Simi K. Prakash, R. Reddy, Anna R. Mathulla, J. Rajeswaran, D. Shukla
Abstract Introduction Traumatic brain injury (TBI) is a global health problem and is a silent epidemic of the modern times. Studies indicate litigation is a prominent factor that accounts for poor outcome and prolonged recovery from mild TBI. Depression is the most frequently diagnosed psychiatric disorder after TBI. Postconcussion symptoms, litigation, and suboptimal effort could contribute to the neuropsychological functioning of TBI patients medicolegal cases (MLCs). With increase in TBI and medicolegal cases, there is a requirement for comprehensive neuropsychological assessment. Method The aim of the study was to evaluate the cognitive functions, postconcussion, and depressive symptoms in TBI patients with MLC and without MLCs (non-MLC). Patients were also assessed on electrophysiological parameters. An observational cross-sectional design was adopted, the sample size was 30 TBI patients in total, 15 (MLC) and 15 (non-MLC), and 11 patients from each group for electrophysiological assessment. The patients were in the age range of 18 to 50 years. Results The MLC group had poor performance compared with the non-MLC group on both neuropsychological and electrophysiological measures. There was evidence of significant difference in verbal working memory, verbal learning, and memory and visuoconstructive ability. In the MLC group, postconcussion and depressive scores were negatively correlated with visuospatial span. Conclusion Findings from this study indicate differences in the neuropsychological performance and electroencephalographic measures in between MLC and non-MLC groups. The results could be indicative of persistent cognitive problems associated with TBI for patients pursuing litigation. Poor performance could also be attributed to suboptimal level of effort. However, being a preliminary study with a small sample size, the findings need to be treated with caution.
{"title":"Neuropsychological Profile of Traumatic Brain Injury Patients with Medicolegal Cases: A Pilot Study","authors":"Simi K. Prakash, R. Reddy, Anna R. Mathulla, J. Rajeswaran, D. Shukla","doi":"10.1055/s-0041-1740943","DOIUrl":"https://doi.org/10.1055/s-0041-1740943","url":null,"abstract":"Abstract Introduction Traumatic brain injury (TBI) is a global health problem and is a silent epidemic of the modern times. Studies indicate litigation is a prominent factor that accounts for poor outcome and prolonged recovery from mild TBI. Depression is the most frequently diagnosed psychiatric disorder after TBI. Postconcussion symptoms, litigation, and suboptimal effort could contribute to the neuropsychological functioning of TBI patients medicolegal cases (MLCs). With increase in TBI and medicolegal cases, there is a requirement for comprehensive neuropsychological assessment. Method The aim of the study was to evaluate the cognitive functions, postconcussion, and depressive symptoms in TBI patients with MLC and without MLCs (non-MLC). Patients were also assessed on electrophysiological parameters. An observational cross-sectional design was adopted, the sample size was 30 TBI patients in total, 15 (MLC) and 15 (non-MLC), and 11 patients from each group for electrophysiological assessment. The patients were in the age range of 18 to 50 years. Results The MLC group had poor performance compared with the non-MLC group on both neuropsychological and electrophysiological measures. There was evidence of significant difference in verbal working memory, verbal learning, and memory and visuoconstructive ability. In the MLC group, postconcussion and depressive scores were negatively correlated with visuospatial span. Conclusion Findings from this study indicate differences in the neuropsychological performance and electroencephalographic measures in between MLC and non-MLC groups. The results could be indicative of persistent cognitive problems associated with TBI for patients pursuing litigation. Poor performance could also be attributed to suboptimal level of effort. However, being a preliminary study with a small sample size, the findings need to be treated with caution.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"100 1","pages":"107 - 115"},"PeriodicalIF":0.2,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74441753","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}
Omar Al-Taei, Abdulrahman Al-Mirza, M. Ali, Humaid Al-Kalbani, T. Al-Saadi
Abstract Introduction The world populace is aging and it is anticipated that 2 billion people will be older than 60 years by 2050. Traumatic brain injury (TBI) is a major cause of death and disability worldwide. In the United States, 2.8 million people pursue medical attention yearly. TBI exemplifies a leading cause of mortality and morbidity among the geriatric age group worldwide. Methods A retrospective study of geriatric cases who were admitted to the Neurosurgery Department in Khoula Hospital from January 1, 2016, to December 31, 2019, was conducted. Patients' demographics, risk factors, neuro-vital sign, diagnosis, Glasgow coma scale (GCS) on arrival, treatment types, and length of stay (LOS) were recorded. Results Two hundred and thirty-four patients were admitted due to TBI in four years period. Seventy-five percent of the study cohort were more than 75 years old. Male to female ratio was 2.4:1. Subdural hematoma (SDH) was the most common TBI diagnosis based on computed tomography (77.4%). Most of the patients were having GCS scores of 14 to 15 (67.9%). Sixteen percent of the patients received antiepileptic medications. The majority of the patients underwent surgical intervention (70.5%). Eighty percent of the patients stayed in the hospital for less than 15 days. There was a significant difference between the LOS and type of surgery. Subarachnoid hemorrhage was found to have the highest mean age (79.7 years). Intracerebral hemorrhage patients had the longest LOS in the hospital with a mean of 44.2 days. There was no significant difference between the age of patients and type of surgery. Conclusion The number of TBI in the elderly population is increasing annually. The most common type of TBI in our cohort was SDH and most of the patients were treated with burr hole surgery.
