R. Qazi, Lal Rehman, Farrukh Javeed, Sana Akbar Qazi, T. Ahmed, Asad Abbas
Objective: To determine the prevalence of low vitamin D3 levels in patients having proven lumbar disc herniation and its relationship with different patient parameters. Materials and Methods: This is a prospective study carried out on 100 patients at the Neurosurgery department, Jinnah postgraduate medical center from Feb 2018 to April 2019. Serum Vitamin D levels and other characteristics were assessed in patients with prolapsed lumbar intervertebral discs. Low levels of Vitamin D were defined as insufficiency (10 ng/ml – 30 ng/ml) and deficiency (< 10 ng/ml). Results: Out of 100 patients in the study, only 21% had optimal serum vitamin D3 levels, and 79% had hypovitaminosis (57% insufficient and 22% deficiency). Low vitamin D levels were prevalent in all age groups, with deficiency more prevalent in the older age group (p-value = 0.004). The BMI (body mass index) of the patients showed a linear correlation with vitamin D levels. Conclusion: Decreased vitamin D levels are prevalent in patients having herniated lumbar discs. The study showed that older-aged patients and high BMI exhibited severe vitamin D deficiency. As a result, recommendations are that preventive initiative for this specific hypovitaminosis target a broader population to intercept the occurrence of low vitamin D levels and the associated repercussions.
{"title":"The Prevalence of Low Vitamin D3 Levels in Patients with Lumbar Disc Herniation and Its Relationship with Different Patient Parameters","authors":"R. Qazi, Lal Rehman, Farrukh Javeed, Sana Akbar Qazi, T. Ahmed, Asad Abbas","doi":"10.36552/pjns.v26i2.637","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.637","url":null,"abstract":"Objective: To determine the prevalence of low vitamin D3 levels in patients having proven lumbar disc herniation and its relationship with different patient parameters.\u0000Materials and Methods: This is a prospective study carried out on 100 patients at the Neurosurgery department, Jinnah postgraduate medical center from Feb 2018 to April 2019. Serum Vitamin D levels and other characteristics were assessed in patients with prolapsed lumbar intervertebral discs. Low levels of Vitamin D were defined as insufficiency (10 ng/ml – 30 ng/ml) and deficiency (< 10 ng/ml).\u0000Results: Out of 100 patients in the study, only 21% had optimal serum vitamin D3 levels, and 79% had hypovitaminosis (57% insufficient and 22% deficiency). Low vitamin D levels were prevalent in all age groups, with deficiency more prevalent in the older age group (p-value = 0.004). The BMI (body mass index) of the patients showed a linear correlation with vitamin D levels.\u0000Conclusion: Decreased vitamin D levels are prevalent in patients having herniated lumbar discs. The study showed that older-aged patients and high BMI exhibited severe vitamin D deficiency. As a result, recommendations are that preventive initiative for this specific hypovitaminosis target a broader population to intercept the occurrence of low vitamin D levels and the associated repercussions.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"16 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85401813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zubair Mustafa Khan, Zehra Safdar, Syed Ahmad Faizan, Asif Shabir, Muhammad Shakir, Asif Bashir
Objective: A descriptive case series was conducted to find the frequency of complications and complications of decompressive craniectomy with expansion duraplasty in severe head injury. Material and Methods: 189 patients fulfilling the selection criteria were included. All patients had TBI which was confirmed by CT scan. Surgery was performed on the day of admission under general anesthesia and a large trauma flap. Patients were monitored daily by evaluators from the date of surgery until hospital discharge or death. Patients were followed up for 3 months and the outcome was assessed using the Glasgow outcome scale (GOS). Results: Mean age of the patients was 36.57 years. There were 61.4% (116) males and 38.6% (73) females. 3.7% had CSF leakage. 1.6% had meningitis. Wound infection was seen in 7.4% of patients. Forty percent had a favorable outcome and 60% had a poor outcome. Fifty patients out of 111 patients between 18 – 40 years showed good outcomes. Twenty-six out of 78 from the 41 – 60 years age group showed good outcomes. Out of 189 total, 76 patients had a good outcome. The outcome was good in 63 patients out of 148 patients with GCS 5 – 8, whereas 13 (out of 41) patients had a good outcome with GCS below 5. Conclusion: We discovered that the result was good in 40% of patients, with 11 percent of complications recorded. Therefore, we concluded that decompressive craniectomy with expansion duraplasty is an effective procedure for the treatment of the severe head injury.
