15 research outputs found
Primary Decompressive Craniectomy – Salvation in Closed TBI
No full textObjective: To evaluate the role of early Decompressive Craniectomy in closed traumatic brain injury in relation to functional outcome.Material and Methods: A study was conducted at the Department of Neurosurgery, Northwest General Hospital and Research Centre Peshawar Pakistan. 09 months Data from 22/06/2011 to 21/03/2012 was collected, and all the consecutive cases of closed head injury that required Decompressive Craniectomy (Primary Decompression) based on clinical an radiological findings were included in the study.Results: Out of 23 patients, 13 showed moderate to good recovery making this procedure one of the priority treatment options in closed traumatic brain injury.Conclusion: The promising outcome in our study suggests that an early Decompressive Craniectomy should be considered in severe closed head injury to improve the outcome
Epidemiology of Traumatic Brain Injury (TBI_ in UAE – A Review
No full textObjective: To evaluate the causes and pattern of Traumatic Brain Injury (TBI) in Dubai, UAE.Material and Methods: This descriptive study was carried out at Rashid Hospital, Dubai UAE from June 1, 2008 to August 27, 2008. All the patients admitted to neurosurgical unit referred from A&E were included and the total no. was 96 patients in this short study. Demographic data, causes and pattern of injury and presentation with clinical and radiological findings were recorded.Results: Most of the patients were young males (7.7:1) in the age range of 21 – 30 years. RTA being the most common (45%) cause in non-Arab expatriate population and 49 patients had minor injuries only with the rest included in moderate to severe category. The results were consistent with the international studies.Conclusion: Traumatic Brain Injury (TBI) is a potentially preventable cause of mortality and morbidity in young population world over and still there is a need for formulating new strategies to avoid it
Complications following Pediatric Posterior Fossa Tumors Surgery
No full textObjective: The goal of this study was to identify complications postoperatively occurring after posterior fossa tumor surgery in the pediatric population.
Methods: A retrospective review of cases of children under 15 years who underwent surgery for Posterior fossa tumors was conducted. Documented complications arising in the postoperative phase, in-hospital mortality rates, their management, and the patient’s general well-being were tracked till discharge. Complications were categorized based on a contracted version of the original Clavien-Dindo system, a system that was specifically designed for ranking the severity of surgical complications.
Results: 64.5% of males and 35.4% of females have a mean age of 9.22 ± 1.7 years. Between the onset of symptoms and the diagnosis, the average duration of time was 42.3 ± 12.8 days. The number of medulloblastoma cases was 19 and 11 cases each of ependymoma and pilocytic astrocytoma. Overall, the mean duration of stay was 8.1 ± 3.9 days. Hydrocephalous and CSF leaks from incision sites were the most frequent postop compilations, accounting for 58.3% of all the complications. Other complications reported were wound site infections in 12.5% of cases, peri-tumor edema in 16.6%, cerebellar mutism in 10.41%, tumor bed bleeds in 6.2%, and hospital-acquired pneumonia in 5.3% of cases.
Conclusion: The development of hydrocephalus and cerebrospinal fluid leaks were the most frequent complications, followed by peri-tumor edema, tumor bed hematoma, cerebellar mutism, oropharyngeal apraxia, also systemic complications including sepsis, postoperative pneumonia, and meningitis
Surgical Outcome & Cost Analysis of Single Stage Anterior Decompression and Cage Fixation in Patients with Thoracic and Lumbar Tuberculous Spondylitis: A Single Centre Experience Over Six – Years with Comprehensive Literature Review
No full textObjective: For Tuberculous spondylitis (TS) the optimal mode of management for extensive tuberculous spondylitis is still a subject of debate. We determined the outcome for single stage anterior decompression and cage fixation for dorso-lumbar TS.
Material and Methods: This prospective study was conducted between 2012 and 2018. Worsening or new onset neurological deficit, increasing deformity, large paraspinal abscess and those not responding to anti-tuberculous drug therapy were included. Patients with severe comorbidities (> ASA class III) and recurrent cases were excluded. Demographics, clinical features, radiological characteristics, intraoperative details, postoperative complications and follow-up condition were recorded.
