A. Hussain, Musa Khan, S. Khan, Mumtaz Ali, Akramullah, M. Zubair, M. Mumtaz
Objectives: To assess the neurological improvement after decompression for dorsal spine tuberculosis in terms of Frankel grading. Materials and Method: Prospective study was done in the Neurosurgery department, Prime Teaching Hospital Peshawar from 2018 to 2021. Patients of both genders aged between 18 to 60 years were selected while those unfit for surgery or requiring conservative management were excluded from the study. After clinical examination and radiological findings, the patients were diagnosed with dorsal spine tuberculosis requiring surgery. All patients were followed for 3 months post-operatively. Neurological improvement was measured by comparing pre and post-op Frankel grading. Complications were also documented. Results: Out of 38 patients included in the study, 16 (42%) were male and 22 (58%) were female. The mean age of presentation was 34 ± 5. The distribution for age groups was 18 – 30 (08), 31 – 40 (13), 41 – 50 (11), and 51 – 60 (06). Level of disease D4 – D8 were 17 (44.8%) and D9 – D12 was 21 (55.2%). Pre-operative neurological status of the patients was (5.2%) Frankel A, (10.5%) Frankel B, (47.3) Frankel C, (22%) Frankel D, and (7.8%) Frankel E while Post-operative grading was (2.6%) Frankel A, (5.2%) Frankel B, (23.6%) Frankel C, (47.3%) Frankel D and (18.4) Frankel E. 3 patients experienced worsening of neurology, 2 patients bleeding and CSF leak and 1 patient died as a complication of the surgery. Conclusion: Surgical option involving decompression of spine TB followed by stabilization is utilized in a majority of patients with neurological deficits. It is very effective and the results are good. The main advantage is thorough debridement and achievement of spinal stabilization. Keywords: Dorsal Spine Tuberculosis, Frankel Grading, Spinal Stabilization.
{"title":"Neurological Improvement after Decompression for Dorsal Spine Tuberculosis (TB)","authors":"A. Hussain, Musa Khan, S. Khan, Mumtaz Ali, Akramullah, M. Zubair, M. Mumtaz","doi":"10.36552/pjns.v26i2.692","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.692","url":null,"abstract":"Objectives: To assess the neurological improvement after decompression for dorsal spine tuberculosis in terms of Frankel grading. \u0000Materials and Method: Prospective study was done in the Neurosurgery department, Prime Teaching Hospital Peshawar from 2018 to 2021. Patients of both genders aged between 18 to 60 years were selected while those unfit for surgery or requiring conservative management were excluded from the study. After clinical examination and radiological findings, the patients were diagnosed with dorsal spine tuberculosis requiring surgery. All patients were followed for 3 months post-operatively. Neurological improvement was measured by comparing pre and post-op Frankel grading. Complications were also documented. \u0000Results: Out of 38 patients included in the study, 16 (42%) were male and 22 (58%) were female. The mean age of presentation was 34 ± 5. The distribution for age groups was 18 – 30 (08), 31 – 40 (13), 41 – 50 (11), and 51 – 60 (06). Level of disease D4 – D8 were 17 (44.8%) and D9 – D12 was 21 (55.2%). Pre-operative neurological status of the patients was (5.2%) Frankel A, (10.5%) Frankel B, (47.3) Frankel C, (22%) Frankel D, and (7.8%) Frankel E while Post-operative grading was (2.6%) Frankel A, (5.2%) Frankel B, (23.6%) Frankel C, (47.3%) Frankel D and (18.4) Frankel E. 3 patients experienced worsening of neurology, 2 patients bleeding and CSF leak and 1 patient died as a complication of the surgery. \u0000Conclusion: Surgical option involving decompression of spine TB followed by stabilization is utilized in a majority of patients with neurological deficits. It is very effective and the results are good. The main advantage is thorough debridement and achievement of spinal stabilization. \u0000Keywords: Dorsal Spine Tuberculosis, Frankel Grading, Spinal Stabilization.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86544324","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}
Rana Zubair Mahmood, Mukhtiyar Ahmed Lakho, Talha Abbas, Abdul Wajid, Touqeer Ahmed, Umer Farooq, Sarfraz Khattak
Objectives: We aimed to see the results of conservative management of CSF rhinorrhea in post-traumatic patients. Material and Methods: An observational study was conducted on 50 patients for 3 months from 1st November 2021 to 31th Jan 2022. Patients presented to neurosurgery unit II, PINS. All patients had a history of road traffic accidents (RTA). Results: The age range was 10 – 50 years. The mean age was 25 years. All patients were managed conservatively for one week. We advised complete bed rest to all patients for 2 weeks. Head ends of all patients were slightly inclined from 15 – 30 degrees to reduce pressure in basal cisterns. We gave acetazolamide, mannitol, antibiotics, and anti-epileptic medication to all patients. CSF rhinorrhea in our 43 (86%) patients was stopped completely. In our 5 (10%) patients, CSF rhinorrhea was cured completely after doing a lumbar puncture with drainage of CSF and with the placement of a lumbar drain at a rate of 10 ml per hour. In our 2 (4%) patients, CSF rhinorrhea was not cured. We have to do surgery either by trans cranial or endoscopic repair of CSF rhinorrhea. Conclusion: CSF rhinorrhea is best cured by conservative management except in 4% of cases.