{"title":"Prevalence and Outcomes of Geriatric Traumatic Brain Injury in Developing Countries: A Retrospective Study","authors":"Omar Al-Taei, Abdulrahman Al-Mirza, M. Ali, Humaid Al-Kalbani, T. Al-Saadi","doi":"10.1055/s-0041-1740942","DOIUrl":"https://doi.org/10.1055/s-0041-1740942","url":null,"abstract":"Abstract Introduction The world populace is aging and it is anticipated that 2 billion people will be older than 60 years by 2050. Traumatic brain injury (TBI) is a major cause of death and disability worldwide. In the United States, 2.8 million people pursue medical attention yearly. TBI exemplifies a leading cause of mortality and morbidity among the geriatric age group worldwide. Methods A retrospective study of geriatric cases who were admitted to the Neurosurgery Department in Khoula Hospital from January 1, 2016, to December 31, 2019, was conducted. Patients' demographics, risk factors, neuro-vital sign, diagnosis, Glasgow coma scale (GCS) on arrival, treatment types, and length of stay (LOS) were recorded. Results Two hundred and thirty-four patients were admitted due to TBI in four years period. Seventy-five percent of the study cohort were more than 75 years old. Male to female ratio was 2.4:1. Subdural hematoma (SDH) was the most common TBI diagnosis based on computed tomography (77.4%). Most of the patients were having GCS scores of 14 to 15 (67.9%). Sixteen percent of the patients received antiepileptic medications. The majority of the patients underwent surgical intervention (70.5%). Eighty percent of the patients stayed in the hospital for less than 15 days. There was a significant difference between the LOS and type of surgery. Subarachnoid hemorrhage was found to have the highest mean age (79.7 years). Intracerebral hemorrhage patients had the longest LOS in the hospital with a mean of 44.2 days. There was no significant difference between the age of patients and type of surgery. Conclusion The number of TBI in the elderly population is increasing annually. The most common type of TBI in our cohort was SDH and most of the patients were treated with burr hole surgery.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"275 1","pages":"101 - 106"},"PeriodicalIF":0.2,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78447138","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. Vemula, B. Prasad, H. N. Banavath, Pavan Kale, Mohana Murali Krishna N, Sreeram Gokanapudi
Background Traumatic brain injury (TBI) is a major cause of morbidity and mortality in young individuals. Goal of management in TBI patients is mainly focused on the secondary injury. Since the cisterns and the brain communicate, it would be possible to decrease the pressure in both these compartments by opening the cisterns to the atmospheric pressure. Objective To study the outcomes and predictors of outcome with cisternostomy in the management of TBI. Methods A single tertiary care center's prospective observational study of outcomes with cisternostomy with intraoperative intracranial pressure (ICP) monitoring. Patients were evaluated clinically and radiologically with Marshall CT score. They were categorized into mild, moderate, and severe head injury groups based on Glasgow coma scale (GCS) score. Outcomes were evaluated with Glasgow outcome scale (GOS) score. Results A total of 25 patients with TBI were enrolled in this study. They underwent cisternostomy with intraoperative ICP monitoring. They were categorized into 4 groups based on the age. In our study, mortality rate was 32%. As much as 48% had good recovery at 3 months follow-up with GOS 4 and 5. Mean ICP after cisternostomy was 6.36 ± 1.91 mm Hg. In our study, there was decrease in ICP after cisternostomy. Conclusion Age, time interval from trauma to surgery, and ICP showed prognostic importance on outcomes. Cisternostomy can efficiently decrease the ICP in the TBI patients and reduce postoperative complications.