Results: One patient with mean age of 45.6 ± 14.9 years with 17 (54.8%) males and 14 (45.2%) females. Mean symptoms duration was 71.9 ± 29.4 days. 41.9% had spasticity & 25.8% had sphincter dysfunction on presentation. Half (48%) of patients had a Frankel grade 3 or less bilaterally. Mean length of the procedure was 137.4 ± 19.9 minutes. 19.4% (n = 6) had postoperative pulmonary complications, 16.1% (n = 5) wound infection, 9.7% (n = 3) had worsening of neurologic deficit and one (3.2%) remained static. Graft extrusion and cage subsidence were noted in one (3.2%) patient each. Favorable outcome was observed in 83.9% (n = 26) while 16.1% (n = 5) had unfavorable outcome. Mean out-of-pocket cost was 164677.4 ± 11469.9 rupees (USD: 1187 approx).
Conclusion: Timely spinal decompression with stabilization at the onset of the Pott’s disease in patients who fulfil the criteria as surgical candidates carries a promising outcome
Beyond Victimhood: Sentimentalism in Contemporary Immigrations Novels
No full textImmigrants have gone from being underrepresented to misrepresented within literature, with many contemporary US novels perpetuating narratives that either victimize or vilify immigrants. Taking inspiration from James Baldwin’s critique of “the wet eyes of the sentimentalist” author, this research turns to the contemporary immigration novels American Dirt and Esperanza Rising to assess the ways in which immigrant stories are depicted and to analyze the ways that this reductive representation can result in many harmful, real world, implications. Counterintuitively, one of the largest consequences of such sentimental literature is a lack of empathy for American immigrants. Painting immigrants in a manner that reduces them to their struggle and strips them of their human complexity significantly hinders an audience’s ability to relate to and empathize with their circumstances. Such narratives may result in temporary pity and the reinforcement of harmful, inferiorizing stereotypes rather than invoking sincere, productive empathy.https://orb.binghamton.edu/research_days_posters_2025/1196/thumbnail.jp
Lateral Intraventricular Epidermoid Cyst: A rare case report
No full textAbstract:
Epidermoid cysts originate from ectopic embryonic epithelial cells and are a very common type of benign intracranial tumor. However, the incidence of intraventricular epidermoid cysts is low, and lateral intraventricular epidermoid cysts are even rarer. Here, we present a case of lateral intraventricular epidermoid cyst and review the relevant literature. A 33?year?old male who was presented with complaints of aphasia, vomiting, inability to walk and previous history VP shunt which was blocked on examination. A computed tomography of the brain showed a low?density mass in the lateral ventricle and enlargement of the left ventricle. Cranial magnetic resonance imaging further confirmed that the mass was an epidermoid cyst. The patient underwent microscopic surgical resection combined with endoscopy via the Keen’s point as a tract to reach the ventricle. The mass was satisfactorily removed, and the patient recovered well. Lateral intraventricular epidermoid cysts often present with clinical symptoms due to the invasion of surrounding brain tissue or blockage of the cerebrospinal fluid system. Diagnosis relies on examination by magnetic resonance imaging, and treatment relies on surgical resection. The prognoses of patients are mostly excellent and depend on whether the tumor is resected cleanly or not.
Key Words:
Epidermoid cyst, lateral intraventricular, prognosis, surger
Outcome of Topical Epidural Methylprednisolone Versus Control in Lumbar Disc Surgery Patients
No full textObjective: The use of topical intraoperative methylprednisolone in lumbar disc surgery leads to significant improvement in pain relief and early resumption of daily life activities. The study determined the outcome of topical epidural methylprednisolone.