{"title":"Results of Conservative Management of CSF Rhinorrhea in Post Traumatic Patients","authors":"Rana Zubair Mahmood, Mukhtiyar Ahmed Lakho, Talha Abbas, Abdul Wajid, Touqeer Ahmed, Umer Farooq, Sarfraz Khattak","doi":"10.36552/pjns.v26i2.689","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.689","url":null,"abstract":"Objectives: We aimed to see the results of conservative management of CSF rhinorrhea in post-traumatic patients. \u0000Material and Methods: An observational study was conducted on 50 patients for 3 months from 1st November 2021 to 31th Jan 2022. Patients presented to neurosurgery unit II, PINS. All patients had a history of road traffic accidents (RTA). \u0000Results: The age range was 10 – 50 years. The mean age was 25 years. All patients were managed conservatively for one week. We advised complete bed rest to all patients for 2 weeks. Head ends of all patients were slightly inclined from 15 – 30 degrees to reduce pressure in basal cisterns. We gave acetazolamide, mannitol, antibiotics, and anti-epileptic medication to all patients. CSF rhinorrhea in our 43 (86%) patients was stopped completely. In our 5 (10%) patients, CSF rhinorrhea was cured completely after doing a lumbar puncture with drainage of CSF and with the placement of a lumbar drain at a rate of 10 ml per hour. In our 2 (4%) patients, CSF rhinorrhea was not cured. We have to do surgery either by trans cranial or endoscopic repair of CSF rhinorrhea. \u0000Conclusion: CSF rhinorrhea is best cured by conservative management except in 4% of cases.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79499163","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}
Muhammad Hassan Raza, Iqbal Ahmad, Adnan Khaliq, Zain Saleh
Objective: To determine the success of endoscopic septostomy in the management of isolated lateral ventricular hydrocephalus. Material and Methods: A retrospective analysis of data was done and records of all patients who underwent endoscopic septostomy for isolated lateral ventricular hydrocephalus due to any cause for the last 4 years, December 2017 to December 2021 at Punjab Institute of Neurosciences, Lahore. Radiological and clinical outcomes and complications were recorded. A total of 60 cases were reviewed. Results: Out of 60 patients, 95% were in the age group of 3 – 25 years and 5% were in the age group of 26 – 71 years. There was 54% male whereas 46% were female. Septostomy was successful in relieving hydrocephalus in 75% of cases. Conclusion: Endoscopic septostomy is an effective procedure for the management of isolated lateral ventricles. Keywords: Septostomy, Hydrocephalus, Isolated Lateral Ventricles.