背景外伤性脑损伤(TBI)是年轻人发病和死亡的主要原因。TBI患者的治疗目标主要集中在继发性损伤。由于蓄水池和大脑相互交流，通过打开蓄水池，使其与大气压力保持一致，就有可能降低这两个隔间的压力。目的探讨脑池造口术治疗脑外伤的疗效及预测因素。方法采用单一三级保健中心对术中颅内压(ICP)监测的胆池造口术的预后进行前瞻性观察研究。采用Marshall CT评分对患者进行临床和影像学评价。根据格拉斯哥昏迷量表(GCS)评分将患者分为轻度、中度和重度脑损伤组。采用格拉斯哥结局量表(GOS)评分对结果进行评估。结果共纳入25例TBI患者。他们接受了胆池造口术，术中监测ICP。他们根据年龄分为4组。在我们的研究中，死亡率为32%随访3个月，有48%的患者恢复良好，GOS评分为4和5。胆池造瘘后平均颅内压为6.36±1.91 mm Hg，本研究胆池造瘘后颅内压降低。结论年龄、外伤至手术时间间隔、颅内压对预后有重要影响。脑池造瘘术可有效降低颅内压，减少术后并发症。
{"title":"Outcomes and Predictors of Outcome with Cisternostomy in the Management of Traumatic Brain Injury—A Prospective Observational Study at Tertiary Centre","authors":"R. Vemula, B. Prasad, H. N. Banavath, Pavan Kale, Mohana Murali Krishna N, Sreeram Gokanapudi","doi":"10.1055/s-0041-1739478","DOIUrl":"https://doi.org/10.1055/s-0041-1739478","url":null,"abstract":"Background Traumatic brain injury (TBI) is a major cause of morbidity and mortality in young individuals. Goal of management in TBI patients is mainly focused on the secondary injury. Since the cisterns and the brain communicate, it would be possible to decrease the pressure in both these compartments by opening the cisterns to the atmospheric pressure. Objective To study the outcomes and predictors of outcome with cisternostomy in the management of TBI. Methods A single tertiary care center's prospective observational study of outcomes with cisternostomy with intraoperative intracranial pressure (ICP) monitoring. Patients were evaluated clinically and radiologically with Marshall CT score. They were categorized into mild, moderate, and severe head injury groups based on Glasgow coma scale (GCS) score. Outcomes were evaluated with Glasgow outcome scale (GOS) score. Results A total of 25 patients with TBI were enrolled in this study. They underwent cisternostomy with intraoperative ICP monitoring. They were categorized into 4 groups based on the age. In our study, mortality rate was 32%. As much as 48% had good recovery at 3 months follow-up with GOS 4 and 5. Mean ICP after cisternostomy was 6.36 ± 1.91 mm Hg. In our study, there was decrease in ICP after cisternostomy. Conclusion Age, time interval from trauma to surgery, and ICP showed prognostic importance on outcomes. Cisternostomy can efficiently decrease the ICP in the TBI patients and reduce postoperative complications.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"33 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81053277","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}
Utkarsh Khandelwal, Anuj Ajayababu, T. Sinha, S. Bhoi
Abstract Tension pneumocephalus is a rare and life-threatening neurosurgical emergency in the setting of blunt or penetrating head trauma, especially in those with craniofacial fractures, which emergency physicians should be aware about. Early identification and appropriate treatment measures including supine positioning, 100% oxygen via mask, early neurosurgery consultation and, if required, operative intervention are paramount to optimal neurological and survival outcome. Definitive diagnosis requires imaging usually in the form of computed tomography (CT) head and serial monitoring of neurological status, optic nerve sheath diameter measurement and repeat imaging, essential to identify patients who might have features of increased pressure on brain matter, which could lead to adverse neurological and clinical outcomes. We present two cases of tension pneumocephalus with the characteristic Mount Fuji sign on CT head, who were managed nonoperatively with optimal neurological outcome. In patients with severe head or maxillofacial trauma presenting to emergency department, CT should be evaluated for signs of tension pneumocephalus, and such patients need to be closely observed for complications of pressure effect on brain matter to ensure optimal neurological and survival outcomes.
