Objectives:The Aim of this study was to evaluate the impact of clinico-radiological parameters on the outcome of the treatment in brain tuberculosis.Materials and Methods:This study was conducted in the Department of Neurosurgery and Neurology Skims Srinagar India for a period of two years from November 2009 to November 2011. A total of 61 patients presenting with brain tuberculosis admitted at skims during these two years were included in the study. Patients having clinical, laboratory and radiological findings suggestive of brain tuberculosis were included in the study. On correlating the CT characteristics-tuberculomas, basal exudates and hydrocephalus with sequelae at 6,12 and 18 months - focal deficit, cognitive impairment, and diplopia.Results:It was seen that basal exudates correlated with all the three neurological sequelae i.e.; with focal deficit (P = 0.001), cognitive impairment (P = 0.011), and diplopia (P = 0.021). Hydrocephalus correlated well with cognitive impairment (P = 0.031) and tuberculoma correlated with none of these clinical characteristics.Conclusion:We concluded that the mortality and neurologic sequelae were directly related to the clinical stage of disease at presentation. Correlating the CT characteristics we concluded that basal exudates correlated with all the three sequelae i.e.; with focal deficit, cognitive impairment, and diplopia. Hydrocephalous correlated well with cognitive impairment and tuberculoma correlated with none of these clinical characteristics.
Compression of trigeminal nerve in cavernous sinus leading to trigeminal neuralgia is one of the rare presentations of pituitary tumor. We report a patient whose presenting complaint was trigeminal neuralgia in V1, V2 distribution and he had pituitary macroadenoma invading ipsilateral cavernous sinus. After surgery, the neuralgia disappeared completely.
Cases of paraplegia form a considerable proportion of patient population visiting neurosurgical and neurologic units. Paraplegia not only alters the physical condition of the patient but also his/her mental, psychological, and social well-being. We collected data of 30 patients with paraplegia admitted during a period of 4 years who were followed then for a minimum period of 1 year. Those patients were evaluated for their neurologic improvement and complications usually associated with paraplegia. We found that patients with preserved sensations have better outcome and should be aggressively treated by surgery; whereas in patients who have no motor and sensory function at the time of injury, the decision regarding surgery should be guarded. We also derived that most common complications on follow-up include pressure sores, bladder dysfunction, and deep venous thrombosis, and evaluating them for depression and anxiety is mostly overlooked. We stress that the need of the hour in a resource-limited society such as ours is an intensely committed psychological rehabilitation in this group of patients.
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