{"title":"Results of Endoscopic Septostomy in Isolated Lateral Ventricular Hydrocephalus","authors":"Muhammad Hassan Raza, Iqbal Ahmad, Adnan Khaliq, Zain Saleh","doi":"10.36552/pjns.v26i2.688","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.688","url":null,"abstract":"Objective: To determine the success of endoscopic septostomy in the management of isolated lateral ventricular hydrocephalus. \u0000Material and Methods: A retrospective analysis of data was done and records of all patients who underwent endoscopic septostomy for isolated lateral ventricular hydrocephalus due to any cause for the last 4 years, December 2017 to December 2021 at Punjab Institute of Neurosciences, Lahore. Radiological and clinical outcomes and complications were recorded. A total of 60 cases were reviewed. \u0000Results: Out of 60 patients, 95% were in the age group of 3 – 25 years and 5% were in the age group of 26 – 71 years. There was 54% male whereas 46% were female. Septostomy was successful in relieving hydrocephalus in 75% of cases. \u0000Conclusion: Endoscopic septostomy is an effective procedure for the management of isolated lateral ventricles. \u0000Keywords: Septostomy, Hydrocephalus, Isolated Lateral Ventricles.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88835424","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}
Samra Majeed, Fareeha Majid, N. Tahir, W. Azim, Azam Niaz, A. H. Vohra
Introduction/Objective: About fifteen percent of the primary CNS tumors are intraspinal. About two-thirds of tumors are intradural extramedullary (IDEM). This study was conducted to review the outcome of operative management of intradural extramedullary tumors in correlation with the factors, both clinical & histopathological, influencing the neurology of patients & prognosis. Materials and Methods: It was a multicenter study including 42 patients conducted from December 2018 to December 2020. All patients were diagnosed by MRI with and without contrast. Patients were surgically treated & analyzed for clinical features i.e., pain by visual analog scale (VAS) & neurology by modified McCormick scale both preoperatively & post-operatively. Clinical features & outcomes were correlated with tumor size & histopathology. p-value < 0.05 was considered significant. Results: This study included 42 cases. The most common diagnosis was schwannoma (76.19%). The average intradural space occupied at presentation was 82%. The most common location was dorsal (90.4%). The visual analog score for pain (VAS) improved in all patients post-operatively from 7 ± 1.9 to 2 ± 0.8 (p = 0.003) & modified McCormick scale from 3.0 ± 1.3 to 2.0 ± 1.0 (p = 0.005). The preoperative symptoms were correlated with the only size of the tumor occupying the intradural space (VAS p = 0.021, modified McCormick scale p = 0.018). Conclusion: All the tumors excised showed some improvement in neurological status. Therefore, all patients diagnosed with IDEM should be operated on even if present with prolonged symptoms or severe neurological compromise. Keywords: Intradural Extramedullary, Meningioma, Schwannoma, Intraspinal.
{"title":"Multidisciplinary Management and Outcome of Intradural Extramedullary Spinal Tumors","authors":"Samra Majeed, Fareeha Majid, N. Tahir, W. Azim, Azam Niaz, A. H. Vohra","doi":"10.36552/pjns.v26i2.691","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.691","url":null,"abstract":"Introduction/Objective: About fifteen percent of the primary CNS tumors are intraspinal. About two-thirds of tumors are intradural extramedullary (IDEM). This study was conducted to review the outcome of operative management of intradural extramedullary tumors in correlation with the factors, both clinical & histopathological, influencing the neurology of patients & prognosis. \u0000Materials and Methods: It was a multicenter study including 42 patients conducted from December 2018 to December 2020. All patients were diagnosed by MRI with and without contrast. Patients were surgically treated & analyzed for clinical features i.e., pain by visual analog scale (VAS) & neurology by modified McCormick scale both preoperatively & post-operatively. Clinical features & outcomes were correlated with tumor size & histopathology. p-value < 0.05 was considered significant. \u0000Results: This study included 42 cases. The most common diagnosis was schwannoma (76.19%). The average intradural space occupied at presentation was 82%. The most common location was dorsal (90.4%). The visual analog score for pain (VAS) improved in all patients post-operatively from 7 ± 1.9 to 2 ± 0.8 (p = 0.003) & modified McCormick scale from 3.0 ± 1.3 to 2.0 ± 1.0 (p = 0.005). The preoperative symptoms were correlated with the only size of the tumor occupying the intradural space (VAS p = 0.021, modified McCormick scale p = 0.018). \u0000Conclusion: All the tumors excised showed some improvement in neurological status. Therefore, all patients diagnosed with IDEM should be operated on even if present with prolonged symptoms or severe neurological compromise. \u0000Keywords: Intradural Extramedullary, Meningioma, Schwannoma, Intraspinal.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"2021 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87860902","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}