{"title":"Trauma-Associated Tension Pneumocephalus with Characteristic Mount Fuji Sign—Case Report","authors":"Utkarsh Khandelwal, Anuj Ajayababu, T. Sinha, S. Bhoi","doi":"10.1055/s-0041-1739482","DOIUrl":"https://doi.org/10.1055/s-0041-1739482","url":null,"abstract":"Abstract Tension pneumocephalus is a rare and life-threatening neurosurgical emergency in the setting of blunt or penetrating head trauma, especially in those with craniofacial fractures, which emergency physicians should be aware about. Early identification and appropriate treatment measures including supine positioning, 100% oxygen via mask, early neurosurgery consultation and, if required, operative intervention are paramount to optimal neurological and survival outcome. Definitive diagnosis requires imaging usually in the form of computed tomography (CT) head and serial monitoring of neurological status, optic nerve sheath diameter measurement and repeat imaging, essential to identify patients who might have features of increased pressure on brain matter, which could lead to adverse neurological and clinical outcomes. We present two cases of tension pneumocephalus with the characteristic Mount Fuji sign on CT head, who were managed nonoperatively with optimal neurological outcome. In patients with severe head or maxillofacial trauma presenting to emergency department, CT should be evaluated for signs of tension pneumocephalus, and such patients need to be closely observed for complications of pressure effect on brain matter to ensure optimal neurological and survival outcomes.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"6 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87670204","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}
Teenu Xavier, M. Kuriakose, Metilda Robin, D. Agrawal
Abstract Background With the advancement in technology, e-learning is an attractive platform to facilitate online continuing medical education. The aim of the study was to develop a web-based nursing education program on the Glasgow coma scale (GCS) and to assess the effectiveness of this module in improving the knowledge of nurses. Methods A one-group pretest posttest study was conducted among nurses working in a tertiary care hospital in New Delhi, India, from November 2015 till July 2016. Before administering the GCS module, an online questionnaire was used to assess the baseline knowledge. After the completion of the module, a posttest questionnaire was administered and assessed. Results A total of 3500 users completed the e-learning GCS module. The mean pretest score was 4.2 ± 2.1, and the mean posttest score was 7.3 ± 2.5. The mean difference in the score was statistically highly significant ( p < 0.05). Conclusion The e-learning module is an effective means of providing continuing online education to the nurses, so that they can update their knowledge.
{"title":"Development and Implementation of an e-Learning Program on Glasgow Coma Scale","authors":"Teenu Xavier, M. Kuriakose, Metilda Robin, D. Agrawal","doi":"10.1055/s-0041-1739480","DOIUrl":"https://doi.org/10.1055/s-0041-1739480","url":null,"abstract":"Abstract Background With the advancement in technology, e-learning is an attractive platform to facilitate online continuing medical education. The aim of the study was to develop a web-based nursing education program on the Glasgow coma scale (GCS) and to assess the effectiveness of this module in improving the knowledge of nurses. Methods A one-group pretest posttest study was conducted among nurses working in a tertiary care hospital in New Delhi, India, from November 2015 till July 2016. Before administering the GCS module, an online questionnaire was used to assess the baseline knowledge. After the completion of the module, a posttest questionnaire was administered and assessed. Results A total of 3500 users completed the e-learning GCS module. The mean pretest score was 4.2 ± 2.1, and the mean posttest score was 7.3 ± 2.5. The mean difference in the score was statistically highly significant ( p < 0.05). Conclusion The e-learning module is an effective means of providing continuing online education to the nurses, so that they can update their knowledge.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"23 1","pages":"001 - 003"},"PeriodicalIF":0.2,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84564514","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}
Abstract A retropharyngeal pseudomeningocele after cervical vertebral fracture dislocation is an extremely rare complication and often associated with hydrocephalus. It usually presents with respiratory difficulty and dysphagia, sometimes as an incidental finding in radiological study. We reported a case of 45-year-old female patient who had posttraumatic lower cervical prevertebral retropharyngeal pseudomeningocele, found as an incidental finding in a routine radiological workup. Patient underwent ACDF but expired 2 weeks postoperatively due to respiratory failure. Although the prognosis of retropharyngeal pseudomeningocele depends upon the severity of initial trauma, early recognition and management can prevent enlargement of cyst and development of respiratory difficulty and dysphagia.
