Introduction Cranioplasty is the surgical repair, reconstruction, and replacement of a removed part of the cranium, thus restoring its shape, symmetry, contour, and continuity, which is extremely important from a cosmetic as well as a psychosocial point of view. Continuing advances in cranioplasty techniques have enabled the repair of large and increasingly complicated calvarial defects; however, the optimal reconstructive material for different clinical scenarios still remains unclear and debatable. Aim The aim of this study was to compare risk factors, complications, and the need for reoperation associated with different methods of cranioplasty, which are implemented in our institute. Materials and Methods This study was a prospective study conducted between August 2016 and January 2019 in a tertiary institute. Sixty patients were studied and divided into three groups of which group 1 included 18 patients who underwent cranioplasty using ETO (ethylene oxidation)-sterilized autologous bone graft, group 2 included 17 patients who underwent cranioplasty using autologous bone graft placed in subcutaneous pocket, and group 3 included 25 patients who underwent titanium mesh cranioplasty. Data were collected and statistical analysis was performed. Result and Conclusion Of the three groups studied, postoperative complications were more in group 1(ETO-sterilized autologous bone graft) and group 3 (titanium mesh cranioplasty) but the difference between the three groups was not statistically significant. Factors such as age, gender, initial diagnosis, interval between decompression craniectomy and cranioplasty, operative time, blood loss, method of fixation, and defect size had no statistically significant effect on postoperative outcomes.
Objective The aim of this study was to introduce a cost-effective and less invasive method for the evacuation of intraparenchymal hemorrhage (IPH). Background IPH in the presence or absence of intraventricular hemorrhage has severe morbidity and has almost 50% mortality whether the patient is managed surgically or medically. Development of minimally invasive surgical techniques offers better outcomes but requires the use of special instruments and a unique skill set that is costly and requires special training. Method We inserted infant feeding tube within the hematoma via the left Kocher's burr hole. We instilled 40,000 IU of urokinase serially at an 8 hours interval for 3 days to evacuate the left gangliocapsular hematoma. Result We have treated a 50 years old hypertensive male patient with left gangliocapsular IPH and right hemiparesis (power: ⅖ on admission). After a month, on follow-up, the patient was conscious and oriented with improved right hemiparesis (power: ⅘). Conclusion This technique of evacuating hematoma is instrumental in peripheral centers in developing as well as under-developed countries where there are limited resources and a better outcome is expected with minimal morbidity.
INTRODUCTION: Percival Pott was the first who described Pott’s puffy tumor as frontal sub-periosteal abscess formation with frontal osteomyelitis. Though the emergence of broad-spectrum antibiotics cases is rare to occur, its higher morbidity makes it an important entity that requires prompt intervention. CASE REPORT: Here we are presenting the case of a 16-year-old female with Pott’s puffy tumor with uncertain etiology as both trauma and upper respiratory tract infection were present in the history. She was presented with the sign and symptoms of infective etiology. Ct scan and all routine investigations were done, and she was diagnosed to have frontal osteomyelitis and sub-periosteal abscess. She was operated on with Riedel’s procedure and recovered completely. During the post-operative phase, her neurological examination was normal and no complications occurred up to 6 months of follow-up. CONCLUSION: Though rare but hazardous Pott’s puffy tumor warrants prompt intervention and primary prevention by appropriate usage of antibiotics. Morbidity can be easily prevented by early management.
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