Pub Date : 2021-12-15DOI: 10.33962/roneuro-2021-092
M. G. Ortega-Sierra, R. D. Delgado-Marrugo, Cristian Camilo Campo-Bedoya, Geraldine Marín-Pérez, Rhonald Gómez-Caballero, Bryan Hernández-Nieto, Gabriel Fernando Gutiérrez-Castillo, John Fredys Bello-Cordero, Mónica Alejandra Torres-Báez, Rafael Ricardo Ramirez-Morales, I. Lozada‐Martínez, L. Moscote-Salazar
Tumefactive multiple sclerosis is a rare variant of multiple sclerosis, characterized by the presence of brain lesions that may be solitary or multiple. Considering that these lesions have a pseudotumoral appearance, it is a challenge to differentiate them from central nervous system neoplasms through neuroimaging. Many cases are associated with the administration of monoclonal antibodies, and due to an increase in the incidence of cancer globally, it is expected that secondary to chemotherapeutic treatments, more and more cases may appear. Taking into account the above, the objective of this review is to review aspects of usefulness in clinical practice, on the diagnosis and approach of this pathological condition
{"title":"Tumefactive multiple sclerosis","authors":"M. G. Ortega-Sierra, R. D. Delgado-Marrugo, Cristian Camilo Campo-Bedoya, Geraldine Marín-Pérez, Rhonald Gómez-Caballero, Bryan Hernández-Nieto, Gabriel Fernando Gutiérrez-Castillo, John Fredys Bello-Cordero, Mónica Alejandra Torres-Báez, Rafael Ricardo Ramirez-Morales, I. Lozada‐Martínez, L. Moscote-Salazar","doi":"10.33962/roneuro-2021-092","DOIUrl":"https://doi.org/10.33962/roneuro-2021-092","url":null,"abstract":"Tumefactive multiple sclerosis is a rare variant of multiple sclerosis, characterized by the presence of brain lesions that may be solitary or multiple. Considering that these lesions have a pseudotumoral appearance, it is a challenge to differentiate them from central nervous system neoplasms through neuroimaging. Many cases are associated with the administration of monoclonal antibodies, and due to an increase in the incidence of cancer globally, it is expected that secondary to chemotherapeutic treatments, more and more cases may appear. Taking into account the above, the objective of this review is to review aspects of usefulness in clinical practice, on the diagnosis and approach of this pathological condition","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45746549","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}
Pub Date : 2021-12-15DOI: 10.33962/roneuro-2021-090
W. Florez-Perdomo, Laura Acevedo-Aguilar, L. Mass-Hernández, Michael Gregorio Ortega Sierra, Jhoyner Alberto Jiménez-Filigrana, Luis Jose Payares-Celins, Roberto Andrés Ramos-Cordoba, Jorge Alberto Nuñez-Gamez
Introduction: Traumatic brain injury is a major public health problem worldwide, with higher incidence rates in low- and middle-income countries. In this context, the development of major complications has been evidenced, such as the formation of haemorrhages due to traumatic rupture of a cerebral aneurysm, which may threaten the patient's life and therefore require immediate medical and neurosurgical procedures. Case: We present the case of a male patient in the fourth decade of life, who presented a closed head trauma with the consequent development of subarachnoid haemorrhage in the territory of the right middle cerebral artery secondary to traumatic aneurysmal rupture Conclusion: One of the complications that can occur in the context of head trauma is the development of subarachnoid haemorrhage due to traumatic aneurysmal rupture. Despite therapeutic options, these scenarios continue to be a challenge in low- and middle-income countries due to the lack of specialized tools in neurosurgical and neurorehabilitation areas
