Bio

Clinical Focus


  • Spinal Cord Injuries
  • TBI (Traumatic Brain Injury)
  • Spinal Fusion
  • Surgical Procedures, Minimally Invasive
  • Brain Tumors
  • Neurosurgery
  • Endoscopy
  • Spinal Cord Tumors

Academic Appointments


Administrative Appointments


  • Assistant Professor of Neurosurgery, Stanford University School of Medicine (2010 - Present)
  • Advising Associate for Neurosurgery, Academic Advising Dean's Office, Stanford University School of Medicine (2012 - Present)

Boards, Advisory Committees, Professional Organizations


  • Editorial Board Member, Open Journal of Modern Neurosurgery (2013 - Present)
  • Member at Large, American Association of South Asian Neurosurgeons (2012 - Present)
  • Education Committee Member, Congress of Neurological Surgeons (2013 - Present)
  • Member, American Association of Neurological Surgeons (2004 - Present)
  • Member, Congress of Neurological Surgeons (2004 - Present)
  • Member, WW Keen Neurosurgical Society (2010 - Present)

Professional Education


  • Residency:Thomas Jefferson Univ Hospital (06/30/2010) PA
  • Internship:Thomas Jefferson Univ Hospital (06/30/2005) PA
  • Medical Education:Tufts University School of Medicine (2004) MA

Research & Scholarship

Current Research and Scholarly Interests


Robotics and the Brain-Machine Interface, Traumatic Brain Injury, Spinal Cord Injury

Publications

Journal Articles


  • History of simulation in medicine: from resusci annie to the ann myers medical center. Neurosurgery Singh, H., Kalani, M., Acosta-Torres, S., El Ahmadieh, T. Y., Loya, J., Ganju, A. 2013; 73: S9-S14

    Abstract

    Medical and surgical graduate medical education has historically used a halstedian approach of "see one, do one, teach one." Increased public demand for safety, quality, and accountability in the setting of regulated resident work hours and limited resources is driving the development of innovative educational tools. The use of simulation in nonmedical, medical, and neurosurgical disciplines is reviewed in this article. Simulation has been validated as an educational tool in nonmedical fields such as aviation and the military. Across most medical and surgical subspecialties, simulation is recognized as a valuable tool that will shape the next era of medical education, postgraduate training, and maintenance of certification.

    View details for DOI 10.1227/NEU.0000000000000093

    View details for PubMedID 24051890

  • Endonasal Access to the Upper Cervical Spine, Part One: Radiographic Morphometric Analysis JOURNAL OF NEUROLOGICAL SURGERY PART B-SKULL BASE Singh, H., Grobelny, B. T., Harrop, J., Rosen, M., Lober, R. M., Evans, J. 2013; 74 (3): 176-184
  • Brain tuberculoma in a non-endemic area. Infectious disease reports Lober, R. M., Veeravagu, A., Singh, H. 2013; 5 (1)

    Abstract

    Brain tuberculoma has previously accounted for up to a third of new intracranial lesions in areas endemic with tuberculosis, but is unexpected in the United States and other Western countries with improved disease control. Here we show the importance of considering this diagnosis in at-risk patients, even with no definitive pulmonary involvement. We describe a young man who presented with partial seizures and underwent craniotomy for resection of a frontoparietal tuberculoma. He subsequently completed six months of antituberculosis therapy and was doing well without neurological sequelae or evidence of recurrence five months after completion of therapy. With resurgence of tuberculosis cases in the United States and other Western countries, intracerebral tuberculoma should remain a diagnostic consideration in at-risk patients with new space occupying lesions. Mass lesions causing neurological sequelae can be safely addressed surgically and followed with antituberculosis therapy.

    View details for DOI 10.4081/idr.2013.e1

    View details for PubMedID 24470952

  • Traumatic epistaxis: Skull base defects, intracranial complications and neurosurgical considerations. International journal of surgery case reports Veeravagu, A., Joseph, R., Jiang, B., Lober, R. M., Ludwig, C., Torres, R., Singh, H. 2013; 4 (8): 656-661

