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Hemanshu Prabhakar

Publications and source records attributed to Hemanshu Prabhakar.

7 recordsLinked to original sources
PubMed2026

Ventriculostomy-Related Infections by Country-Income Level: A Systematic Review and Bayesian Hierarchical Meta-analysis.

Our objective was to perform a systematic review and meta-analysis of published literature on ventriculostomy-related infection (VRI) and evaluate temporal and global trends. We conducted a systematic review and Bayesian hierarchical random-effects meta-analysis of VRI rates in adults, stratified by country-income level (high-income countries [HIC]; low- or middle-income countries [LMIC]), study design, sample size, enrollment period, VRI intervention, and VRI definition. We identified 159 articles published between 1989 and 2025 that included 523,704 patients with 7293 VRIs. The pooled VRI rate was 8.64% [95% CI: 7.44-9.97], with moderate heterogeneity and good model fit. The leave-one-out sensitivity analysis showed a mean absolute change of 0.06% and a maximum change of 0.2%, indicating robust analysis. Five of the 33 represented countries had VRI rates below the global pooled rate of 8.64%. Four were HICs: Singapore (VRI rate 3.3% [0.8-7]), the United States (VRI rate 4.6% [3.4-5.9]), Germany (VRI rate 6.1% [1.1-18.9]), Norway (8.3% [0.3-68.4]), with 1 LMIC: China (8.5% [5.4-12.4]). VRI was significantly higher in studies using definitions beyond CSF culture alone for VRI (+3.16% [0.11- 6.52]) and in those from Europe (+7.29% [4.62-10.10]) and the Western Pacific (+4.09% [1.55-6.98]). No other subgroup demonstrated significant differences. This Bayesian meta-analysis provides global estimates and factors associated with VRI. Standardization of VRI definitions is critical for future benchmarking of VRI rates.

Humans↗
PubMed2004

Transient cardiac asystole in transsphenoidal pituitary surgery: a case report.

Unlike other cardiac arrhythmia, asystole during neurosurgical procedures is not reported in the literature. We describe such a case during transsphenoidal pituitary surgery in a patient who was not having any history of associated cardiac problems. Its possible cause in relation to the perioperative sequence of events has been discussed.

Anesthesia↗
PubMed2003

Reverse brain herniation during posterior fossa surgery.

Posterior fossa tumors are commonly associated with obstructive hydrocephalus. Relieving the raised intracranial pressure by draining the cerebrospinal fluid presents the possibility of reverse herniation of the brain. A 5-year-old male child with a diagnosis of posterior fossa space-occupying lesion and hydrocephalus was scheduled for craniectomy in the prone position. After craniectomy, the surgeons placed an intraventricular shunt catheter to drain out cerebrospinal fluid in an attempt to reduce the tense brain so as to facilitate easy dissection of the tumor. The patient had sudden and severe bradycardia followed by asystole. A diagnosis of reverse coning was made. Immediately, the surgeon injected 10-15 mL normal saline into the ventricles. There was a spontaneous return of the sinus rhythm and the rest of the course of surgery was uneventful. We present this case showing a rare phenomenon and its successful management.

Cerebellar Diseases↗
PubMed2003

Tension pneumocephalus after craniotomy in supine position.

Tension pneumocephalus has been reported frequently after posterior fossa surgery, mostly in procedures done in the sitting position. Though uncommon, tension pneumocephalus is a life-threatening complication that requires urgent diagnosis and treatment. It is rare for this complication to occur after neurosurgical procedures done in the supine position. The authors report a case of an adult patient diagnosed with craniopharyngioma who developed tension pneumocephalus following craniotomy in the supine position.

Adult↗
PubMedDate not supplied

Effect of cerebrospinal fluid return on success rate of percutaneous retrogasserian glycerol rhizotomy.

BACKGROUND AND OBJECTIVE: Trigeminal neuralgia is a painful syndrome, which has been commonly treated with percutaneous retrogasserian glycerol rhizotomy (PRGR). This study was performed to evaluate the effect of cerebrospinal fluid (CSF) return on the success rate of PRGR. METHODS: In this retrospective, nonrandomized, observational case series, 100 cases underwent 140 PRGRs under fluoroscopic guidance and were followed up for 6 to 36 months. The results were compared in the presence or absence of CSF return before PRGR. RESULTS: The PRGR was successful in 115 procedures (82.1%). CSF return was present in 84 procedures (60%) and, among these, 76 PRGRs (90.5%) produced pain relief. More than 1 year of pain relief without medications was present in 60 of 84 procedures (71.4%). CSF return before PRGR was absent in 56 procedures (40%) and success resulted in 39 procedures (69.6%). Pain relief for more than 1 year without medications was present in 19 procedures (33.9%). The success rate and duration of pain relief was greater in the presence of CSF return compared with absence of CSF return (P < .005). The incidence of complications such as facial dysesthesia (40%), corneal anesthesia (2.8%), herpes simplex (3.5%), and nonbacterial meningitis (0.7%) was not significantly different in 2 groups ( P > .05). CONCLUSION: The presence of CSF is an important factor in determining the success rate and duration of pain relief of PRGR.

Adolescent↗