{"title":"Posttraumatic Retropharyngeal Pseudomeningocele—A Case Report","authors":"L. Tyngkan, Vishal Singh, V. Mathew, M. Laharwal","doi":"10.1055/s-0041-1739473","DOIUrl":"https://doi.org/10.1055/s-0041-1739473","url":null,"abstract":"Abstract A retropharyngeal pseudomeningocele after cervical vertebral fracture dislocation is an extremely rare complication and often associated with hydrocephalus. It usually presents with respiratory difficulty and dysphagia, sometimes as an incidental finding in radiological study. We reported a case of 45-year-old female patient who had posttraumatic lower cervical prevertebral retropharyngeal pseudomeningocele, found as an incidental finding in a routine radiological workup. Patient underwent ACDF but expired 2 weeks postoperatively due to respiratory failure. Although the prognosis of retropharyngeal pseudomeningocele depends upon the severity of initial trauma, early recognition and management can prevent enlargement of cyst and development of respiratory difficulty and dysphagia.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"103 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85836865","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}
Abstract Asymmetry of the lateral ventricles is not an uncommon finding. On one end, it is a predictor of intracranial pathology, and on the other, it can represent a normal variant. It needs to be appropriately investigated. In this case report, we presented two cases of asymmetric lateral ventricles, their presentation, progression and management.
{"title":"Asymmetric Lateral Ventricles—A Tale of Two Cases","authors":"Nakul Pahwa","doi":"10.1055/s-0041-1734343","DOIUrl":"https://doi.org/10.1055/s-0041-1734343","url":null,"abstract":"Abstract Asymmetry of the lateral ventricles is not an uncommon finding. On one end, it is a predictor of intracranial pathology, and on the other, it can represent a normal variant. It needs to be appropriately investigated. In this case report, we presented two cases of asymmetric lateral ventricles, their presentation, progression and management.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"119 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75742204","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}
L. Moscote-Salazar, Tariq Janjua, Pilar Bosque-Varela, A. Agrawal
The new coronavirus (COVID-19/SARS-CoV-2) and the associated pandemic is continuously presenting new challenges, and with a growing body of evidence, multiple clinical settings have been created for the neurosurgeons. 1 In fl ammation and demyelination are two pathobiological mechanisms resulting from the entry of the SARS-CoV-2 into the central nervous system (CNS). 2,3 Although cranial nerve involvement was not mentioned in the fi rst reports, in the weeks after the pandemic, it was clinicallycharacterized that patients with COVID-19 can develop anosmia. 4,5 This demonstrates the neuroinvasive potential of this unusual pathogen. 6 Studies suggest that approximately 25 to 30% of patients with severe cranial neurotrauma develop anosmia. 7 The etiologic mechanism of posttraumatic anosmia is a determining factor in recovery. 8 The presence of anosmia in patients with traumatic brain injury (TBI) and concomitant history of COVID-19/SARS-CoV-2 can present a diagnostic challenge. It becomes more challenging as many pathologies, that is, in fl ammatory, neurodegenerative pathologies, medications, and viral infections can also cause anosmia
{"title":"Anosmia in Case of COVID-19 Patients: Dilemmas Faced in Neurotrauma Care","authors":"L. Moscote-Salazar, Tariq Janjua, Pilar Bosque-Varela, A. Agrawal","doi":"10.1055/s-0041-1729351","DOIUrl":"https://doi.org/10.1055/s-0041-1729351","url":null,"abstract":"The new coronavirus (COVID-19/SARS-CoV-2) and the associated pandemic is continuously presenting new challenges, and with a growing body of evidence, multiple clinical settings have been created for the neurosurgeons. 1 In fl ammation and demyelination are two pathobiological mechanisms resulting from the entry of the SARS-CoV-2 into the central nervous system (CNS). 2,3 Although cranial nerve involvement was not mentioned in the fi rst reports, in the weeks after the pandemic, it was clinicallycharacterized that patients with COVID-19 can develop anosmia. 4,5 This demonstrates the neuroinvasive potential of this unusual pathogen. 6 Studies suggest that approximately 25 to 30% of patients with severe cranial neurotrauma develop anosmia. 7 The etiologic mechanism of posttraumatic anosmia is a determining factor in recovery. 8 The presence of anosmia in patients with traumatic brain injury (TBI) and concomitant history of COVID-19/SARS-CoV-2 can present a diagnostic challenge. It becomes more challenging as many pathologies, that is, in fl ammatory, neurodegenerative pathologies, medications, and viral infections can also cause anosmia","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"20 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86416623","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}
Abstract Anatomical variations at the suprascapular notch may limit the available space for the suprascapular nerve (SSN), and cause its entrapment in the tight osseoligamentous tunnel. The author encountered the presence of a trifid superior transverse scapular ligament (STSL) while operating on a patient with SSN entrapment. Surgical division of the three bands resulted in complete regression of symptoms.