{"title":"Outcome & Complications of Decompressive Craniectomy with Expansion Duroplasty in Severe Head Injury","authors":"Zubair Mustafa Khan, Zehra Safdar, Syed Ahmad Faizan, Asif Shabir, Muhammad Shakir, Asif Bashir","doi":"10.36552/pjns.v26i2.684","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.684","url":null,"abstract":"Objective: A descriptive case series was conducted to find the frequency of complications and complications of decompressive craniectomy with expansion duraplasty in severe head injury. \u0000Material and Methods: 189 patients fulfilling the selection criteria were included. All patients had TBI which was confirmed by CT scan. Surgery was performed on the day of admission under general anesthesia and a large trauma flap. Patients were monitored daily by evaluators from the date of surgery until hospital discharge or death. Patients were followed up for 3 months and the outcome was assessed using the Glasgow outcome scale (GOS). \u0000Results: Mean age of the patients was 36.57 years. There were 61.4% (116) males and 38.6% (73) females. 3.7% had CSF leakage. 1.6% had meningitis. Wound infection was seen in 7.4% of patients. Forty percent had a favorable outcome and 60% had a poor outcome. Fifty patients out of 111 patients between 18 – 40 years showed good outcomes. Twenty-six out of 78 from the 41 – 60 years age group showed good outcomes. Out of 189 total, 76 patients had a good outcome. The outcome was good in 63 patients out of 148 patients with GCS 5 – 8, whereas 13 (out of 41) patients had a good outcome with GCS below 5. \u0000Conclusion: We discovered that the result was good in 40% of patients, with 11 percent of complications recorded. Therefore, we concluded that decompressive craniectomy with expansion duraplasty is an effective procedure for the treatment of the severe head injury.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82234383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Syed Ahmad Faizan, Naeem-ul-Hassan, Zubair Mustafa Khan, Tariq Imran, Abdul Majid
Objective: To compare the outcome of SSPF (Short Segment Posterior Fixation) with and without the inclusion of fractured vertebrae in thoracolumbar fractures in terms of visual analog score and vertebral column stability. Materials and Methods: The study enrolled 96 patients who were divided into two groups. Group A treated by SSPF (four screws: one level above and below the fracture), and Group B was treated by PSFFV (six screws: including fractured vertebrae). Assessment of parameters related to clinical and radiological aspects was recorded at 3 – 6 months. Results: Mean ages of patients were 36.96 and 37.41 years with an M:F ratio of 1.8:1 and 1.4:1 in groups A (SSPF) and B (PSFFV), respectively. Mean VAS preoperatively, and postoperatively, at 3 and 6 months were 8.78 vs. 9.01, 4.98 vs. 5.01, 2.08 vs. 2.11, and 0.47 vs. 0.67 in groups A and B, respectively. Mean Kyphotic angle preoperatively, postoperatively, at 3 and 6 months were 21.76 vs. 22.91, 11.13 vs. 10.16, 13.59vs. 11.16 and 14.88 vs. 12.87 in groups A and B respectively. Mean AVH preoperatively, and postoperatively, at 3 and 6 months were 19.11 vs. 18.72, 20.01 vs. 22.71, 20.61 vs. 22.87, and 20.02 vs. 22.67 in groups A and B, respectively. Conclusion: The results of this study favor PSFFV (Group B) over SSPF (Group A) in terms of vertebral column stability which was better achieved in PSFFV. PSFFV was also found superior with no implant failure which declares it safer and more effective than SSPF. None of the techniques was found superior in terms of pain. Radiologically, PSFFV, showed significant improvement in achieving anterior vertebral height, while there was no important distinction in kyphotic angle between the two.
