Ketan Verma
Boston Children's Hospital
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Featured researches published by Ketan Verma.
Clinical Anatomy | 2015
Martin M. Mortazavi; Ketan Verma; Olivia A. Harmon; Christoph J. Griessenauer; Nimer Adeeb; Nicholas Theodore; R. Shane Tubbs
Spinal cord injury is a highly prevalent condition associated with significant morbidity and mortality. The pathophysiology underlying it is extraordinarily complex and still not completely understood. We performed a comprehensive literature review of the pathophysiologic processes underlying spinal cord injury. The mechanisms underlying primary and secondary spinal cord injury are distinguished based on a number of factors and include the initial mechanical injury force, the vascular supply of the spinal cord which is associated with spinal cord perfusion, spinal cord autoregulation, and post‐traumatic ischemia, and a complex inflammatory cascade involving local and infiltrating immunomodulating cells. This review illustrates the current literature regarding the pathophysiology behind spinal cord injury and outlines potential therapeutic options for reversing these mechanisms. Clin. Anat. 28:27–36, 2015.
Childs Nervous System | 2011
R. Shane Tubbs; Sanjay Krishnamurthy; Ketan Verma; Mohammadali M. Shoja; Marios Loukas; Martin M. Mortazavi; Aaron A. Cohen-Gadol
IntroductionAnterior midline intracranial cysts may be found most often in three forms: cavum septum pellucidum, cavum vergae, and cavum velum interpositum. A single offering that reviews these entities is difficult to find in the extant literature. Therefore, the present review was performed.Materials and methodsVarious search engines and germane texts were reviewed for the terms cavum septum pellucidum, cavum vergae, and cavum velum interpositum.ResultsWe report the findings of our search of the literature regarding these midline cystic structures.ConclusionsA better understanding of the associated anatomy, embryology, and pathology of these cysts will assist the clinician who treats such patients.
Journal of Neurosurgery | 2011
Tubbs Rs; Ketan Verma; Sheryl Riech; Martin M. Mortazavi; Shoja Mm; Marios Loukas; Joel K. Curé; Anna Zurada; Aaron A. Cohen-Gadol
As fetal intracranial vessels may persist into adulthood, knowledge of their anatomy and potential clinical and surgical complications should be borne in mind by the surgeon. A comprehensive review of these vessels, however, is not easily identified in the literature. Therefore, the present analysis was undertaken so that such information is available to the clinician and morphologist.
Childs Nervous System | 2011
Martin M. Mortazavi; Ketan Verma; R. Shane Tubbs; Nicholas Theodore
BackgroundExperimental approaches to limit the spinal cord injury and to promote neurite outgrowth and improved function from a spinal cord injury have exploded in recent decades. Due to the cavitation resulting after a spinal cord injury, newer important treatment strategies have consisted of implanting scaffolds with or without cellular transplants. There are various scaffolds, as well as various different cellular transplants including stem cells at different levels of differentiation, Schwann cells and peripheral nerve implants, that have been reviewed. Also, attention has been given to different re-implantation techniques in avulsion injuries.MethodsUsing standard search engines, this literature is reviewed.ConclusionCellular and paracellular transplantation for application to spinal cord injury offers promising results for those patients with spinal cord pathology.
Journal of Neurosurgery | 2012
Tubbs Rs; Rompala Oj; Ketan Verma; Martin M. Mortazavi; Brion Benninger; Marios Loukas; Chambers Mr
OBJECT Although the uncovertebral region is neurosurgically relevant, relatively little is reported in the literature, specifically the neurosurgical literature, regarding its anatomy. Therefore, the present study aimed at further elucidation of this regions morphological features. METHODS Morphometry was performed on the uncinate processes of 40 adult human skeletons. Additionally, range of motion testing was performed, with special attention given to the uncinate processes. Finally, these excrescences were classified based on their encroachment on the adjacent intervertebral foramen. RESULTS The height of these processes was on average 4.8 mm, and there was an inverse relationship between height of the uncinate process and the size of the intervertebral foramen. Degeneration of the vertebral body (VB) did not correlate with whether the uncinate process effaced the intervertebral foramen. The taller uncinate processes tended to be located below C-3 vertebral levels, and their average anteroposterior length was 8 mm. The average thickness was found to be 4.9 mm for the base and 1.8 mm for the apex. There were no significant differences found between vertebral level and thickness of the uncinate process. Arthritic changes of the cervical VBs did not necessarily deform the uncinate processes. With axial rotation, the intervertebral discs were noted to be driven into the ipsilateral uncinate process. With lateral flexion, the ipsilateral uncinate processes aided the ipsilateral facet joints in maintaining the integrity of the ipsilateral intervertebral foramen. CONCLUSIONS A good appreciation for the anatomy of the uncinate processes is important to the neurosurgeon who operates on the spine. It is hoped that the data presented herein will decrease complications during surgical approaches to the cervical spine.
Childs Nervous System | 2014
Martin M. Mortazavi; Christoph J. Griessenauer; Sanjay Krishnamurthy; Ketan Verma; Marios Loukas; R. Shane Tubbs
IntroductionThe inferior petrosal sinus is an important component of the cerebral venous system with implications in diagnosis and treatment of a variety of diseases such as Cushing’s disease, carotid cavernous, and dural arteriovenous fistulas.MethodsThis manuscript will review the anatomy, embryology, and clinical implications of the inferior petrosal sinus.ConclusionsKnowledge of the inferior petrosal sinus is of great importance for open surgical approaches to the skull base and endovascular access to the cavernous sinus and sellar region.