{"title":"Aneurysmal subarachnoid haemorrhage in the context of a patient with traumatic brain injury","authors":"W. Florez-Perdomo, Laura Acevedo-Aguilar, L. Mass-Hernández, Michael Gregorio Ortega Sierra, Jhoyner Alberto Jiménez-Filigrana, Luis Jose Payares-Celins, Roberto Andrés Ramos-Cordoba, Jorge Alberto Nuñez-Gamez","doi":"10.33962/roneuro-2021-090","DOIUrl":"https://doi.org/10.33962/roneuro-2021-090","url":null,"abstract":"Introduction: Traumatic brain injury is a major public health problem worldwide, with higher incidence rates in low- and middle-income countries. In this context, the development of major complications has been evidenced, such as the formation of haemorrhages due to traumatic rupture of a cerebral aneurysm, which may threaten the patient's life and therefore require immediate medical and neurosurgical procedures.\u0000Case: We present the case of a male patient in the fourth decade of life, who presented a closed head trauma with the consequent development of subarachnoid haemorrhage in the territory of the right middle cerebral artery secondary to traumatic aneurysmal rupture\u0000Conclusion: One of the complications that can occur in the context of head trauma is the development of subarachnoid haemorrhage due to traumatic aneurysmal rupture. Despite therapeutic options, these scenarios continue to be a challenge in low- and middle-income countries due to the lack of specialized tools in neurosurgical and neurorehabilitation areas","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44428220","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}
Pub Date : 2021-12-15DOI: 10.33962/roneuro-2021-087
Sarwar Mohammad, L. Tripathy, Ejaz Ahmed Bari
Lateral angular dermoid may have associated bony defects which must be recognized before surgery. High-resolution 3-D CT scans and MRIs define these lesions very clearly. Total excision with attention to the bony defect is usually curative. CSF leak from the operative wound at the surgery or in the post-operative period signifies the intracranial connection or dural adhesion unnoticed by the Ophthalmologist before surgery.
{"title":"Congenital sphenoid wing defect with lateral angular dermoid presenting with CSF leak after orbital surgery","authors":"Sarwar Mohammad, L. Tripathy, Ejaz Ahmed Bari","doi":"10.33962/roneuro-2021-087","DOIUrl":"https://doi.org/10.33962/roneuro-2021-087","url":null,"abstract":"Lateral angular dermoid may have associated bony defects which must be recognized before surgery. High-resolution 3-D CT scans and MRIs define these lesions very clearly. Total excision with attention to the bony defect is usually curative. CSF leak from the operative wound at the surgery or in the post-operative period signifies the intracranial connection or dural adhesion unnoticed by the Ophthalmologist before surgery.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48270524","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}
Pub Date : 2021-12-15DOI: 10.33962/roneuro-2021-089
Dany Leonardo Contreras-De La Hoz, Germán Camilo Viracacha-López, Julieth Vivian Sarmiento-Palma, Loraine Llerena-Gutierrez, Julio César Mantilla-Pardo, Guillermo Andre Blanco-Fernandez, Criss Madeley Millan-Puerto, Rodrigo Alberto Caicedo-Lozada, Anderson Fabian Guerrero-Ceron, David Eduardo Espinosa-Ortiz, I. Lozada‐Martínez, L. Moscote-Salazar
The pineal gland is an endocrine organ located in the cranial vault. Its endocrine function has been extensively studied and has been found to be the cause of important regulatory functions in the physiology of the human body. Although the initial approaches to the suggestive action of this organ on the organism were of a philosophical and spiritual nature, in the last century technological advances have made it possible to clearly elucidate its effector function as an endocrine gland. In this order of ideas, the objective of this review is to address basic and recent descriptions of the physiology of the pineal gland.