Samra Majeed, Sana Majeed, Muhammad Umair, Shahzaib Tasdique, Waqas Mehdi, Anjum Habib Vohra
Background/Objective: The commonest of pituitary gland tumors is pituitary adenoma which may be excised transcranially or trans nasal trans sphenoidal using either microscope or endoscope, in this study, the microscope was used. The objective was to see the short-term outcome of patients after microscopic transnasal trans-sphenoidal pituitary adenomectomy. Material & Methods: This was a descriptive prospective study carried out from July 2019 to July 2021. 80 cases were included. All patients were investigated by contrast brain MRI, hormonal assay for pituitary gland & visual perimetry. Patients were evaluated for complications at 48 hours and 7 days. Results: Mean age of the study population was 41.78 ± 11.75 years. There were 61 (76%) men & 19 (24%) women. 55 (68.8%) patients had functioning and 25 (3.3%) patients had nonfunctioning adenoma. Among 33 (41.3%) patients size of the adenoma was < 0.9 cm and 47 (58.8%) patients had adenoma > 1.0 cm. 12 patients had CSF leaks within 48 hours of surgery and 5 had a persistent leak on the 7th day. No statistically significant association was seen between age, gender, and size of adenoma and persistent CSF leak (P > 0.05). Diabetes insipidus was found in 9 patients. 3 had post-operative hematoma, 01 patient had meningitis and 2 patients died. Conclusion: microscopic transnasal trans-sphenoidal surgery is a safe procedure yet associated with significant complications.
{"title":"Short-Term Complications of Microscopic Trans Nasal Transsphenoidal Pituitary Adenomectomy","authors":"Samra Majeed, Sana Majeed, Muhammad Umair, Shahzaib Tasdique, Waqas Mehdi, Anjum Habib Vohra","doi":"10.36552/pjns.v26i2.694","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.694","url":null,"abstract":"Background/Objective: The commonest of pituitary gland tumors is pituitary adenoma which may be excised transcranially or trans nasal trans sphenoidal using either microscope or endoscope, in this study, the microscope was used. The objective was to see the short-term outcome of patients after microscopic transnasal trans-sphenoidal pituitary adenomectomy. \u0000Material & Methods: This was a descriptive prospective study carried out from July 2019 to July 2021. 80 cases were included. All patients were investigated by contrast brain MRI, hormonal assay for pituitary gland & visual perimetry. Patients were evaluated for complications at 48 hours and 7 days. \u0000Results: Mean age of the study population was 41.78 ± 11.75 years. There were 61 (76%) men & 19 (24%) women. 55 (68.8%) patients had functioning and 25 (3.3%) patients had nonfunctioning adenoma. Among 33 (41.3%) patients size of the adenoma was < 0.9 cm and 47 (58.8%) patients had adenoma > 1.0 cm. 12 patients had CSF leaks within 48 hours of surgery and 5 had a persistent leak on the 7th day. No statistically significant association was seen between age, gender, and size of adenoma and persistent CSF leak (P > 0.05). Diabetes insipidus was found in 9 patients. 3 had post-operative hematoma, 01 patient had meningitis and 2 patients died. \u0000Conclusion: microscopic transnasal trans-sphenoidal surgery is a safe procedure yet associated with significant complications.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80144346","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}
Muhammad Adeel Razzaque, Waqas Noor Chughtai, Sumera Nighat, Muhammad Tahir, Shakeel Ahmad, Moazma Nawaz, Aaiza Rehman
Objective: To study the efficacy of the posterior and posterolateral approach in thoracolumbar tuberculosis. Material and Methods: 60 patients with thoracolumbar TB spine were enrolled in the study from 2015 to 2021. These patients had single-level disease with low back pain and neurological compromise in lower limbs. The diagnosis was made on an MRI of the spine and elevated ESR levels. All patients were started with antituberculous treatment. The pain was measured on the VAS score, and neurological status was assessed on the ASIA score. Kyphosis angle was calculated on a lateral x-ray of the spine. All patients were operated on by posterior and posterolateral approaches with decompression and fusion. At follow-up, fusion was assessed on every visit by x-ray along with neurological status and pain score. Results: The mean age of patients was 45.8 years (25 to 66 years). 59.5% patients achieved radiological fusion on follow-up x-rays. There was a significant improvement in VAS score preoperatively mean and SD6.38 ± 1.24to postoperatively 4.45 ± 1.09. The mean and SD of kyphosis in patients preoperatively was 22.3 ± 3.06 to post-operative 22.3 ± 3.06 with a p-value < 0.05 which shows significant improvement. Conclusion: Posterior and posterolateral decompression and fusion of thoracolumbar tuberculosis is a good surgical approach in respect of neurological outcome, correction of kyphosis, and pain improvement.