Childs Nervous System | 2011
Martin M. Mortazavi; Ketan Verma; Aman Deep; Fatemeh B. Esfahani; Patrick R. Pritchard; R. Shane Tubbs; Nicholas Theodore
IntroductionSpinal cord injury is a complex cascade of reactions secondary to the initial mechanical trauma that puts into action the innate properties of the injured cells, the circulatory, inflammatory, and chemical status around them, into a non-permissive and destructive environment for neuronal function and regeneration. Priming means putting a cell, in a state of “arousal” towards better function. Priming can be mechanical as trauma is known to enhance activity in cells.Materials and methodsA comprehensive review of the literature was performed to better understand the possible chemical primers used for spinal cord injuries.ConclusionsTaken together, many studies have shown various promising results using the substances outlined herein for treating SCI.
Journal of Neurosurgery | 2013
R. Shane Tubbs; Martin M. Mortazavi; Sanjay Krishnamurthy; Ketan Verma; Christoph J. Griessenauer; Aaron A. Cohen-Gadol
OBJECT During intracranial approaches to the skull base, vascular relationships are important. One relationship that has received scant attention in the literature is that between the superior petrosal sinus (SPS) and the opening of the Meckel cave (that is, the porus trigeminus). METHODS Cadaver dissections were performed in 25 latex-injected adult cadaveric heads (50 sides). Specifically, the relationship between the SPS and the opening of the Meckel cave was observed. The goal was to enhance knowledge of the relationship between the SPS and the opening of the Meckel cave. RESULTS Of the 50 sides, 68%, 18%, and 16% of SPSs traveled superior to, inferior to, and around the opening to the Meckel cave, respectively. In the latter cases, a venous ring was formed around the proximal trigeminal nerve. No sinus entered the Meckel cave. In general, the porus trigeminus was narrowed on sides found to have an SPS that encircled this region. Sinuses that traveled only inferior to the porus were in general smaller than sinuses that traveled superior or encircled this opening. No statistically significant differences were noted between the various sinus relationships and sex, age, or side of the head. CONCLUSIONS Knowledge of the relationship between the SPS and the opening of the Meckel cave may be useful to the skull base surgeon. Based on this study, some individuals may retain the early embryonic position of their SPS in relation to the trigeminal nerve.
Childs Nervous System | 2011
R. Shane Tubbs; Ketan Verma; Sheryl Riech; Martin M. Mortazavi; W. Jerry Oakes; Aaron A. Cohen-Gadol
Theodor Kocher began using silk sutures in the late nineteenth century as a result of the overwhelming number of surgical infections related to catgut [10]. When compared to catgut, silk is not only cheaper but is also more easily sterilized [7]. Silk sutures tend to react less with tissues and result in stronger wound closures [3]. Harvey Cushing used the silk suture with a delicate curved needle for neurosurgical purposes [1] and silk has remained a popular suture material in neurosurgery. However, inflammation along the suture line is sometimes noticeable immediately after surgery. Also, silk sutures can lead to suppuration and sinus draining when used in clean wounds [3]. However, delayed silk allergies are rare [9, 15]. Silk allergies have also had an impact on areas other than neurosurgery. Celedon et al. [2] found sensitization to silk possibly leading to pathogenesis and severity of asthma. Silk is also considered a potent antigen and it is believed that the symptoms related to interstitial cystitis are in turn caused by an allergic reaction to buried silk sutures [8]. Also, silk sutures used during herniorrhaphy have caused delayed inflammatory intra-abdominal masses [12]. Silk sutures are also believed to trigger a hypersensitivity reaction leading to necrotizing granulomas [13]. Kurosaki et al. [11] also reported a case where the patient experienced recurrent granulomas, which may have been caused by IgE-mediated hypersensitivity reaction to silk fibroin. The primary problem with silk sutures is that they are non-absorbable, often hindering successful treatment [14]. Hence, absorbable synthetic polymers are a viable alternative. Such polymers can have equal tensile strength and knot stability [15, 18]. Also, silk sutures’ radiolucency can serve as a disadvantage when used as an embolic agent [4]. If a successful diagnosis of silk allergy is made, removing the sutures can eradicate the allergy.
Clinical Anatomy | 2012
R. Shane Tubbs; Olivia Rompala; Ketan Verma; Mehran Malakpour; Mohammadali M. Shoja; Martin M. Mortazavi; Marios Loukas
James Drake (1667–1707) was a renowned physician, anatomist, and writer whose name was recognized throughout London. He was highly involved in the politics of his time and was a well‐known pamphleteer. He also delved into comedies and plays. Drake became a fellow of the Royal Society and the College of Physicians before his early death at 40 years of age. He authored one of the most deservedly popular medical treatises of his time, Anthropologia Nova, which remained a valuable resource to physicians and anatomists alike for decades. The present article reviews the contributions of this little known name in the history of anatomy. Clin. Anat. 25:295–298, 2012.