Premature infants still have a higher rate of shunt failure. Patients with meningitis, aqueductal stenosis, postcranial surgery hydrocephalus, congenital abnormalities, and a past history of surgical excision of mass lesion may have early shunt failure. However, the frequency of shunt failure that we observed (23 %) was much lower than that quoted earlier in the literature and this may be a consequence of rigorous periodic evaluation of patients with VP shunt in situ.

Pituitary adenomas represent 15 to 19% of all surgically resected primary brain tumors. 1,2 In the United States, the estimated annual incidence is 8.2 to 14.7 cases per 100,000 people, making pituitary adenoma the third most common primary intracranial tumor after glioma and meningioma. 2 Unselected autopsy studies show that 20 to 27% of the general population harbor subclinical pituitary adenomas, so called 'incidentaloma'. [2][3][4][5] Clinically occult pituitary adenoma can be picked up in 10% or more of routine MRI scans. 6,7 ABSTRACT: Objective: The purpose of this retrospective review of all operated cases of pituitary adenomas in the last decade, is to define the demographic patterns and characteristics of such tumors and to assess surgical outcomes with regards to safety and efficacy of trans-sphenoidal tumor removal in our institution. Methods: Surgically treated pituitary adenomas presenting from 1995 till 2005 were reviewed for different variables. Results were expressed as mean, standard deviation and median for continuous and number with percentage for categorical data. Chi square test was applied to measure differences and significance was taken at p value < 0.05. Results: One hundred and twenty-five patients were operated for pituitary adenoma. Sixty-three percent were male and mean age was 37 years. Sixty percent of the patients presented with headache and/or visual symptoms. Twelve percent presented with pituitary apoplexy and 28% presented with symptoms due to pituitary hyperfunction. Fifty-five percent of patients had functioning and 44% had nonfunctioning adenomas. Mean pre operative tumor diameter from 86 pre op MRI scans was 26.76 mm (3-78 mm). Eighty-four percent of patients underwent trans-sphenoidal tumor resection and three percent had craniotomy. Mean size of post op residual tumor as calculated from 76 available post operative scans was 5.3 mm (range 0-31 mm). 17.6% of the patients required hormone replacement beyond three months and 10% were re-operated. Overall mortality was 1.6%. Conclusion: In Pakistan, patients are more likely to present either with apoplexy or with a giant pituitary adenoma than patients reported from developed countries. Overall, our results have been satisfactory and comparable with the literature. Le test du chi-carré a été utilisé pour l'analyse des données et la valeur de p a été fixée à < 0,05. Résultats : Cent vingt-cinq patients ont subi une chirurgie pour un adénome pituitaire. L'âge moyen était de 37 ans et 63% étaient des hommes. Soixante pour cent des patients ont consulté initialement pour de la céphalée et/ou des symptômes visuels, 12% pour apoplexie pituitaire et 28% pour des symptômes d'hyperpituitarisme. Chez 55% des patients l'adénome était fonctionnel et chez 44% l'adénome ne l'était pas. Le diamètre moyen de la tumeur avant la chirurgie, évalué au moyen de 86 IRM préopératoires, était de 26,76 mm (3 à 78 mm). Quatre-vingt-quatre pour cent des patients ont subi une résection trans-sphénoïdale de la tumeur et 3% ont subi une craniotomie. La ta...

Overall our results were comparable to published international literature. However, the authors observed significant differences in demographics, especially in terms of age, gender distribution, and mean BMI of patient population as well as frequency of involvement of upper lumbar discs.

No abstract

Cranioplasty is a frequently performed procedure in neurosurgery. The pediatric population for this procedure is distinct from the adult one because of the growing skulls and thinner bones of the calvarium. A paucity of data on the outcomes of this procedure in the pediatric population has been identified repeatedly. We conducted a retrospective cohort study to investigate the outcomes in a pediatric population that underwent cranioplasty after craniectomy at our institute in a developing-world country. Our cohort showed no association of complication rate or cosmetic outcomes with the timing of cranioplasty, area of skull defect, type of implant used, or method of storage.