{"title":"Efficacy of Posterior and Posterolateral Approach for Decompression and Fusion for Thoracolumbar Tuberculosis","authors":"Muhammad Adeel Razzaque, Waqas Noor Chughtai, Sumera Nighat, Muhammad Tahir, Shakeel Ahmad, Moazma Nawaz, Aaiza Rehman","doi":"10.36552/pjns.v26i2.687","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.687","url":null,"abstract":"Objective: To study the efficacy of the posterior and posterolateral approach in thoracolumbar tuberculosis. \u0000Material and Methods: 60 patients with thoracolumbar TB spine were enrolled in the study from 2015 to 2021. These patients had single-level disease with low back pain and neurological compromise in lower limbs. The diagnosis was made on an MRI of the spine and elevated ESR levels. All patients were started with antituberculous treatment. The pain was measured on the VAS score, and neurological status was assessed on the ASIA score. Kyphosis angle was calculated on a lateral x-ray of the spine. All patients were operated on by posterior and posterolateral approaches with decompression and fusion. At follow-up, fusion was assessed on every visit by x-ray along with neurological status and pain score. \u0000Results: The mean age of patients was 45.8 years (25 to 66 years). 59.5% patients achieved radiological fusion on follow-up x-rays. There was a significant improvement in VAS score preoperatively mean and SD6.38 ± 1.24to postoperatively 4.45 ± 1.09. The mean and SD of kyphosis in patients preoperatively was 22.3 ± 3.06 to post-operative 22.3 ± 3.06 with a p-value < 0.05 which shows significant improvement. \u0000Conclusion: Posterior and posterolateral decompression and fusion of thoracolumbar tuberculosis is a good surgical approach in respect of neurological outcome, correction of kyphosis, and pain improvement.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79927059","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}
A. Hussain, S. Khan, Ramzan Hussain, A. Ihsan, Mumtaz Ali
Objectives: We examined the surgical outcome and complications of anterior cranial Fossa meningiomas. Materials and Methods: A prospective study was conducted at the Department of Neurosurgery Prime Teaching Hospital, Peshawar, KPK, Pakistan from June 2019 to June 2021. A total of 31 patients were selected through non-probability consecutive sampling. After clinical examination and radiological findings, the patients were diagnosed with anterior cranial Fossa meningiomas. Microsurgical Trans cranial approaches did. Clinical outcomes and complications were documented. Tumor anterior cranial fossa meningiomas. A low Karnofsky performance scale index was used to analyze the functional impairment of the patients. Results: 9 (29.03%) were male and 22 (70.96%) patients were female. The mean age of presentation was 42 ± 5 years. Headache 25 (80.6%) and Visual loss were the main presenting symptoms 24 (77.5%), and Tuberculum sellae meningioma patients 08 (25.08%). The most common approach was Bifrontal craniotomy for OGM in 9 patients and two small OGM were operated on utilizing frontolateral craniotomy. The rest of the cases were operated through Pterional craniotomy. Tuberculamsalle meningiomas surgery results in a visual improvement in 6 patients (75%), Complete tumor resection was achieved in 22 (70.9%) patients and subtotal resection is achieved in 6 (19.3%) patients. In a few patients 03 (9.67%) only safe debulking and biopsy were taken. Postoperative hemorrhage was in 4 (12.9%) patients. Conclusion: Transcranial approach for microsurgical resection of anterior cranial fossa meningiomas is an effective and feasible approach in terms of visual outcome and extent of resection. Keywords: Anterior cranial Fossa Meningioma, Bifrontal Craniotomy, Front-lateral craniotomy.