目的:比较有无椎体骨折纳入短节段后路固定治疗胸腰椎骨折的视觉模拟评分和脊柱稳定性。材料与方法:96例患者被分为两组。A组采用SSPF(4枚螺钉:骨折上下一节位)，B组采用PSFFV(6枚螺钉:包括椎骨骨折)。在3 - 6个月时记录临床和放射学方面相关参数的评估。结果:A组(SSPF)和B组(PSFFV)患者平均年龄分别为36.96岁和37.41岁，M:F比分别为1.8:1和1.4:1。A、B组术前、术后3、6个月VAS均值分别为8.78∶9.01、4.98∶5.01、2.08∶2.11、0.47∶0.67。术前、术后、3、6个月平均后倾角分别为21.76、22.91、11.13、10.16、13.59。A、B组分别为11.16、14.88和12.87。A、B组术前、术后3、6个月平均AVH分别为19.11 vs. 18.72、20.01 vs. 22.71、20.61 vs. 22.87、20.02 vs. 22.67。结论:本研究结果在脊柱稳定性方面PSFFV (B组)优于SSPF (A组)，PSFFV的脊柱稳定性更好。PSFFV也被发现优于无种植失败，这表明它比SSPF更安全、更有效。在疼痛方面，没有发现任何一种技术更优越。放射学上，PSFFV在获得前椎体高度方面表现出显著的改善，而两者在后凸角方面没有重要的区别。
{"title":"Comparison of Short Segment Percutaneous Transpedicular Fixation With and Without Inclusion of Fractured Vertebrae in Thoracolumbar Fractures","authors":"Syed Ahmad Faizan, Naeem-ul-Hassan, Zubair Mustafa Khan, Tariq Imran, Abdul Majid","doi":"10.36552/pjns.v26i2.683","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.683","url":null,"abstract":"Objective: To compare the outcome of SSPF (Short Segment Posterior Fixation) with and without the inclusion of fractured vertebrae in thoracolumbar fractures in terms of visual analog score and vertebral column stability. \u0000Materials and Methods: The study enrolled 96 patients who were divided into two groups. Group A treated by SSPF (four screws: one level above and below the fracture), and Group B was treated by PSFFV (six screws: including fractured vertebrae). Assessment of parameters related to clinical and radiological aspects was recorded at 3 – 6 months. \u0000Results: Mean ages of patients were 36.96 and 37.41 years with an M:F ratio of 1.8:1 and 1.4:1 in groups A (SSPF) and B (PSFFV), respectively. Mean VAS preoperatively, and postoperatively, at 3 and 6 months were 8.78 vs. 9.01, 4.98 vs. 5.01, 2.08 vs. 2.11, and 0.47 vs. 0.67 in groups A and B, respectively. Mean Kyphotic angle preoperatively, postoperatively, at 3 and 6 months were 21.76 vs. 22.91, 11.13 vs. 10.16, 13.59vs. 11.16 and 14.88 vs. 12.87 in groups A and B respectively. Mean AVH preoperatively, and postoperatively, at 3 and 6 months were 19.11 vs. 18.72, 20.01 vs. 22.71, 20.61 vs. 22.87, and 20.02 vs. 22.67 in groups A and B, respectively. \u0000Conclusion: The results of this study favor PSFFV (Group B) over SSPF (Group A) in terms of vertebral column stability which was better achieved in PSFFV. PSFFV was also found superior with no implant failure which declares it safer and more effective than SSPF. None of the techniques was found superior in terms of pain. Radiologically, PSFFV, showed significant improvement in achieving anterior vertebral height, while there was no important distinction in kyphotic angle between the two.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87043890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sajid khan Utmanzai, Tariq Jamal, Aafaq Ahmad Qarnain Khalil, Iqra muhammad ali, Mumtaz ali
A ventriculoperitoneal shunt is a common procedure for hydrocephalus. It is a life-saving procedure but is not risk-free. Some of the most common complications are shunt blockage and infection but they can also present with uncommon presentations. We report A child who presented with extrusion of a shunt catheter through the rectum. It was treated as an infected shunt. Externalization of the shunt was done through the abdominal site and the exposed shunt was removed through the rectum by gentle traction. Once CSF was clear a new shunt was placed on the opposite side. Keywords: VP shunt, shunt infection, anal extrusion. Key Message: Exposure to a shunt catheter through the rectum is an uncommon presentation. It should be treated as an infected shunt. Most of these cases do not cause peritonitis or meningitis. The exposed shunt catheter should be removed through the rectum by gentle traction. Abbreviations: VP-Ventriculoperitoneal, CSF: Cerebrospinal fluid. ETV -Endoscopic Third Ventriculostomy.
