Introduction: Non compressive myelopathy is defined as "spinal cord dysfunction in the absence of clinico-radiological evidence of spinal cord compression." It can result from demyelinating, infectious, autoimmune, vascular, degenerative and metabolic disorders in the absence of demonstrable compression by imaging techniques. We aimed in analyzing the etiological profile of non-compressive myelopathies in a tertiary care hospital of Central Tamil nadu. Material and Methods: In the Neurology department, we conducted an observational study at Thanjavur Medical College, Thanjavur, from September 2017 to September 2018. Patients of non-compressive myelopathies who underwent magnetic resonance imaging (MRI) of the spine were segregated into two categories: Degenerative and non-Degenerative, as well as into acute, subacute and chronic myelopathies.Results: The study had 75 patients with a median age of 34.5 years and male: female ratio of 1.35:1. Presentation was acute in 10 patients (13%), subacute in 5 (6.5%), chronic in 54 (72.5%) and history of relapse and remission in 6(8%) patients. Degenerative etiology was found for 42 (56%) others were non degenerative (demyelinating, autoimmune, vascular, nutritional, or physical agent). MRI study carried out in all cases showed signal changes in 51 cases (68%) which included myelomalacia, demyelination, atrophy of cord, infarction of cord. Etiological diagnosis could be established in 74 (97.3%) cases. Conclusion:Underlying etiology (degenerative, demyelinating, autoimmune, infectious, vascular, metabolic disorder, or physical agent) was found in 91.3% patients of noncompressive myelopathy. Clinical features combined with MRI findings are helpful in defining the cause of non-compressive myelopathies. A follow-up of long term may reveal some of the diagnosis especially degenerative myelopathies in early stage.

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Introduction: Large territory middle cerebral artery strokes are devastating events that result in high rates of disability and death. Nearly half of all stroke survivors never regain functional independence. Current research aimed to study the clinical profile and risk factors of massive middle cerebral artery (MCA) infarction and to study the relation of alcoholism and its pattern to massive MCA stroke. Material and methods: Patients admitted with massive MCA infarct with an early ischemic change on CT affecting at least >50% of the MCA territory within 48 hours of symptom onset were included in the study. Stroke mimics and those with history of previous stroke were excluded. Study design was a cross sectional, observational study. Results: A total of 60 cases were analyzed. Mean age was 55.4. 35% subjects had NIHSS >20.Diabetes was present in 18. Total of 60% were alcoholics, and 83% of males were alcoholics.31 subjects were heavy drinkers. Binge drinking was present in 30%.Mean duration of alcohol was 9.5 years. Average intake per day was 120 ml. Mean ASPECT score in the subjects was 3. 25 patients had a MRS 4 at discharge. Craniotomy done in 6 cases. Total death were 17(29%). Aspiration pneumonia was the common cause of death (5). Conclusion: NIHSS 20 or more was associated with adverse outcome (P value <0.05).60% were alcoholics. Binge intake in 30%(associated with adverse outcome P value <0.05). Mean Aspect score was 3 (3 or less associated with adverse outcome P value <0.05).

Background: Stroke is one of the leading causes of mortality and morbidity in today's world. With early intervention and improvements in critical care the mortality from stroke is decreasing. Today there are more chances of a patient surviving after a stroke than it was 2 decades ago. But this downward shift in mortality has caused increased prevalence of patients surviving with considerable neurodeficits and cognitive dysfunction. These patients are at increased risk of developing depression which may directly affect the recovery process. Yet the depression in post-stroke patient is rarely recognised and treated. Many a times such patients remain bed-ridden, neglected depressed and only a small number of these patients are treated for depression. Some of this has to do with the fact that there are not many randomised controlled trials dealing with this aspect. Gradually with increasing survival of the patients with stroke data is becoming available suggesting that the treatment of depression in post-stroke patient have a positive effect on recovery of these patients. We conducted this study to identify the prevalence and severity of depression in post stroke patients and to assess its relationship with demographic variables and stroke characteristics. Methods: This was a cross sectional study comprising of 52 patients selected on the basis of pre-defined inclusion criteria and was carried out in Department of Neurology of a tertiary care medical institute situated in an urban area. All patients attending follow up stroke OPDS having a history of stroke confirmed on imaging (Computed tomographic, MRI or MR angiography) were included in this study. Dependent variable of our study was depression while independent variables were demographic and clinical factors such as age, gender, marital status, financial status, residence status, education level and the clinical variables were stroke type, side and site of stroke. All the patients were interviewed using the preformed questionnaire specifically designed for this study. The data was tabulated and analysed. SPSS Statistics version 2.0 was used to analyze the collected data. Results: Forty four patients with stroke out of 52 (85%) met the criteria for depression. out of which 40 were males and 12 were females with a M: F ratio being 1:0.3. Demographic variables and stroke types (hemorrhagic versus thromboembolic) were not significantly associated with post stroke depression. A peculiar finding we encountered was infarcts in the middle cerebral artery territory were significantly associated with depression. Majority of the patients (87 %) had ischaemic stroke and most common location was found to be left hemisphere (60%). Most common territory was found to be left middle cerebral artery territory which was affected in 50% of the patients.81% patients were found to be having illness since more than 6 months. Depression was more common in male patients of more than 45 years of age. There was a significant association between the post stroke depression and left ...

Corona virus disease 2019 (COVID19) is a pandemic disease which started in December 2019 in Wuhan, China. Now it has spread all over the world with over 7 crore cases and still counting. The typical symptoms of COVID19 can range from mild to severe respiratory illness. Although the respiratory system complications COVID19 have been the most frequent and life threatening, there are increasing reports of central and peripheral nervous system (PNS) involvement. Various studies done in many countries showed that many COVID19 patients presented with neurological manifestations. There are many review studies available throughout the world describing them. There are not many studies in India, especially in southern states done in COVID19 patients. Hence this observational study is done in Thanjavur medical college hospital , a tertiary care center in Tamilnadu, India, to study the various neurological manifestations found in COVID19 patients.