{"title":"Suprascapular Nerve Entrapment by a Trifid Superior Transverse Scapular Ligament","authors":"P. S. Bhandari","doi":"10.1055/s-0041-1734344","DOIUrl":"https://doi.org/10.1055/s-0041-1734344","url":null,"abstract":"Abstract Anatomical variations at the suprascapular notch may limit the available space for the suprascapular nerve (SSN), and cause its entrapment in the tight osseoligamentous tunnel. The author encountered the presence of a trifid superior transverse scapular ligament (STSL) while operating on a patient with SSN entrapment. Surgical division of the three bands resulted in complete regression of symptoms.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"246 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75047091","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}
Abstract Background and Objectives The towel test is a reliable and straightforward technique to find elbow flexion in brachial plexus birth palsy. This study evaluates the role and reliability of towel test in children at 6 and 9 months of age. Materials and Methods We conducted the towel test in 30 consecutive children at 6 and 9 months of their ages between 2015 and 2020. We recorded the results along with the side involved in these children and the mother’s handedness. Based on the results of towel tests, we did a statistical correlation. Results Sixteen of the 30 children were boys. Twelve of the 30 children had left-side involvement. Four mothers were left handed. Four (13%) infants (male = 3; female = 1) had false-negative towel test at 6 and 9 months. There is a significant correlation between the left-hand mother’s and infant who had false-negative towel test (p < 0.01) Conclusion The towel test is reliable and straightforward to assess the elbow flexion at 6 and 9 months. It can be falsely negative in 13% of children because of handedness. Mother’s handedness is crucial and should be recorded during the children assessment. Alternate tests will further evaluate the elbow flexion in such false-negative towel-tested brachial plexus birth palsy children.
{"title":"Reliability of Towel Test for Elbow Flexion Assessment in Brachial Plexus Birth Palsy","authors":"J. Jerome, S. Vanathi, G. Prabu, K. Thirumagal","doi":"10.1055/s-0041-1732787","DOIUrl":"https://doi.org/10.1055/s-0041-1732787","url":null,"abstract":"Abstract Background and Objectives The towel test is a reliable and straightforward technique to find elbow flexion in brachial plexus birth palsy. This study evaluates the role and reliability of towel test in children at 6 and 9 months of age. Materials and Methods We conducted the towel test in 30 consecutive children at 6 and 9 months of their ages between 2015 and 2020. We recorded the results along with the side involved in these children and the mother’s handedness. Based on the results of towel tests, we did a statistical correlation. Results Sixteen of the 30 children were boys. Twelve of the 30 children had left-side involvement. Four mothers were left handed. Four (13%) infants (male = 3; female = 1) had false-negative towel test at 6 and 9 months. There is a significant correlation between the left-hand mother’s and infant who had false-negative towel test (p < 0.01) Conclusion The towel test is reliable and straightforward to assess the elbow flexion at 6 and 9 months. It can be falsely negative in 13% of children because of handedness. Mother’s handedness is crucial and should be recorded during the children assessment. Alternate tests will further evaluate the elbow flexion in such false-negative towel-tested brachial plexus birth palsy children.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"27 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81987635","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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