{"title":"Extrusion of the Peritoneal Catheter of Ventriculoperitoneal Shunt Through the Rectum","authors":"Sajid khan Utmanzai, Tariq Jamal, Aafaq Ahmad Qarnain Khalil, Iqra muhammad ali, Mumtaz ali","doi":"10.36552/pjns.v26i2.675","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.675","url":null,"abstract":"A ventriculoperitoneal shunt is a common procedure for hydrocephalus. It is a life-saving procedure but is not risk-free. Some of the most common complications are shunt blockage and infection but they can also present with uncommon presentations. We report A child who presented with extrusion of a shunt catheter through the rectum. It was treated as an infected shunt. Externalization of the shunt was done through the abdominal site and the exposed shunt was removed through the rectum by gentle traction. Once CSF was clear a new shunt was placed on the opposite side.\u0000Keywords: VP shunt, shunt infection, anal extrusion.\u0000Key Message: Exposure to a shunt catheter through the rectum is an uncommon presentation. It should be treated as an infected shunt. Most of these cases do not cause peritonitis or meningitis. The exposed shunt catheter should be removed through the rectum by gentle traction.\u0000Abbreviations: VP-Ventriculoperitoneal, CSF: Cerebrospinal fluid. ETV -Endoscopic Third Ventriculostomy.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"64 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83277355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tariq Imran Khokhar, Muhammad Naveed Majeed, Khawar Anwar, Ali Faizan Bukhari, Asif Bashir
Objectives: The incidence and microsurgical outcomes of intracranial epidermoid cysts in the Department of Neurosurgery III, Punjab Institute of Neurosciences (PINS), Lahore, Pakistan, are described in this case series. Materials and Methods: This study was a data analysis of a case series of 15 patients (mean age, 40 years) of both gender with intracranial epidermoid cysts who had microsurgical surgical excision over five years. Results: This study comprised 11 (73.3%) male and 4 (26.7%) female patients, 11 (73.3%) cases were infratentorial and 4 (26.7%) cases were in supratentorial region. The epidermoid was located in the CP angle in 11 (73.3%) patients, 3 (20%) in the midline supra sellar region, and 1 (6.66%) in the frontotemporal region. The presenting complaints were mainly headache in 11 (73.33%), cranial nerve palsy and cerebellar signs in 8 (53.3%) patients, Trigeminal neuralgia in 3 (20%) patients, Fits and hydrocephalus in 2 (13.3%) patients. There were 14 (93.3%) patients with GTR (gross total resection), 1 (6.6%) patients STR (subtotal resection). According to Karnofsky's performance scoring (KPS), 3 (20%) patients improved, 11 (73.3%) patients had the same KPS, and 1 (6.6%) patient had a lower KPS. Conclusion: The epidermoid cysts in the brain are usually found in the infratentorial region rather than the supratentorial region. Infratentorial lesions typically cause cranial nerve deficits, whereas the supratentorial area symptom is a headache.
