No abstract

While the indications for surgery in extra- and subdural hematomas are relatively established, the role, timing and the indications for the surgical treatment of cerebral contusions remains nebulous. The pathophysiology of brain edema and the resultant increase in intracranial pressure due to brain contusions is discussed. The role and limitations of early evacuation of contused brain are considered in this article.

Posttraumatic epileptogenesis provides an opportunity for the clinician to study the phenomenon of seizurogenesis along with the process of apoptosis which is triggered by traumatic brain injury (TBI), there is a simultaneous effort at neuro regeneration, neo synaptogenesis and plasticity. The seat of maximal neuronal changes after TBI is the hypothalamus. This loss of hilar cell inhibition of the hypothalamus on the CA3 region of the dentate gyrus results in mossy fibre sprouting and an attempt at neo synaptogenesis. While neo synaptogenesis is associated with long term potentiation (memory), it can also result in seizurogenesis. Pharmacologic inhibition of epileptogenesis remains in the realm of experimental therapeutics, but is likely to replace conventional antiepileptic drugs in the preventive management of post traumatic seizure disorder.

A 04-year-old child sustained a severe head injury as a result of a fall from the fourth floor to a cemented surface on 20 Sep 2011. Prompt resuscitation by the pediatric team and decompressive craniectomy followed by elective ventilation resulted in remarkable recovery of both the motor deficit (Hemiplegia) and Dysphasia.

No abstract

An analysis of the mechanism of epilepsy and epileptogenesis after traumatic brain injury will give us an insight into neural circuitry. In a retrospective analysis of 48 cases of moderate and severe traumatic brain injury, who reported for follow up to our centre over a period of two years. Of these, 12 patients with post traumatic epilepsy were identified. The risk factors, EEG patterns and the quality of control were analyzed. The pathophysiology and paradigms of management have been discussed.

No abstract

No abstract