{"title":"Clinical outcome and complication of anterior cranial Fossa meningiomas in tertiary care Hospital Peshawar","authors":"A. Hussain, S. Khan, Ramzan Hussain, A. Ihsan, Mumtaz Ali","doi":"10.36552/pjns.v26i2.671","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.671","url":null,"abstract":"Objectives: We examined the surgical outcome and complications of anterior cranial Fossa meningiomas.\u0000Materials and Methods: A prospective study was conducted at the Department of Neurosurgery Prime Teaching Hospital, Peshawar, KPK, Pakistan from June 2019 to June 2021. A total of 31 patients were selected through non-probability consecutive sampling. After clinical examination and radiological findings, the patients were diagnosed with anterior cranial Fossa meningiomas. Microsurgical Trans cranial approaches did. Clinical outcomes and complications were documented. Tumor anterior cranial fossa meningiomas. A low Karnofsky performance scale index was used to analyze the functional impairment of the patients.\u0000Results: 9 (29.03%) were male and 22 (70.96%) patients were female. The mean age of presentation was 42 ± 5 years. Headache 25 (80.6%) and Visual loss were the main presenting symptoms 24 (77.5%), and Tuberculum sellae meningioma patients 08 (25.08%). The most common approach was Bifrontal craniotomy for OGM in 9 patients and two small OGM were operated on utilizing frontolateral craniotomy. The rest of the cases were operated through Pterional craniotomy. Tuberculamsalle meningiomas surgery results in a visual improvement in 6 patients (75%), Complete tumor resection was achieved in 22 (70.9%) patients and subtotal resection is achieved in 6 (19.3%) patients. In a few patients 03 (9.67%) only safe debulking and biopsy were taken. Postoperative hemorrhage was in 4 (12.9%) patients.\u0000Conclusion: Transcranial approach for microsurgical resection of anterior cranial fossa meningiomas is an effective and feasible approach in terms of visual outcome and extent of resection.\u0000Keywords: Anterior cranial Fossa Meningioma, Bifrontal Craniotomy, Front-lateral craniotomy.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"126 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79611125","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}
Amjad Qaisarani, Rizwan AhmedK han, Irfan Sheikh, M. Fayyaz
Objective: To determine the frequency of complications of microvascular decompression for patients with trigeminal neuralgia undergoing surgical decompression. Materials and Methods: A descriptive case study was carried out in the Neurosurgery Unit 1, Lahore General Hospital. The study included 80 patients who fulfilled the inclusion criteria. Informed consent was obtained and possible outcomes and complications of surgery were explained beforehand to the patients. Demographic details were noted. Surgical site infection, CSF leak, Facial numbness, Facial palsy, Hearing impairment, and Postoperative hematoma as complications were assessed. The presence of complications was recorded. Data was stratified for age and gender from. Chi-square was used as a statistical test, taking a p-value ?0.05 as the level of significance. Results: The study included 80 patients. The mean age of the patients was 40.8 ± 11.7 years. Overall complications were reported in 21 (26.3%) patients. Distribution of complications was as follows; surgical site infection 2 (9.5%), CSF leak (19.0%), facial palsy 5 (23.8%), facial numbness 9 (42.9%), hearing impairment 2 (9.5%) and post-operative hematoma 5 (23.8%). Conclusion: Microvascular decompression (MVD) is recommended neurosurgical procedure for medically refractory patients with trigeminal pain if there is no contraindication for surgery. Surgical complications can be minimized by meticulous surgery resulting in adequate tissue respect. Another means to get better and long-lasting results with fewer complications is by using an autologous muscle graft.