{"title":"Incidence and Surgical Outcome of the Intracranial Epidermoid Cyst at Punjab Institute of Neurosciences Lahore, Pakistan","authors":"Tariq Imran Khokhar, Muhammad Naveed Majeed, Khawar Anwar, Ali Faizan Bukhari, Asif Bashir","doi":"10.36552/pjns.v26i2.693","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.693","url":null,"abstract":"Objectives: The incidence and microsurgical outcomes of intracranial epidermoid cysts in the Department of Neurosurgery III, Punjab Institute of Neurosciences (PINS), Lahore, Pakistan, are described in this case series. \u0000Materials and Methods: This study was a data analysis of a case series of 15 patients (mean age, 40 years) of both gender with intracranial epidermoid cysts who had microsurgical surgical excision over five years. \u0000Results: This study comprised 11 (73.3%) male and 4 (26.7%) female patients, 11 (73.3%) cases were infratentorial and 4 (26.7%) cases were in supratentorial region. The epidermoid was located in the CP angle in 11 (73.3%) patients, 3 (20%) in the midline supra sellar region, and 1 (6.66%) in the frontotemporal region. The presenting complaints were mainly headache in 11 (73.33%), cranial nerve palsy and cerebellar signs in 8 (53.3%) patients, Trigeminal neuralgia in 3 (20%) patients, Fits and hydrocephalus in 2 (13.3%) patients. There were 14 (93.3%) patients with GTR (gross total resection), 1 (6.6%) patients STR (subtotal resection). According to Karnofsky's performance scoring (KPS), 3 (20%) patients improved, 11 (73.3%) patients had the same KPS, and 1 (6.6%) patient had a lower KPS. \u0000Conclusion: The epidermoid cysts in the brain are usually found in the infratentorial region rather than the supratentorial region. Infratentorial lesions typically cause cranial nerve deficits, whereas the supratentorial area symptom is a headache.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82287576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdul Mannan Aftab, Abdul Aziz khan, Khalid Zadran, Aamir Zaman
Objective: We determined the outcome of per operational external ventricular drainage in pediatric patients with posterior fossa tumors and hydrocephalus. Material And Methods: 54 patients included presenting with posterior fossa tumors and mild to moderate hydrocephalous were considered for per operative external ventricular drainage. The external ventricular drain was then weaned off in one week. If it cannot be removed due to persistent hydrocephalous it was converted into a permanent ventriculoperitoneal shunt. Results: In the study, the mean age was 7 years. Twenty-seven children had ependymoma, 19% of children had medulloblastoma, and 54% of children had pilocytic astrocytoma. Moreover, 67% of children had weaned off and 33% of children had converted to VP shunt. There existed an insignificant difference in the outcome (yes/ no) concerning age groups, gender, and tumor type. Conclusion: Our study concludes that the outcome of per operative external ventricular drainage was weaned off (67%) and converted to VP shunt (33%) in pediatrics with posterior fossa tumors and hydrocephalous.