    Abstract

    Endonasal procedures may be necessary during management of craniofacial trauma. When a skull base fracture is present, these procedures carry a high risk of violating the cranial vault and causing brain injury or central nervous system infection.A 52-year-old bicyclist was hit by an automobile at high speed. He sustained extensive maxillofacial fractures, including frontal and sphenoid sinus fractures (Fig. 1). He presented to the emergency room with brisk nasopharyngeal hemorrhage, and was intubated for airway protection. He underwent emergent stabilization of his nasal epistaxis by placement of a Foley catheter in his left nare and tamponade with the Foley balloon. A six-vessel angiogram showed no evidence of arterial dissection or laceration. Imaging revealed inadvertent insertion of the Foley catheter and deployment of the balloon in the frontal lobe (Fig. 2). The balloon was subsequently deflated and the Foley catheter removed. The patient underwent bifrontal craniotomy for dural repair of CSF leak. He also had placement of a ventriculoperitoneal shunt for development of post-traumatic hydrocephalus. Although the hospital course was a prolonged one, he did make a good neurological recovery.The authors review the literature involving violation of the intracranial compartment with medical devices in the settings of craniofacial trauma.Caution should be exercised while performing any endonasal procedure in the settings of trauma where disruption of the anterior cranial base is possible.

    View details for DOI 10.1016/j.ijscr.2013.04.033

    View details for PubMedID 23792475

  • Primary spinal germ cell tumors: a case analysis and review of treatment paradigms. Case reports in medicine Loya, J. J., Jung, H., Temmins, C., Cho, N., Singh, H. 2013; 2013: 798358-?

    Abstract

    Objective. Primary intramedullary spinal germ cell tumors are exceedingly rare. As such, there are no established treatment paradigms. We describe our management for spinal germ cell tumors and a review of the literature. Clinical Presentation. We describe the case of a 45-year-old man with progressive lower extremity weakness and sensory deficits. He was found to have enhancing intramedullary mass lesions in the thoracic spinal cord, and pathology was consistent with an intramedullary germ cell tumor. A video presentation of the case and surgical approach is provided. Conclusion. As spinal cord germinomas are highly sensitive to radiation and chemotherapy, a patient can be spared radical surgery. Diverse treatment approaches exist across institutions. We advocate biopsy followed by local radiation, with or without adjuvant chemotherapy, as the optimal treatment for these tumors. Histological findings have prognostic value if syncytiotrophoblastic giant cells (STGCs) are found, which are associated with a higher rate of recurrence. The recurrence rate in STGC-positive spinal germinomas is 33% (2/6), whereas it is only 8% in STGC-negative tumors (2/24). We advocate limited volume radiotherapy combined with systemic chemotherapy in patients with high risk of recurrence. To reduce endocrine and neurocognitive side effects, cranio-spinal radiation should be used as a last resort in patients with recurrence.

    View details for DOI 10.1155/2013/798358

    View details for PubMedID 24312128

  • High-resolution ultrasonography in the diagnosis and intraoperative management of peripheral nerve lesions Clinical article JOURNAL OF NEUROSURGERY Lee, F. C., Singh, H., Nazarian, L. N., Ratliff, J. K. 2011; 114 (1): 206-211

    Abstract

    The diagnosis of peripheral nerve lesions relies on clinical history, physical examination, electrodiagnostic studies, and radiography. Magnetic resonance neurography offers high-resolution visualization of structural peripheral nerve lesions. The availability of MR neurography may be limited, and the costs can be significant. By comparison, ultrasonography is a portable, dynamic, and economic technology. The authors explored the clinical applicability of high-resolution ultrasonography in the preoperative and intraoperative management of peripheral nerve lesions.The authors completed a retrospective analysis of 13 patients undergoing ultrasonographic evaluation and surgical treatment of nerve lesions at their institution (nerve entrapment [5], trauma [6], and tumor [2]). Ultrasonography was used for diagnostic (12 of 13 cases) and intraoperative management (6 of 13 cases). The authors examine the initial impact of ultrasonography on clinical management.Ultrasonography was an effective imaging modality that augmented electrophysiological and other neuroimaging studies. The modality provided immediate visualization of a sutured peroneal nerve after a basal cell excision, prompting urgent surgical exploration. Ultrasonography was used intraoperatively in 2 cases to identify postoperative neuromas after mastectomy, facilitating focused excision. Ultrasonography correctly diagnosed an inflamed lymph node in a patient in whom MR imaging studies had detected a schwannoma, and the modality correctly diagnosed a tendinopathy in another patient referred for ulnar neuropathy. Ultrasonography was used in 6 patients to guide the surgical approach and to aid in intraoperative localization; it was invaluable in localizing the proximal segment of a radial nerve sectioned by a humerus fracture. In all cases, ultrasonography demonstrated the correct lesion diagnosis and location (100%); in 7 (58%) of 12 cases, ultrasonography provided the correct diagnosis when other imaging and electrophysiological studies were inconclusive or inadequate.High-resolution ultrasonography may provide an economical and accurate imaging modality with utility in diagnosis and management of peripheral nerve lesions. Further research is required to assess the role of ultrasonography in evaluation of peripheral nerve pathology.