{"title":"Recent descriptions on physiological concepts of the pineal gland: what's new?","authors":"Dany Leonardo Contreras-De La Hoz, Germán Camilo Viracacha-López, Julieth Vivian Sarmiento-Palma, Loraine Llerena-Gutierrez, Julio César Mantilla-Pardo, Guillermo Andre Blanco-Fernandez, Criss Madeley Millan-Puerto, Rodrigo Alberto Caicedo-Lozada, Anderson Fabian Guerrero-Ceron, David Eduardo Espinosa-Ortiz, I. Lozada‐Martínez, L. Moscote-Salazar","doi":"10.33962/roneuro-2021-089","DOIUrl":"https://doi.org/10.33962/roneuro-2021-089","url":null,"abstract":"The pineal gland is an endocrine organ located in the cranial vault. Its endocrine function has been extensively studied and has been found to be the cause of important regulatory functions in the physiology of the human body. Although the initial approaches to the suggestive action of this organ on the organism were of a philosophical and spiritual nature, in the last century technological advances have made it possible to clearly elucidate its effector function as an endocrine gland. In this order of ideas, the objective of this review is to address basic and recent descriptions of the physiology of the pineal gland.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48366499","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}
Alec Clark, Arnav Barpujari, Brandon Lucke-Wold, Ken Porche, Dimitri Laurent, Matthew Koch, Matthew Decker
Background: Cerebral amyloid angiopathy (CAA) has classically been described as a disease of the elderly. Genetic predisposition has been linked to the APOE e3/e3 allele. Evidence suggests that brain insult in the form of injury, prior surgical intervention, or radiation can exacerbate the clearance of toxic proteins in patients susceptible to CAA.
Case: We describe a unique case of CAA in a 30-year-old male who had prior surgical interventions for spina bifida, Chiari malformation, and hydrocephalus as a child.
Conclusions: The case is used to teach important components regarding diagnosis, clinical suspicion, and highlight the need for further investigation regarding the emerging role of the glymphatic system and its role in clinical pathology.
{"title":"Cerebral amyloid angiopathy: early presentation in a patient with prior neurosurgical interventions. Case report.","authors":"Alec Clark, Arnav Barpujari, Brandon Lucke-Wold, Ken Porche, Dimitri Laurent, Matthew Koch, Matthew Decker","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cerebral amyloid angiopathy (CAA) has classically been described as a disease of the elderly. Genetic predisposition has been linked to the APOE e3/e3 allele. Evidence suggests that brain insult in the form of injury, prior surgical intervention, or radiation can exacerbate the clearance of toxic proteins in patients susceptible to CAA.</p><p><strong>Case: </strong>We describe a unique case of CAA in a 30-year-old male who had prior surgical interventions for spina bifida, Chiari malformation, and hydrocephalus as a child.</p><p><strong>Conclusions: </strong>The case is used to teach important components regarding diagnosis, clinical suspicion, and highlight the need for further investigation regarding the emerging role of the glymphatic system and its role in clinical pathology.</p>","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":"35 4","pages":"499-502"},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39904408","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}
Pub Date : 2021-12-15DOI: 10.33962/roneuro-2021-082
I. Lozada‐Martínez, M. G. Ortega-Sierra, María Milagros Daza-Vega, Leidy Natalia Cárdenas-Hormiga, Jorge Eduardo Contreras-Saldarriaga, Carlos Eduardo Garcia-Moron, J. Serna-Trejos, Jorge Alberto Nuñez-Gamez, Daniela Gómez-Murillo, Mary Elena Rosero-Burgos, L. Moscote-Salazar
Growth hormone is responsible for stimulating the growth and differentiation of cells of various tissues and cell types contribute to protein synthesis and the mobilization of fatty acids. At the nervous system level, it stimulates the regeneration of neurons, astrocytes, endothelial cells, oligodendrocytes, and even neuronal myelination. Traumatic brain injuries can alter the secretion of this hormone, due to the deformation of brain tissue and the alteration of neurometabolism by the subsequent ischemia. Knowing the basic aspects of pituitary disorders in this type of patient allows early identification and management to avoid complications
