31. 12/14 (86%) children developed PPCS in the MTH group, compared to 2/16 (12.5%) children in the control group P=0.0003 Temporal lobe damage in minor head injury RESULTS Persistent post concussion syndrome (PPCS)
32.
33.
34.
35. ROLE OF PIRACETAM IN POST-CONCUSSION SYNDROME A PROSPECTIVE RANDOMIZED STUDY Deepak Agrawal, K Naveen*, CS Bal*, AK Mahapatra Departments of Neurosurgery* and Nuclear medicine*, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, INDIA
46. Piracetam in minor head injury STUDY DESIGN 20 PATIENTS WITH POSTCONCUSSION SYNDROME & ABNORMAL SPECT PIRACETAM GROUP CONTROL GROUP 10 PATIENTS 800 mg PIRACETAM (Cerecetam) TDS x 6 WEEKS CLINICAL EVALUATION & REPEAT SPECT AT 6 WEEKS 10 PATIENTS NO PIRACETAM CLINICAL EVALUATION & REPEAT SPECT AT 6 WEEKS
51. CRANIO-CERVICAL JUNCTION ANOMALIES AS A CAUSE OF VERTEBRO-BASILAR INSUFFICIENCY Deepak Agrawal, Naveen K*, SS kale, C S Bal*, A K Mahapatra Departments of Neurosurgery and *Nuclear medicine, All India Institute of Medical Sciences, New Delhi-110029
This is the hospital I did my residency in as well the research using SPECT
2. For our Imaging need we have
A number of imaging techniques are available for use in neurosciences and can be braodly divided into …
In..
The Biochemical interactions between brain tissue and injected substance (HMPAO,ECD, Iophane) form the underlying principle of SPECT. However to make these interactions recordable these substances have to be labeled with radioactive tracers ( 99m HMPAO, 99m ECD, 123 I-iophane)
And the radio activity of the trapped sbstances forms the basis of SPECT
Although SPECT can & is used for imaging the whole body, Brain SPECT has two important uses… 1 To see for regional cerebral perfusion and the most commonly used rediopharamceuticals for this purpose are the Hexam methyl .. And Ethylene Cysteine Dimer 2ndly For imaging of the neurotransmitter systems using radiopharmaceutical Ioflupane
It is well known tha…. In a presentation in this very auditorium a few weeks by my collegue on pediatric head injury and outcome prediction back it was c
The hippocampus is a key structure in the medial temporal lobe, and is located within the hippocampal formation, that also includes the dentate gyrus, subicular complex, and entorhinal cortex. & The reason we decided to target MTL in patients with concussion was …
Just to get a few definations out of the way-There are a number for different criteria defining minor head injury. We decided to stick to this definition as it is very simple to apply and has been around for a relatively long time to be validated
The definition of PCS is more tenacious and we used the DSM 4 criteria to define PCS. This critria include...
Our research on post concussion syndrome focussed on the medial temporal lobe. This research has been published in the JNS a couple of months back
We decided to use a pharmacological intervention and use SPECT to see its utility
To briefly describe this drug which we used in our next study
So we did not use much creativity and did the same study all over again, except that we used an intervention in the form of piracetam
The way SPECT methodology differed from the previous study was in quantification of the cerebral perfusion. Compared to visual scale previously we used Circular region of interest (ROI)
Radiotracer counts
During my posting in neurology department, I became interested in stroke. However, as the posting was of two months duration only, I could not conduct any studies. On return to my own department, I realized that many patients with cranio-cervical junction anomalies had features of posterior circulation ischemia.
We therefore decided to study CCJ anomalies as a cause of verterbro basilar insufficiency.
At the outset we were concerned whether SPECT could assess the posterior circulation adequately. A review of the literature however dispelled our doubts.