Flat panel detector-CT with endovenous injection. Description of a novel technique for obtaining cerebral arteries imaging: Technical note Romanian Neurosurgery (2016) XXX 3: 397 - 398 | 397 Research on Post –Traumatic Neurodegenerative disorders from India Ashok Munivenkatappa1, Amit Agrawal2 1National Institute of Epidemiology (ICMR), Chennai, INDIA 2Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, INDIA Traumatic brain injury (TBI) is a major public health burden in our country, due to accelerated urbanization, unprecedented motorization, growing industrialization, changing life styles and absence of safety policies among people. In 2002 it was estimated that 1.6 million Indian populations sustain traumatic brain injury with 200,000 deaths (1). TBI continues to pose a serious public health challenge, with numerous deaths at the scene and a large percentage of surviving patients have lifelong disabilities. TBI is a diseases process not an event. Any severities of brain injury manifest problems in multi spectrum that lasts for days, months, years, sometimes the post traumatic sequel continues throughout the life. Such changes includes cellular and sub cellular inflammation that cause significant effect on patient cognitive, behavioral and personality level. Among sensitized individuals the chronic pathological changes can lead to neurodegenerative conditions. Dementia is a neurodegenerative condition characterized by progressive memory loss with other mental deficiency. In India there is increase in prevalence and incidence of dementia. As per urban reports from several regions of our country the prevalence of dementia in India ranges from 0.8 to 4.1%. The percentage varies from north, south, east and west due to multi ethnic, multi-cultural and environmental differences (2). A study among Kashmiri Pandit population from north India has reported that the incidence rate of dementia is 5.34 per 1000 person-years (3). Apart from ageing, positive family history, illiteracy, and low socio economic status the non-communicable diseases like stroke and brain injury form a major risk factor for progressive dementia. Unfortunately, the published Indian literature on post traumatic dementia is still far short of the actual need. Studies from developed countries have reported that TBI is an important risk factor for later cognitive decline, which has been linked to development of dementia and chronic neurodegenerative conditions (4-6). Delayed progressive persistent neuro- inflammation have been demonstrated among TBI cases by both histopathological and neuroimaging studies (7, 8). Among chronic neurodegenerative conditions Alzheimer’s constitutes about three forth of cases, followed by dementia with Levy bodies and vascular type (6). Several studies have reported that 398 | Munivenkatappa, Agrawal - Post –Traumatic Neurodegenerative disorders from India patients with moderate to severe TBI are at higher risk of developing Alzheimer’s disease (4). Recent studies have reported that repetitive mild TBI (also concussion injury) have linked to increased risk for chronic traumatic encephalopathy (CTE) a variant of neurodegenerative diseases (9). Studies are focussing on exploring possible reason and also any targets that can reduce or completely treat post traumatic progressive neuro inflammation responsible for neuro degenerative diseases. Our country has enough resources with respect to both TBI and dementia, but the research in this area is limited. The geriatricians, neuroscientists, and clinicians should integrate to improve the research quality in TBI and neuro degenerative disorders. Translation research in this area is very crucial for epidemiological and intervention research that aimed to reduce or prevent the disease condition. Correspondence Dr. Ashok Munivenkatappa Scientist C, VRDL project, National Institute of Epidemiology (ICMR), Chennai – 77 E-mail: ashokmphdns@gmail.com Phone: +91-9844250897 References 1. Gururaj G (2002) Epidemiology of traumatic brain injuries: Indian scenario. Neurological research 24: 24-28. 2. Das SK, Pal S, Ghosal MK. Dementia: Indian scenario. Neurol India. 2012 Nov-Dec;60(6):618-24. 3. Raina SK, Pandita KK, Razdan S. Incidence of dementia in a Kashmiri migrant population. Ann Indian Acad Neurol. 2009 Jul;12(3):154-6. 4. Fleminger S, Oliver DL, Lovestone S, Rabe-Hesketh S, Giora A. Head injury as a risk factor for Alzheimer's disease: the evidence 10 years on; a partial replication. J Neurol Neurosurg Psychiatry. 2003 Jul;74(7):857-62. 5. Gardner RC, Burke JF, Nettiksimmons J, Kaup A, Barnes DE, Yaffe K. Dementia risk after traumatic brain injury vs nonbrain trauma: the role of age and severity. JAMA Neurol. 2014 Dec;71(12):1490-7. 6. LoBue C, Wilmoth K, Cullum CM, Rossetti HC, Lacritz LH, Hynan LS, Hart J Jr, Womack KB. Traumatic brain injury history is associated with earlier age of onset of frontotemporal dementia. J Neurol Neurosurg Psychiatry. 2015 Sep 10. [Epub ahead of print] 7. Farbota KD, Sodhi A, Bendlin BB, McLaren DG, Xu G, Rowley HA, Johnson SC. Longitudinal volumetric changes following traumatic brain injury: a tensor-based morphometry study. J Int Neuropsychol Soc. 2012 Nov;18(6):1006-18. 8. Johnson B, Neuberger T, Gay M, Hallett M, Slobounov S. Effects of subconcussive head trauma on the default mode network of the brain. J Neurotrauma. 2014 Dec 1;31(23):1907-13. 9. Gardner RC, Yaffe K. Epidemiology of mild traumatic brain injury and neurodegenerative disease. Mol Cell Neurosci. 2015 May;66(Pt B):75-80.