{"title":"Basic considerations on growth hormone deficiency in traumatic brain injury","authors":"I. Lozada‐Martínez, M. G. Ortega-Sierra, María Milagros Daza-Vega, Leidy Natalia Cárdenas-Hormiga, Jorge Eduardo Contreras-Saldarriaga, Carlos Eduardo Garcia-Moron, J. Serna-Trejos, Jorge Alberto Nuñez-Gamez, Daniela Gómez-Murillo, Mary Elena Rosero-Burgos, L. Moscote-Salazar","doi":"10.33962/roneuro-2021-082","DOIUrl":"https://doi.org/10.33962/roneuro-2021-082","url":null,"abstract":"Growth hormone is responsible for stimulating the growth and differentiation of cells of various tissues and cell types contribute to protein synthesis and the mobilization of fatty acids. At the nervous system level, it stimulates the regeneration of neurons, astrocytes, endothelial cells, oligodendrocytes, and even neuronal myelination. Traumatic brain injuries can alter the secretion of this hormone, due to the deformation of brain tissue and the alteration of neurometabolism by the subsequent ischemia. Knowing the basic aspects of pituitary disorders in this type of patient allows early identification and management to avoid complications","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42628488","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}
Pub Date : 2021-12-15DOI: 10.33962/roneuro-2021-080
Sabrina Rahman, Md Moshiur Rahman
The occlusion of a cerebral artery by a thrombus accounts for about 80% of strokes. Reperfusion can save hypoperfused brain tissue from early cerebral blood flow restoration (CBF), thus limiting neurological impairment. The most successful treatments for stroke care have proven to be reperfusion techniques. One of the key drawbacks of these treatment methods is that early ischemic brain tissue reperfusion can lead to adverse effects, including blood-brain barrier breakdown, which can lead to cerebral oedema, haemorrhage of the brain, or both. Haemorrhages are especially devastating after reperfusion and are associated with exceptionally high morbidity and mortality. Fear of haemorrhage-related reperfusion greatly restricts the use of stroke therapies. Reperfusion injury, a mechanism that further damages brain cells, the ischemic arterial wall, and the microvasculature, is due to the deleterious effects of early restoration of cerebral blood flow following stroke. It seems clear that the brain will benefit from therapies to restore CBF to an ischemic region. The brain's reliance on normal CBF levels is underlined by the sensitivity of the brain to relatively short ischaemic cycles. Experimental and clinical data, however, suggests that tissue damage can be aggravated by organ reperfusion. [1] Studies have failed to prove that infarct size is increased by reperfusion. Reperfusion can aggravate the formation of oedema and lead to abnormal blood flow patterns and microvascular lesions within the reperfused areas.
{"title":"Reperfusion injury in brain stroke","authors":"Sabrina Rahman, Md Moshiur Rahman","doi":"10.33962/roneuro-2021-080","DOIUrl":"https://doi.org/10.33962/roneuro-2021-080","url":null,"abstract":"The occlusion of a cerebral artery by a thrombus accounts for about 80% of strokes. Reperfusion can save hypoperfused brain tissue from early cerebral blood flow restoration (CBF), thus limiting neurological impairment. The most successful treatments for stroke care have proven to be reperfusion techniques. One of the key drawbacks of these treatment methods is that early ischemic brain tissue reperfusion can lead to adverse effects, including blood-brain barrier breakdown, which can lead to cerebral oedema, haemorrhage of the brain, or both. Haemorrhages are especially devastating after reperfusion and are associated with exceptionally high morbidity and mortality. Fear of haemorrhage-related reperfusion greatly restricts the use of stroke therapies. Reperfusion injury, a mechanism that further damages brain cells, the ischemic arterial wall, and the microvasculature, is due to the deleterious effects of early restoration of cerebral blood flow following stroke. It seems clear that the brain will benefit from therapies to restore CBF to an ischemic region. The brain's reliance on normal CBF levels is underlined by the sensitivity of the brain to relatively short ischaemic cycles. Experimental and clinical data, however, suggests that tissue damage can be aggravated by organ reperfusion. [1] Studies have failed to prove that infarct size is increased by reperfusion. Reperfusion can aggravate the formation of oedema and lead to abnormal blood flow patterns and microvascular lesions within the reperfused areas.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69567730","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}
Pub Date : 2021-12-15DOI: 10.33962/roneuro-2021-085
A. Clark, A. Barpujari, B. Lucke-Wold, Ken Porche, D. Laurent, M. Koch, M. Decker
Background: Cerebral amyloid angiopathy (CAA) has classically been described as a disease of the elderly. Genetic predisposition has been linked to the APOE e3/e3 allele. Evidence suggests that brain insult in the form of injury, prior surgical intervention, or radiation can exacerbate the clearance of toxic proteins in patients susceptible to CAA. Case: We describe a unique case of CAA in a 30-year-old male who had prior surgical interventions for spina bifida, Chiari malformation, and hydrocephalus as a child. Conclusions: The case is used to teach important components regarding diagnosis, clinical suspicion, and highlight the need for further investigation regarding the emerging role of the glymphatic system and its role in clinical pathology.
