MASSON SYNDROME PRESENTING WITH RECURRENT SEIZURES - 27/04/2016
NEONATAL STROKE DUE TO VARICELLA ARTERIOPATHY - 21/01/2016
MASSIVE CEREBRAL INFARCTION FOLLOWING EVACUATION OF INTRACEREBRAL HEMATOMA - 15/09/2015

Articles signed on Romanian Journal of NEUROLOGY:

DYKE-DAVIDOFF-MASSON SYNDROME PRESENTING WITH RECURRENT SEIZURES

Romanian Journal of Neurology, Volume XV, No. 1, 2016

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

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Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

M. Rajaguru, V. Umamaheswara Reddy, Amit Agrawal, V. Ganesh and Anil Tadikonda

ABSTRACT

Dyke-Davidoff-Masson syndrome (DDMS) is cerebral hemiatrophy occurring following brain insult resulting from infarct, trauma or infection in utero or soon after birth. Clinical features of this syndrome include variable degree of contralateral hemiparesis, facial asymmetry, seizures and mental retardation. Recurrent seizures is the most debilitating and poor prognostic indicator of this disease. Neuroimaging plays pivotal role in establishing the diagnosis of DDMS syndrome. CT/MR imaging shows unilateral cerebral parenchymal atrophy, prominent sulcal spaces, ipsilateral ventriculomegaly, cerebellar atrophy, falcine and superior Sagittal sinus shift to affected side. Bone windowing in CT scan shows decreased skull volume on affected side calvarial thickening, elevation of sphenoid wing and petrous temporal bone, expanded sinuses and mastoids. Here we describe 34 years old female who had hemiparesis, seizures and facial asymmetry since childhood and imaging evaluation established diagnosis of congenital type of DDMS.

Keywords: Dyke-Davidoff-Masson syndrome, seizures, hemiatrophy and ventriculomegaly

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NEONATAL STROKE DUE TO VARICELLA ARTERIOPATHY

Romanian Journal of Neurology, Volume XIV, No. 4, 2015

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

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Promoting Global Health

N.S. Sampath Kumar, Reddy V. Umamaheswara, Amit Agrawal, V. Ganesh and A. Mithilesh

ABSTRACT

Varicella zoster is one of the common infective etiological factors known to produce arteriopathy of cerebral vasculature. Varicella zoster infection spreads transaxonally first to the adventitia and later transmurally to intima. Primary infection or reactivation of varicella zoster, both are associated with involvement of cerebral vessels of large as well as of small calibre varicella zoster associated arteriopathy was reported up to 12 months after the infection. Recurrence of strokes are seen post varicella infection. Hence the identification of varicella zoster as an etiological agent of ischemic stroke in neonatal age group patients is necessary and requires follow-up. Other neurologic sequelae following varicella infection are aneurysm formation leading to subarachnoid and cerebral haemorrhage, carotid dissection and rarely peripheral arterial disease. Due to lack of adequate epidemiological, neuroimaging and laboratory data, guidelines for treatment of varicella ateriopathy are not clear.

Keywords: post varicella arteriopathy, varicella zoster, arterial stenoses, middle cerebral artery, post varicella sequelae, seizures

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MASSIVE CEREBRAL INFARCTION FOLLOWING EVACUATION OF INTRACEREBRAL HEMATOMA

Romanian Journal of Neurology, Volume XIII, No. 3, 2014

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

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Promoting Global Health

Amit Agrawal, S. Satish Kumar and Umamaheswara V. Reddy

ABSTRACT

Rarely primary ICH and infarction can occur simultaneously and development of cerebral infarction soon after intracerebral hemorrhage is still rarer. Uncontrolled atherosclerotic risk factors including hypertension and hyperlipidemia together with antithrombotic therapy are the major reasons for the simultaneous ischemic and hemorrhagic lesions. We report a 67 year male presented with history of sudden onset of left hemiplegia. An urgent CT scan brain showed a large right basal ganglionic hematoma with mass effect and midline shift. The patient underwent evacuation of hematoma. After initial improvement the patient again deteriorated on day 3. A follow up CT scan showed hemorrhagic infarct at the site of surgery with mass effect and midline shift.