{"title":"Per-Operative External Ventricular Drainage Results in Children with Posterior Fossa Tumors and Hydrocephalus","authors":"Abdul Mannan Aftab, Abdul Aziz khan, Khalid Zadran, Aamir Zaman","doi":"10.36552/pjns.v26i2.685","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.685","url":null,"abstract":"Objective: We determined the outcome of per operational external ventricular drainage in pediatric patients with posterior fossa tumors and hydrocephalus. \u0000Material And Methods: 54 patients included presenting with posterior fossa tumors and mild to moderate hydrocephalous were considered for per operative external ventricular drainage. The external ventricular drain was then weaned off in one week. If it cannot be removed due to persistent hydrocephalous it was converted into a permanent ventriculoperitoneal shunt. \u0000Results: In the study, the mean age was 7 years. Twenty-seven children had ependymoma, 19% of children had medulloblastoma, and 54% of children had pilocytic astrocytoma. Moreover, 67% of children had weaned off and 33% of children had converted to VP shunt. There existed an insignificant difference in the outcome (yes/ no) concerning age groups, gender, and tumor type. \u0000Conclusion: Our study concludes that the outcome of per operative external ventricular drainage was weaned off (67%) and converted to VP shunt (33%) in pediatrics with posterior fossa tumors and hydrocephalous.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90876806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Qazi, Lal Rehman, T. Ahmed, Sana Akbar Qazi, Ali Afzal
Objective: To determine the frequency of early post-traumatic CSF (cerebrospinal fluid) rhinorrhea in patients with head trauma. Materials and Methods: A prospective study was conducted in the Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi from 13th December 2019 to 12th December 2020. This study comprised 155 patients who had suffered head trauma. All patients were followed for one week. If patients developed clear, watery discharge from the nose, this was documented as being CSF rhinorrhea. The frequency was then further divided into immediate and early. Results: The ages of the patients were 34.28 ± 14.20 years on average. The prevalence of CSF rhinorrhea was observed in 3.2% (5/155) patients. In all the patients, the CSF leak presented within the first 48 hours i.e. it was immediate. Conclusion: Although rare, this post-traumatic complication continues to be a challenge in terms of morbidity and subsequent mortality. Key Words: Cerebrospinal fluid, Rhinorrhea, Head Trauma.
{"title":"The Frequency of Early Post Traumatic Cerebrospinal Fluid Rhinorrhea in Patients with Head Trauma","authors":"R. Qazi, Lal Rehman, T. Ahmed, Sana Akbar Qazi, Ali Afzal","doi":"10.36552/pjns.v26i2.638","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.638","url":null,"abstract":"Objective: To determine the frequency of early post-traumatic CSF (cerebrospinal fluid) rhinorrhea in patients with head trauma.\u0000Materials and Methods: A prospective study was conducted in the Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi from 13th December 2019 to 12th December 2020. This study comprised 155 patients who had suffered head trauma. All patients were followed for one week. If patients developed clear, watery discharge from the nose, this was documented as being CSF rhinorrhea. The frequency was then further divided into immediate and early.\u0000Results: The ages of the patients were 34.28 ± 14.20 years on average. The prevalence of CSF rhinorrhea was observed in 3.2% (5/155) patients. In all the patients, the CSF leak presented within the first 48 hours i.e. it was immediate.\u0000Conclusion: Although rare, this post-traumatic complication continues to be a challenge in terms of morbidity and subsequent mortality.\u0000Key Words: Cerebrospinal fluid, Rhinorrhea, Head Trauma.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81100952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The study analyzed the complications and satisfactory surgical outcomes of posterior fossa brain tumor surgery in Lahore Medical City Lahore. Materials and Methods: A prospective study was conducted and included 40 children who were diagnosed with posterior fossa brain tumors by history, physical examination, and later radiologically were admitted and operated on at the Pediatric Neurosurgery Department in Lahore medical City Lahore between the period of March 2021 and March 2022. Results: There were 26 (65%) male and 14 (35% females) individuals among the 40 patients. The average age was 12.5 years. This study found that great surgical outcomes were observed in 10 instances (25 percent), good outcomes in 20 cases (50%), and bad outcomes in 10 cases (25%). The most frequent clinical manifestations were headache (38%), vomiting (30%), ataxia (10%), blurred vision (10%), and cranial nerve palsy (12.5%). The best prognosis is shown in children with Pilocytic astrocytoma, followed by ependymoma, while the poorest outcome is seen in children with medulloblastoma. Conclusion: Pediatric neurosurgeons continue to face particular difficulty in the surgical treatment of posterior fossa brain tumors. Our study compares the outcomes, complications, and surgical outcomes to prior clinical investigations.