{"title":"Cerebral amyloid angiopathy: early presentation in a patient with prior neurosurgical interventions","authors":"A. Clark, A. Barpujari, B. Lucke-Wold, Ken Porche, D. Laurent, M. Koch, M. Decker","doi":"10.33962/roneuro-2021-085","DOIUrl":"https://doi.org/10.33962/roneuro-2021-085","url":null,"abstract":"Background: Cerebral amyloid angiopathy (CAA) has classically been described as a disease of the elderly. Genetic predisposition has been linked to the APOE e3/e3 allele. Evidence suggests that brain insult in the form of injury, prior surgical intervention, or radiation can exacerbate the clearance of toxic proteins in patients susceptible to CAA.\u0000Case: We describe a unique case of CAA in a 30-year-old male who had prior surgical interventions for spina bifida, Chiari malformation, and hydrocephalus as a child.\u0000Conclusions: The case is used to teach important components regarding diagnosis, clinical suspicion, and highlight the need for further investigation regarding the emerging role of the glymphatic system and its role in clinical pathology.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48271889","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}
Pub Date : 2021-12-15DOI: 10.33962/roneuro-2021-086
N. Lizen, R. Dharmajaya, A.Gofar. Sastrodiningrat, Mahyudanil Mahyudanil
Introduction: Traumatic brain injury is a major cause of disability, death, and economic loss in many countries around the world. The annual incidence in the United States is reported to reach 1.7 million sufferers, in Europe it is reported as 262 per 100,000 people per year, and in Indonesia, the incidence is increasing by 1% every year. Direct and indirect damage resulting from a traumatic brain injury can cause inflammation by activating glial cells and leukocytes, inducing the release of proinflammatory cytokines, and accelerating neurodegeneration and neuroinflammation. Recently, the neutrophil-to-lymphocyte ratio (NLR) has been proposed to be a predictor of clinical outcomes for various neurological diseases such as stroke and traumatic brain injury. To put it simply, elevated NLR levels in patients with intracerebral haemorrhage were independently associated with worse clinical outcomes. Researchers want to research the relationship between NLR and outcome based on 6 months GOS in traumatic brain injury patients at Haji Adam Malik General Hospital Medan. Methods: An observational analytic study with a retrospective cohort design. Samples were selected based on inclusion and exclusion criteria from a traumatic brain injury at H. Adam Malik General Hospital Medan in 2018-2020. Results: The research data were normally distributed and analyzed by the Pearson trial; the sig value was obtained. (2-tailed) of 0.798 (P > 0.05), which means there is no between NLR and 6 months GOS outcome in traumatic brain injury patients. Conclusion: There was no relationship between NLR and outcome based on GOS 6 months of traumatic brain injury patients.
