AIm: We present our experiences in the management of extradural haematoma in children which involved an aggressive diagnostic approach, prompt surgical evacuation results in an excellent outcome. mAterIAl and methOds: 170 EDH patients who underwent surgery in our department from January 2006 to July 2010 included in this prospective study. Each patient evaluated in term of age, sex, mode of injury, localization of haematoma, clinical presentation, CT findings, operative measures and outcome.results: Out of 170 cases 72%, (n=122) were boys and 28 %,( n=48) were girls. The boys to girls ratio was 2.54: 1. Age ranged from 1.8 to 18 years with a mean age of 9.49 years. Most of the victims are in the 11-18 years age group 44% ( n=74). The most common mode of injury was fall 41%, (n = 70) followed by Road traffic Accident (RTA) 32%, (n = 54) .The most common clinical presentation was altered sensorium 61 %, (n= 104), followed by headache and/or vomiting 56 %, (n = 96). The mortality rate was 8%.COnClusIOn: EDH is recognized as one of the most rewarding neurosurgical emergencies. It must be diagnosed in the early period of the trauma and evacuated early to prevent potential mortality and morbidity. Different factors affect the outcome of extradural haematoma Surgery including age of the patient, presence of cranial fractures, associated brain lesions and pre-operative neurological condition of patient, duration of time interval between onset of coma and surgical intervention. Better prognosis is seen in patients less than 10 years of age. sOnuÇ: Beyin cerrahisi acil yaklaşımları içerisinde en yüzgüldürücü sonuçları olan patolojilerden birisi de ekstradural hematomlardır. Bu tür hematomlar travmanın erken döneminde tanınmalı ve cerrahi tedavisi mortalite ve morbiditeyi önlemek için en hızlı şekilde yapılmalıdır. Ekstradural hematomların cerrahi sonuçları değişik faktörler tarafından etkilenmektedir; bunlar, hastanın yaşı, kranial kemik kırıklarının olması, beyinde ek lezyonların olması, hastanın ameliyat öncesi klinik durumu ve hastanın komaya giriş süresi ile ameliyata alınış süresi arasında geçen süre gibi etkenler sayılabilir. Yaşı 10'dan küçük olan hastaların prognozu daha iyi olmaktadır.
This prospective study was conducted to compare the outcome between medical and surgical treatment of primary intracerebral haemorrhage at the department of Neurosurgery, Dhaka Medical College
Background: Conventional radiography and CT scan failed to reveal the posterior fossa tumors which not accurately show tumors behind bone. MRI is currently recognized as the optimal screening technique for detection of posterior fossa tumors. We tried to compare the MRI findings with the histopathological findings of different types of posterior fossa tumors in pediatric patients. Histopathological reports were regarded as the gold standard.
Objective: To assess the diagnostic effectiveness of MRI in detection of posterior cranial fossa tumors in pediatric patients.
Methods: This cross sectional study was carried out in the department of Neurosurgery, DMCH, NINS and some private hospitals in Dhaka from March, 2012 to November, 2013. Purposive sampling technique was applied and 34 cases were included in the study. Data were collected by specially designed questionnaire and analysed by SPSS.
Results: Out of 34 cases, MRI failed to match with the histopathological diagnosis only in 2 cases. One case was diagnosed as cerebellar astrocytoma by MRI, histopathology proved it brain abscess. In another case, MRI diagnosed as ependymoma but histopathology revealed medulloblastoma.
Conclusion: It can be concluded That MRI is accepted as the most effective imaging modality in the diagnosis of paediatric posterior fossa tumors. T1WI, T2WI, FLAIR, axial, sagittal, coronal and T1WI post contrast sequences permit confident diagnosis and localization of the pediatric posterior fossa tumor.
Bang. J Neurosurgery 2020; 10(1): 62-66
<p>This study was undertaken to determine the influence of Glasgow coma scale (GCS) on admission on clinical outcome of patients with unilateral chronic subdural hematoma after surgery. A cross- sectional study was conducted on 33 consecutive patients, among them 28 were male, 5 were female with GCS 6 to 15. 19 patients out of 22 who had GCS 14-15 had favorable GOS at 24 hours as compared to 2 out of 7 in GCS 9-13 group and none in GCS ≤8 group. All patients (22 out of 22) had favorable GOS at the time of discharge in GCS 14-15 group while 8 out of 9 had favorable GOS in GCS 9-14 group and 1 out of 2 patients had favorable GOS in GCS ≤8 group. Chi square test showed significant difference in outcome between 14-15, 9-13 and ≤8 GCS groups (p values 0.001, 0.015, 0.013 respectively). In conclusion, clinical outcome of patients with unilateral chronic subdural hematoma depends on Glasgow coma scale on admission. </p>
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