{"title":"Pediatric Posterior Fossa Brain Tumor Surgical Outcome","authors":"Mian Awais, Akhtar Muner, Laeeq-ur-Rehman, Syed Misbah, Rimla Ayesha","doi":"10.36552/pjns.v26i2.686","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.686","url":null,"abstract":"Objective: The study analyzed the complications and satisfactory surgical outcomes of posterior fossa brain tumor surgery in Lahore Medical City Lahore. \u0000Materials and Methods: A prospective study was conducted and included 40 children who were diagnosed with posterior fossa brain tumors by history, physical examination, and later radiologically were admitted and operated on at the Pediatric Neurosurgery Department in Lahore medical City Lahore between the period of March 2021 and March 2022. \u0000Results: There were 26 (65%) male and 14 (35% females) individuals among the 40 patients. The average age was 12.5 years. This study found that great surgical outcomes were observed in 10 instances (25 percent), good outcomes in 20 cases (50%), and bad outcomes in 10 cases (25%). The most frequent clinical manifestations were headache (38%), vomiting (30%), ataxia (10%), blurred vision (10%), and cranial nerve palsy (12.5%). The best prognosis is shown in children with Pilocytic astrocytoma, followed by ependymoma, while the poorest outcome is seen in children with medulloblastoma. \u0000Conclusion: Pediatric neurosurgeons continue to face particular difficulty in the surgical treatment of posterior fossa brain tumors. Our study compares the outcomes, complications, and surgical outcomes to prior clinical investigations.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79700218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. A. Rehman, Junaid Aziz, Inamullah Asghar, T. Anwar, Anum Wahab, Muhammad Akmal Hussain
Objective: The study aimed to report the incidence of CSF leakage in patients with a tethered spinal cord, post-operatively. Materials and Methods: A total of 75 individuals aged more than 2 years and of either gender who were hospitalized for surgery for tethered cord syndrome were included. All patients had a preoperative MRI of the spine, and those above the age of 6 had urodynamic tests. Clinical evaluations were performed until hospital release, then again at 3, 6, and 12 months. Urodynamic tests and spine MRIs were redone one year following surgery. Under general anesthesia, all patients had microscopic untethering procedures to release tethering materials and heal the thecal sac. Results: 52% of patients fall under TCS type ‘simple’, whereas, 48% of patients found with complex TCS. The frequency of CSF leakage in post-operative patients with a tethered spinal cord was found in 17.33%. No CSF leak was reported in the majority of patients (49%) patients in the age group 2-30 years. 52% of patients with simple TCS reported no CSF leak, whereas, only 13(18%) patients with complex TCS reported CSF leaks. 40% of patients reported no CSF leak who was diagnosed with complex TCS. There existed a significant relationship between the types of TCS (simple/complex) for CSF leak distribution. Conclusion: This study concluded that the frequency of CSF leakage in post-operative patients with tethered spinal cord was found in 17.33% of patients. Keywords: Tethered Spinal Cord (TCS), CSF Leakage, Lipomyelomeningocele.