引言：在世界许多国家，创伤性脑损伤是导致残疾、死亡和经济损失的主要原因。据报道，美国的年发病率达到170万，欧洲的发病率为每年每10万人262人，印度尼西亚的发病率每年以1%的速度增长。创伤性脑损伤引起的直接和间接损伤可通过激活神经胶质细胞和白细胞、诱导促炎细胞因子的释放、加速神经退行性变和神经炎症而引起炎症。最近，中性粒细胞与淋巴细胞比率（NLR）被认为是各种神经疾病（如中风和创伤性脑损伤）临床结果的预测指标。简单地说，脑出血患者NLR水平升高与较差的临床结果独立相关。研究人员希望在棉兰Haji Adam Malik综合医院研究基于6个月GOS的创伤性脑损伤患者NLR与预后之间的关系。方法：采用回顾性队列设计进行观察性分析研究。样本是根据2018-2020年棉兰H.Adam Malik综合医院创伤性脑损伤的纳入和排除标准选择的。结果：研究数据正态分布，并通过Pearson试验进行分析；获得sig值。（2尾）为0.798（P>0.05），这意味着创伤性脑损伤患者的NLR和6个月GOS结果之间没有差异。结论：颅脑损伤患者6个月GOS的NLR与预后无相关性。
{"title":"Correlation of neutrophil lymphocyte ratio to clinical outcomes based on 6 months surveillance on traumatic brain injury patients at Haji Adam Malik General Hospital","authors":"N. Lizen, R. Dharmajaya, A.Gofar. Sastrodiningrat, Mahyudanil Mahyudanil","doi":"10.33962/roneuro-2021-086","DOIUrl":"https://doi.org/10.33962/roneuro-2021-086","url":null,"abstract":"Introduction: Traumatic brain injury is a major cause of disability, death, and economic loss in many countries around the world. The annual incidence in the United States is reported to reach 1.7 million sufferers, in Europe it is reported as 262 per 100,000 people per year, and in Indonesia, the incidence is increasing by 1% every year. Direct and indirect damage resulting from a traumatic brain injury can cause inflammation by activating glial cells and leukocytes, inducing the release of proinflammatory cytokines, and accelerating neurodegeneration and neuroinflammation. Recently, the neutrophil-to-lymphocyte ratio (NLR) has been proposed to be a predictor of clinical outcomes for various neurological diseases such as stroke and traumatic brain injury. To put it simply, elevated NLR levels in patients with intracerebral haemorrhage were independently associated with worse clinical outcomes. Researchers want to research the relationship between NLR and outcome based on 6 months GOS in traumatic brain injury patients at Haji Adam Malik General Hospital Medan.\u0000Methods: An observational analytic study with a retrospective cohort design. Samples were selected based on inclusion and exclusion criteria from a traumatic brain injury at H. Adam Malik General Hospital Medan in 2018-2020.\u0000Results: The research data were normally distributed and analyzed by the Pearson trial; the sig value was obtained. (2-tailed) of 0.798 (P > 0.05), which means there is no between NLR and 6 months GOS outcome in traumatic brain injury patients.\u0000Conclusion: There was no relationship between NLR and outcome based on GOS 6 months of traumatic brain injury patients.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46352719","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}
Pub Date : 2021-12-15DOI: 10.33962/roneuro-2021-084
Pratik Patel, J. Gaurav, Lodha Krishna Govind, Gupta Tarun Kumar, Yadav Kaushal, Rai Abhinav Kumar
Study design: Prospective long term follow-up study Background: Hydrocephalus remains a common cause of admission in pediatric neurosurgery units. Of the two prevalent modalities of treatment for hydrocephalus in infants, i.e. endoscopic third ventriculostomy and ventriculoperitoneal shunt, which one is a better option, especially in a tribal setting, is a matter of debate. Aim: To determine and compare the effectiveness of endoscopic third ventriculostomy versus ventriculoperitoneal shunt for the treatment of infants in a tribal population. Methods: A prospective follow-up study was carried out on 70 patients of hydrocephalus with age less than or equal to 12 months during a period of 7 years from August 2014 to June 2021. A detailed history, physical examination, and computed tomography scan were done in all the cases. Based on patient condition, aetiology and parents choice, 30 patients were treated by Endoscopic third ventriculostomy and 40 patients were treated by ventriculoperitoneal shunt. At enrolment, baseline clinical data were collected. Postoperative data were collected, including assessments of complications and treatment failures. Results: A total of 70 infants with hydrocephalus were enrolled in the study and out of them, 30 (42.86%) underwent ETV and 40 (57.14%) underwent VP shunt for the initial treatment of their hydrocephalus. The mean age of patients was 6.4±1.2 months with a range of 18 days to 342 days. Clinical improvement was shown in 76.67% and 70% in ETV and VP shunt groups respectively. No significant difference (p=0.53) was observed in clinical outcomes in both groups. In the 1 to 6 months of age group, 07 (30.43%) clinically improved patients were from the ETV group, while in the VP shunt group, 10 (35.71%) patients showed improvement. In the 7 to 12 months age group, 16 (69.57%) clinically improved patients were from the ETV group and 18 (64.29%) patients were from the VP shunt group (p=0.69). Association of treatment success with gender, term of gestation and aetiology of hydrocephalus was not statistical significant (p>0.05). Out of 70 patients with hydrocephalus, postoperative complications such as infection, CSF leak, haemorrhage and blockage was found in 09 (12.86%), 08 (11.43%), 05 (7.14%) and 08 (11.43%) patients respectively. A significant higher proportion of infection (p=0.043) and blockage (p=0.023) was found in the VP shunt group than in the ETV group. Conclusion: Treatment success was high in both procedures. VP shunt was found to be more successful than ETV in terms of clinical outcome in both age groups. However, the results were statistically insignificant. A significantly higher proportion of complications was found with VP shunt than ETV therefore greater benefits can be achieved using ETV. Thus for a tribal population, where patient compliance is poor and healthcare accessibility, as well as regular follow-up, is difficult, a procedure like ETV can be considered better than VP shunt.