Materials & Methods: 60 patients included with diagnosed cases of the herniated lumbar disc with ASA Grade 2 and below. Group A was for patients who had to receive topical methylprednisolone while group B was the control group where no topical methylprednisolone had been used. The outcome was measured from OLBI and VAS scores. Results: In Group A, the mean hospital stay was 2 days, mean OLBI score was 35%, mean VAS score was 3, mean time to resumption of ADL was 7 days, mean dose of paracetamol (per day) was 3 mg, mean dose of Ketorolac (per day) was 90 mg. Whereas Group B, mean hospital stay was 3 days, mean OLBI score was 45%, mean VAS score was 5, mean time to resumption of ADL was 10 days, mean dose of paracetamol (per day) was 4 mg, mean dose of Ketorolac (per day) was 100 mg. In Group A, 91% of patients had a favorable outcome and 9% of patients had an unfavorable outcome. Whereas in Group B, 83% of patients had a favorable outcome and 15%of patients had an unfavorable outcome. There existed insignificant results in outcomes concerning diabetic/non-diabetic, and hypertension/non-hypertension. Conclusion: The use of topical intraoperative methylprednisolone in lumbar disc surgery leads to significant improvement in pain relief and early resumption of daily life activities as compared to without the use of topical methylprednisolone.
Keywords: Outcome, Epidural Methylprednisolone, Lumbar Disc Surgery, OLBI (Oldenburg Burnout Inventory), ADL (Activities Of Daily Life)
Outcome of patients operated for depressed skull fracture with dural tear
No full textObjective: The objective of this study was to determine the outcome of patients operated for depressed skull fracture with a dural tear.
Material and Methods: A descriptive case series (n = 155) was carried out in the Department of Neurosurgery, Hayatabad Medical Complex Peshawar for six months.
Results: The mean arrival GCS was 10.64 ± 2.33. About 21.9% (n = 32) patients presented with a GCS of ? 8, while the remaining 78.1% (n = 123) presented with a GCS of ? 8. About 8.4% (n = 13) patients died due to the complications of the brain injury. The most common postoperative complication was found to be progressive neurologic deficit (PND) occurred in 21 (13.5%) patients. Penetrating injury to the head was also associated with unfavorable outcomes after surgery (p = 0.046), which shows that penetrating injury is associated with increased brain damage and hence consequently poor outcomes.
Conclusions: The neurologic status as denoted by the Glasgow coma scale is one of the most important factors which predicts the outcome. Surgical management of depressed skull fractures with dural tear has favorable outcomes in about two-thirds of patients. The remaining one-third patient remains in the severely disabled group. Every effort should be made to reduce the occurrence of complications as they are directly related to postoperative functional outcomes
The Efficacy of Surgery for Supra-Tentorial Gliomas in Preventing Seizures
No full textObjectives: The study examined the surgical outcome of supratentorial gliomas in terms of improvement in seizures in patients who presented to a tertiary care institution.
Material and Methods: A descriptive case series was conducted in Neurosurgery Department at Northwest General Hospital & Research, Peshawar. Patients (n = 95) with supratentorial gliomas with seizures between 18 – 70 years were included. Supratentorial gliomas were diagnosed by neuroimaging as MRI brain with contrast, diffusion-weighted, Fluid-attenuated inversion recovery, and magnetic resonance spectroscopy. The patient was observed for seizures postoperatively. Data was stratified for age and gender.
Results: The majority of patients (36.8%) were in 41 – 50 years. 55.78% of patients were males whereas 44.21% of patients were females. 42 (44.21%) involved the frontal lobe, 16 (16.84%) involved the parietal lobe, 26 (27.36%) involved the temporal lobe, and 11 (11.57%) patients involved the occipital lobe. According to Engel’s classification, 53 patients were in class I, 16 in class II, 10 in class III, and 5 in class IV. 84 (88.42%) experienced post-op seizure reduction. An insignificant association was found with the seizure improvement (yes/no) with different age groups and gender.
Conclusion: The frontal lobe was the most prevalent location for supratentorial gliomas. After surgery, a large proportion of patients improved in terms of seizure management.
Keywords: Seizures, Supratentorial gliomas
Acute Quadriparesis Due to Acute Demyelinating Polyneuropathy in a Patient Newly Diagnosed as a Case of B -cell Lymphoma- an Unusual Presentation. A Case Report with Review of Literature
No full text