{"title":"Frequency of SCF Leakage in Post-operative Patients of Tethered Spinal Cord in A Tertiary Care Hospital","authors":"M. A. Rehman, Junaid Aziz, Inamullah Asghar, T. Anwar, Anum Wahab, Muhammad Akmal Hussain","doi":"10.36552/pjns.v26i2.679","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.679","url":null,"abstract":"Objective: The study aimed to report the incidence of CSF leakage in patients with a tethered spinal cord, post-operatively.\u0000Materials and Methods: A total of 75 individuals aged more than 2 years and of either gender who were hospitalized for surgery for tethered cord syndrome were included. All patients had a preoperative MRI of the spine, and those above the age of 6 had urodynamic tests. Clinical evaluations were performed until hospital release, then again at 3, 6, and 12 months. Urodynamic tests and spine MRIs were redone one year following surgery. Under general anesthesia, all patients had microscopic untethering procedures to release tethering materials and heal the thecal sac.\u0000Results: 52% of patients fall under TCS type ‘simple’, whereas, 48% of patients found with complex TCS. The frequency of CSF leakage in post-operative patients with a tethered spinal cord was found in 17.33%. No CSF leak was reported in the majority of patients (49%) patients in the age group 2-30 years. 52% of patients with simple TCS reported no CSF leak, whereas, only 13(18%) patients with complex TCS reported CSF leaks. 40% of patients reported no CSF leak who was diagnosed with complex TCS. There existed a significant relationship between the types of TCS (simple/complex) for CSF leak distribution.\u0000Conclusion: This study concluded that the frequency of CSF leakage in post-operative patients with tethered spinal cord was found in 17.33% of patients.\u0000Keywords: Tethered Spinal Cord (TCS), CSF Leakage, Lipomyelomeningocele.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73327478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sohail Amir, Mushtaq, Shahid Ayub, Tabraiz Wali Shah
Objective: The goal of this study was to see how transpedicular fixation for degenerative spondylolisthesis affected lumbago. Methodology: A retrospective observational study was conducted at the Department of Neurosurgery in Hayatabad Medical Complex, Peshawar between May 2018 and February 2020. Degenerative spondylolisthesis was diagnosed using static and dynamic spinal X-rays. The research excluded the patients with grade 5 spondylolisthesis, congenital anomalies, or prior spinal surgery. The visual rating scale was used to assess pain alleviation (GRS). Dynamic or static lumbosacral X-rays and 3D CT scans were used to assess union. Results: In total 70 patients, 38 (54.3%) were male and 32 (45.7%) were female. L5–S1 was impacted in most of the cases (68%). 40% of patients were having Meyerding grade II. All patients had pedicle screw fixation. Following surgery, 44 (63%) patients reported no pain, and 12 (17%) patients reported mild discomfort. 8 (11%) patients reported moderate pain and 6(9%) patients experienced severe pain. There existed a significant difference between pre/postoperative moderate-severe GRS scores (p-value: 0.000336). After surgery, we were able to negotiate surgical unions with 91.4% of the patients. Conclusion: For individuals with spondylolisthesis who need pain relief, transpedicular fixation is a safe, straightforward, and effective treatment. It also aids with the surgical union and the improvement of the neurological condition. Keywords: Spondylolisthesis, Meyerding grading, Transpedicular fixation.
{"title":"Results of Lumbar Transpedicular Fixation for Spondycolisthesis, in Terms of Back Pain Relief","authors":"Sohail Amir, Mushtaq, Shahid Ayub, Tabraiz Wali Shah","doi":"10.36552/pjns.v26i2.690","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.690","url":null,"abstract":"Objective: The goal of this study was to see how transpedicular fixation for degenerative spondylolisthesis affected lumbago. \u0000Methodology: A retrospective observational study was conducted at the Department of Neurosurgery in Hayatabad Medical Complex, Peshawar between May 2018 and February 2020. Degenerative spondylolisthesis was diagnosed using static and dynamic spinal X-rays. The research excluded the patients with grade 5 spondylolisthesis, congenital anomalies, or prior spinal surgery. The visual rating scale was used to assess pain alleviation (GRS). Dynamic or static lumbosacral X-rays and 3D CT scans were used to assess union. \u0000Results: In total 70 patients, 38 (54.3%) were male and 32 (45.7%) were female. L5–S1 was impacted in most of the cases (68%). 40% of patients were having Meyerding grade II. All patients had pedicle screw fixation. Following surgery, 44 (63%) patients reported no pain, and 12 (17%) patients reported mild discomfort. 8 (11%) patients reported moderate pain and 6(9%) patients experienced severe pain. There existed a significant difference between pre/postoperative moderate-severe GRS scores (p-value: 0.000336). After surgery, we were able to negotiate surgical unions with 91.4% of the patients. \u0000Conclusion: For individuals with spondylolisthesis who need pain relief, transpedicular fixation is a safe, straightforward, and effective treatment. It also aids with the surgical union and the improvement of the neurological condition. \u0000Keywords: Spondylolisthesis, Meyerding grading, Transpedicular fixation.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85455509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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