{"title":"Complications of Microvascular Decompression in patients with Trigeminal Neuralgia","authors":"Amjad Qaisarani, Rizwan AhmedK han, Irfan Sheikh, M. Fayyaz","doi":"10.36552/pjns.v26i2.634","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.634","url":null,"abstract":"Objective: To determine the frequency of complications of microvascular decompression for patients with trigeminal neuralgia undergoing surgical decompression.\u0000Materials and Methods: A descriptive case study was carried out in the Neurosurgery Unit 1, Lahore General Hospital. The study included 80 patients who fulfilled the inclusion criteria. Informed consent was obtained and possible outcomes and complications of surgery were explained beforehand to the patients. Demographic details were noted. Surgical site infection, CSF leak, Facial numbness, Facial palsy, Hearing impairment, and Postoperative hematoma as complications were assessed. The presence of complications was recorded. Data was stratified for age and gender from. Chi-square was used as a statistical test, taking a p-value ?0.05 as the level of significance.\u0000Results: The study included 80 patients. The mean age of the patients was 40.8 ± 11.7 years. Overall complications were reported in 21 (26.3%) patients. Distribution of complications was as follows; surgical site infection 2 (9.5%), CSF leak (19.0%), facial palsy 5 (23.8%), facial numbness 9 (42.9%), hearing impairment 2 (9.5%) and post-operative hematoma 5 (23.8%).\u0000Conclusion: Microvascular decompression (MVD) is recommended neurosurgical procedure for medically refractory patients with trigeminal pain if there is no contraindication for surgery. Surgical complications can be minimized by meticulous surgery resulting in adequate tissue respect. Another means to get better and long-lasting results with fewer complications is by using an autologous muscle graft.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91146399","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}
Peer Asad Aziz, Muhammad Hamid Ali, Sanaullah Pathan, Mubarak Hussain, Suhail Ahmed Aghani, Riaz Ahmed Raja
Background/Objective: Glioblastomas are among the commonest primary brain cancers. This study aimed to assess the trend shift of high-grade glioma in our setting among the young and pediatric population. Materials and Methods: This is a descriptive and cross-sectional study; it was carried out at the Department of Neurosurgery, Liaquat University of Medical and Health Sciences, between duration. All cases with suspected brain tumors, irrespective of age or gender were assessed for glioblastoma. Once a solid tumor was identified on imaging with consistent features of glioblastoma, a provisional diagnosis was established. After that, the patient underwent a brain biopsy. Patients' gender, demographics, clinical presentation, radiologic records, etc. were collected in a predefined proforma. Results: 22 patients were diagnosed with glioblastoma with a high frequency of patients between the age range of 20 to 30 years. The most common location of the tumor was subcortical near the midline. There was slight male predominance. 8 patients had levels of KPS at presentation < 70 and among those two were infants, four were in a vegetative state, and two had a loss of consciousness secondary to increased intracranial pressure. The recurrence rate among those who came back for follow-ups was 27.2%. Conclusion: Though it is a short study with short follow-up results were astonishing due to perhaps trend shift among Glioblastoma patients, a further detailed workup is needed in different dimensions especially molecular level and genetics to know exactly about the disease and the national registry should be carried and alarmed to identify the problem at once, counter effectively and make a future strategy.
{"title":"Increment of High-Grade Gliomas Among Pediatric and Young Adult Population","authors":"Peer Asad Aziz, Muhammad Hamid Ali, Sanaullah Pathan, Mubarak Hussain, Suhail Ahmed Aghani, Riaz Ahmed Raja","doi":"10.36552/pjns.v26i2.696","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.696","url":null,"abstract":"Background/Objective: Glioblastomas are among the commonest primary brain cancers. This study aimed to assess the trend shift of high-grade glioma in our setting among the young and pediatric population. \u0000Materials and Methods: This is a descriptive and cross-sectional study; it was carried out at the Department of Neurosurgery, Liaquat University of Medical and Health Sciences, between duration. All cases with suspected brain tumors, irrespective of age or gender were assessed for glioblastoma. Once a solid tumor was identified on imaging with consistent features of glioblastoma, a provisional diagnosis was established. After that, the patient underwent a brain biopsy. Patients' gender, demographics, clinical presentation, radiologic records, etc. were collected in a predefined proforma. \u0000Results: 22 patients were diagnosed with glioblastoma with a high frequency of patients between the age range of 20 to 30 years. The most common location of the tumor was subcortical near the midline. There was slight male predominance. 8 patients had levels of KPS at presentation < 70 and among those two were infants, four were in a vegetative state, and two had a loss of consciousness secondary to increased intracranial pressure. The recurrence rate among those who came back for follow-ups was 27.2%. \u0000Conclusion: Though it is a short study with short follow-up results were astonishing due to perhaps trend shift among Glioblastoma patients, a further detailed workup is needed in different dimensions especially molecular level and genetics to know exactly about the disease and the national registry should be carried and alarmed to identify the problem at once, counter effectively and make a future strategy.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82143360","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}
{"title":"Is ENLS (Emergency Neuro Life Support) a need for brain emergencies in recent times?","authors":"Muhammad Khurram Ijaz","doi":"10.36552/pjns.v26i2.701","DOIUrl":"https://doi.org/10.36552/pjns.v26i2.701","url":null,"abstract":"","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87531769","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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