    View details for DOI 10.3171/2010.2.JNS091324

    View details for Web of Science ID 000285669500041

    View details for PubMedID 20225925

  • Dorsal Epidural Intervertebral Disk Herniation With Atypical Radiographic Findings: Case Report and Literature Review JOURNAL OF SPINAL CORD MEDICINE Teufack, S. G., Singh, H., Harrop, J., Ratliff, J. 2010; 33 (3): 268-271

    Abstract

    Intervertebral disk herniation is relatively common. Migration usually occurs in the ventral epidural space; rarely, disks migrate to the dorsal epidural space due to the natural anatomical barriers of the thecal sac.Case report.A 49-year-old man presented with 1 week of severe back pain with bilateral radiculopathy to the lateral aspect of his lower extremities and weakness of the ankle dorsiflexors and toe extensors. Lumbar spine magnetic resonance imaging with gadolinium revealed a peripheral enhancing dorsal epidural lesion with severe compression of the thecal sac. Initial differential diagnosis included spontaneous hematoma, synovial cyst, and epidural abscess. Posterior lumbar decompression was performed; intraoperatively, the lesion was identified as a large herniated disk fragment.Dorsal migration of a herniated intervertebral disk is rare and may be difficult to definitively diagnose preoperatively. Dorsal disk migration may present in a variety of clinical scenarios and, as in this case, may mimic other epidural lesions on magnetic resonance imaging.

    View details for Web of Science ID 000281007700011

    View details for PubMedID 20737802

  • Ventral surgical approaches to craniovertebral junction chordomas. Neurosurgery Singh, H., Harrop, J., Schiffmacher, P., Rosen, M., Evans, J. 2010; 66 (3): 96-103

    Abstract

    Chordomas are primarily malignant tumors encountered at either end of the neural axis; the craniovertebral junction and the sacrococcygeal junction. In this article, we discuss the surgical management of craniovertebral junction chordomas.In this paper, we discuss the surgical management of craniovertebral junction chordomas.The following approaches are illustrated: transoral-transpalatopharyngeal approach, high anterior cervical retropharyngeal approach, endoscopic transoral approach, and endoscopic transnasal approach. No single operative approach can be used for all craniovertebral chordomas. Therefore, the location of the tumor dictates which approach or approaches should be used.

    View details for DOI 10.1227/01.NEU.0000365855.12257.D1

    View details for PubMedID 20173533

  • Curvularia fungi presenting as a large cranial base meningioma: case report. Neurosurgery Singh, H., Irwin, S., Falowski, S., Rosen, M., Kenyon, L., Jungkind, D., Evans, J. 2008; 63 (1): E177-?

    Abstract

    Fungal infections are emerging as a growing threat to human health, especially in immunocompromised patients. Candida, Cryptococcus, and Aspergillus are a few of the commonly encountered organisms leading to brain abscesses. In this report, we describe Curvularia geniculata as the causative agent in central nervous system infection.Our review of the literature did not reveal a similar published case of central nervous system infection with this organism. A 35-year-old African-American man presented with obstructive hydrocephalus from a large cranial base lesion. Imaging characteristics on computed tomographic and magnetic resonance imaging scans were consistent with those of a cranial base meningioma.The patient underwent an endoscopic transnasal/transclival approach to the anterior middle cranial base for biopsy and decompression of this lesion. A spindle cell proliferation was observed on frozen section, which favored a diagnosis of meningioma. However, on permanent sections, we identified fungal hyphae with budding. Subsequent biopsies grew Curvularia in fungal cultures. Deoxyribonucleic acid sequencing was used to confirm the identification of the isolate as Curvularia geniculata.Limited data are available for in vitro susceptibility testing of Curvularia, and treatment modalities have not yet been standardized. The prognosis is usually poor. Despite being treated with voriconazole and intravenous amphotericin, this patient progressed to multiorgan failure and ultimately died. This is the first reported case of central nervous system infection by Curvularia geniculata.

    View details for DOI 10.1227/01.NEU.0000335086.77846.0A

    View details for PubMedID 18728558

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