Keywords: intracranial hematoma, cerebral infarction, hypertension

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CAVERNOMA OF CERVICOMEDULLARY REGION PRESENTING WITH HEMIHYPESTHESIA

Romanian Journal of Neurology, Volume XIII, No. 4, 2014

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

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Promoting Global Health

Umamaheswara V. Reddy, Amit Agrawal, N.S. Sampath Kumar, Gauri Rani Karur and Kishor V. Hegde

ABSTRACT

Medullary cavernomas only contribute to 5% of brain stem cavernomas, various clinical presentations for medullary cavernomas have been described like intractable hiccups, dysphagia, hemiparesis, anorexia nervosa and hemihypesthesia. Exact pathomechanism for developing sensory symptoms has not been described earlier. Pressure effects due to changing dynamics in this cavernous malformation resulting in mass effect over the traversing sensory tract fibers is the possible mechanism. Differentials of cavernoma should be considered for any case presenting with hemihypesthesia. Surgery should be done only when there is appropriate indication, as surgery itself causes significant morbidity.

Keywords: cavernoma, cavernous angioma, medulla oblongata, hemihypesthesia

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PICTORIAL REVIEW ON CONSTELLATION OF IMAGING FINDINGS OF BRAIN DEATH ON 3T MRI

Romanian Journal of Neurology, Volume XIV, No. 1, 2015

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

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Promoting Global Health

Umamaheswara V. Reddy, Praveen Kumar Kolla, Amit Agrawal, Kishor V. Hegde, Rakesh Borrugada and Priya Malpani

ABSTRACT

Brain death is physiological loss of function of all intracranial structures above foramen magnum. Imaging is ancillary and are not substitute for clinical diagnosis of brain death. MRI can be useful supplementary diagnostic test for diagnosing brain death especially in cases where bed side clinical tests cannot be performed. No single sign in MRI is specific for brain death. Tonsillar herniation, loss of flow void in bilateral internal carotid arteries and vertebral arteries, swollen cortical gyri, edematous, cerebellar foliae with white matter hyperintensities, effacement of the ventricular system, uncal herniation compressing over the midbrain, brain stem swelling, dilated veins showing increased susceptibility phenomenon due to increase deoxyhemoglobin, diffuse restriction in cerebral cortex are some of the feature of brain death we present the imaging signs brain which we came across in two patients.

Keywords: brain death, tonsillar herniation, brain stem reflexes, Imaging signs, 3Tesla MRI

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DYSPLASTIC WHITE MATTER LESIONS IN PATIENT WITH NEUROFIBROMATOSIS 1

Romanian Journal of Neurology, Volume XIV, No. 2, 2015

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

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Promoting Global Health

P. Amaresh Reddy, Amit Agrawal, V. Umamaheshwar Reddy, P. Radharani and Sahith Reddy

ABSTRACT

Dysplastic white matter lesions/unidentified bright objects /Foci of abnormal signal intensities (FASi’s) in brain MRI are the commonest intracranial abnormality with Neurofibromatosis 1 seen in approximately 70-75% of patients. They are usually multiple, small in size and are typically located in globus pallidus, brainstem, centrum semiovale, thalamus, internal capsule, corpus callosum, and cerebellum. Although clinically silent, patients can present with reduced attention span however neuropsychological functioning of these lesions depends upon the region involved. NF1 lesions should be kept as differential for any hyperintense lesion in basal ganglia and caution is advised not to confuse these lesions with malignant lesions like gliomas as biopsies from these lesions showed benign etiology. Parental counselling regarding the prognosis is very important to alleviate unnecessary apprehension. Interval follow-up is advised for large lesions causing mass effect, showing contrast enhancement or when lesions are located in optic pathway.

Keywords: Neurofibromatosis-1, dysplastic white matter lesions, unidentified bright objects, Foci of abnormal signal intensities, cognition

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Amit Agrawal

Latest posts by Amit Agrawal (see all)

Articles signed on Romanian Journal of NEUROLOGY:

DYKE-DAVIDOFF-MASSON SYNDROME PRESENTING WITH RECURRENT SEIZURES

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