Meningitis remains one of the most dreaded complications of neurosurgical procedures and is common in patients with preexisting infection. Gram-negative organisms are the most common causative pathogens of postoperative meningitis.

MBEN represents a variant that occurs in very young children but has a good prognosis. The favourable outcome is probably related to its spontaneous neurocytic differentiation. The pattern of Bcl-2 immunoreactivity in MBENs indicates that this protein could be a key player in the regulation of neuronal differentiation in medulloblastomas.

Leclercia adecarboxylata, a gram-negative bacillus of the Enterobacteriaceae family, is an uncommonly identified human pathogen. The organism has been reported worldwide and isolated from various environmental sources. Most human infections are polymicrobial and commonly occur in immunocompromised hosts, although nosocomial infections in immunocompetent hosts have been documented. We describe three case reports of L. adecarboxylata isolation from cases of hospital acquired pneumonia admitted to a tertiary care center for neurosurgical care.

In order to optimize the accuracy of imaging in Gamma Knife radiosurgery using the image fusion options available in the Leksell gamma plan. Phantom images from 1.5 Tesla MRI Scan (Magnetom vision -Siemens) and Computed Tomography images from Philips Brilliance 16 CT scanner were used for image fusion in Gammaplan treatment planning system . The images were fused using co-registration technique using multiview and imagemerge modules. Stereotactic coordinates were then calculated for known targets. Vector distances from the centre of the Leksell coordinate system to five known targets were measured in CT, MR and CT-MR fused images and compared with geometrical measurements. The mean values of maximum absolute errors were 0.34 mm ,0.41 mm.0.38 mm (along x-axis), 0.43 mm, 1.53 mm, 0.62 mm (along y-axis) and 0.75 mm 2.02 mm, 0.93 mm (along z-axis) for CT ,MR and CT-MR fused image data respectively.The mean error in calculating the vector distances from the center of the Leksell coordinate system (100, 100, 100) to the known target volumes are 0.22 mm, 0.8 mm and 0.43 mm for CT, MR and CT-MR fused images, respectively. Image fusion functions available in gamma plan are useful for combining the features of CT and MR imaging modalities. These methods are highly useful in clinical situations where the error associated with Magnetic Resonance Imaging is beyond acceptable levels.

Introduction:Biofilms are the source of persistent infections of many pathogenic microbes. They are responsible for nosocomial infection and also associated with many surgical conditions including indwelling medical devices such as ventriculoperitoneal shunt. A significant problem encountered in shunt procedures is obstruction followed by infection, with infection rate ranging from 2% to 27%, often with poor outcome.Materials and Methods:This study was conducted in the Department of Neuromicrobiology at a tertiary neuroinstitute for 6 months from July 1 to December 31, 2014. The samples comprised cerebrospinal fluid (CSF) from suspected cases of shunt infections. Laboratory diagnosis of causative agent was established by adopting standard procedures. Then, isolates were evaluated for production of biofilm by tissue culture plate (TCP) method and tube method.Results:Of the 1642 shunt CSF samples obtained from neurosurgery, 14.79% were culture positive which yielded 254 isolates. About 51.97% were Gram-negative bacilli (GNB), 46.46% were Gram-positive cocci (GPC), and 1.57% were Candida albicans. Among GNB, nonfermenters were the most common (51.52%) followed by Pseudomonas aeruginosa (15.9%). Among GPC, coagulase-negative Staphylococci were 88.13%, out of which 43.26% were methicillin-resistant. Other GPC were Enterococcus spp. (4.24%), Staphylococcus aureus (5.08%), and Streptococcus spp. (2.54%). Among all isolates, 120 were tested for biofilm production, out of which 57.5% were biofilm producers and 42.5% were nonproducers.Conclusions:TCP was the better method to detect biofilm. Most of the biofilm producers were resistant pathogens.

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