{"title":"Endoscopic third ventriculostomy versus ventriculoperitoneal shunt for treatment of hydrocephalus in infants in a tribal population in India","authors":"Pratik Patel, J. Gaurav, Lodha Krishna Govind, Gupta Tarun Kumar, Yadav Kaushal, Rai Abhinav Kumar","doi":"10.33962/roneuro-2021-084","DOIUrl":"https://doi.org/10.33962/roneuro-2021-084","url":null,"abstract":"Study design: Prospective long term follow-up study\u0000Background: Hydrocephalus remains a common cause of admission in pediatric neurosurgery units. Of the two prevalent modalities of treatment for hydrocephalus in infants, i.e. endoscopic third ventriculostomy and ventriculoperitoneal shunt, which one is a better option, especially in a tribal setting, is a matter of debate.\u0000Aim: To determine and compare the effectiveness of endoscopic third ventriculostomy versus ventriculoperitoneal shunt for the treatment of infants in a tribal population.\u0000Methods: A prospective follow-up study was carried out on 70 patients of hydrocephalus with age less than or equal to 12 months during a period of 7 years from August 2014 to June 2021. A detailed history, physical examination, and computed tomography scan were done in all the cases. Based on patient condition, aetiology and parents choice, 30 patients were treated by Endoscopic third ventriculostomy and 40 patients were treated by ventriculoperitoneal shunt. At enrolment, baseline clinical data were collected. Postoperative data were collected, including assessments of complications and treatment failures. \u0000Results: A total of 70 infants with hydrocephalus were enrolled in the study and out of them, 30 (42.86%) underwent ETV and 40 (57.14%) underwent VP shunt for the initial treatment of their hydrocephalus. The mean age of patients was 6.4±1.2 months with a range of 18 days to 342 days. Clinical improvement was shown in 76.67% and 70% in ETV and VP shunt groups respectively. No significant difference (p=0.53) was observed in clinical outcomes in both groups. In the 1 to 6 months of age group, 07 (30.43%) clinically improved patients were from the ETV group, while in the VP shunt group, 10 (35.71%) patients showed improvement. In the 7 to 12 months age group, 16 (69.57%) clinically improved patients were from the ETV group and 18 (64.29%) patients were from the VP shunt group (p=0.69). Association of treatment success with gender, term of gestation and aetiology of hydrocephalus was not statistical significant (p>0.05). Out of 70 patients with hydrocephalus, postoperative complications such as infection, CSF leak, haemorrhage and blockage was found in 09 (12.86%), 08 (11.43%), 05 (7.14%) and 08 (11.43%) patients respectively. A significant higher proportion of infection (p=0.043) and blockage (p=0.023) was found in the VP shunt group than in the ETV group.\u0000Conclusion: Treatment success was high in both procedures. VP shunt was found to be more successful than ETV in terms of clinical outcome in both age groups. However, the results were statistically insignificant. A significantly higher proportion of complications was found with VP shunt than ETV therefore greater benefits can be achieved using ETV. Thus for a tribal population, where patient compliance is poor and healthcare accessibility, as well as regular follow-up, is difficult, a procedure like ETV can be considered better than VP shunt.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47279301","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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