This preliminary study demonstrated the efficacy and safety of complete callosotomy with anterior, hippocampal, and posterior commissurotomy in Lennox-Gastaut syndrome (drop attacks) with moderate to severe mental retardation.
Objectives: To analyze the outcome of a pediatric population with traumatic basal ganglia hematoma (TBGH). Methodology: Patients <15 years of age with TBGH were studied for mode of injury, severity of injury on admission, Glasgow coma scale (GCS) score on admission, radiology, intervention and overall outcome. Observations: Twenty-one patients (male:female = 4:1) with a mean age of 7.2 ± 3.7 years (range 0.33–15 years) were studied. High-velocity trauma (52%) followed by fall from height (38%) were the leading causes. Seventy-six percent of the patients had severe head injury. The mean GCS score on admission was 6.0 ± 2.5 (range 3–12), while the mean GCS score of the group with severe head injury was 4.81 ± 1.7 (range 3–7). Eleven (52.4%) patients had isolated basal ganglia hematoma while 10 (47.6%) had other associated intracranial injuries. Only 3 patients required surgical interventions. Eleven patients (52.4%) expired during their hospital stay. At discharge, 9 (42.9%) had a poor, nonfunctional outcome (Glasgow outcome scale, GOS 2, 3). Conclusion: The severity of head injuries and GCS score on admission mainly determined the ultimate outcome in pediatric TBGH. The mode of injury or associated intracranial injuries did not change the outcome. The presence of TBGH in severely head-injured patients worsens the prognosis and outcome.
Post operative pituitary apoplexy is associated with high mortality, despite early and best management. Partial resection of the giant pituitary adenoma is directly responsible for post operative apoplexy. Maximum possible resection of the tumor by suitable exposure should be the optimal goal of surgery. Surgical exposure, either transcranial or transsphenoidal, should be dictated by tumor configuration on preoperative imaging. Endocrine status, histology of the tumor and clinical presentation do not appear to contribute to post operative pituitary apoplexy.
Objectives:Semi-quantitative and quantitative assessment of the effect of bone marrow-derived mononuclear cells (BM-MNC) on early and late phase of nerve regeneration in rat sciatic nerve model.Materials and Methods:Sciatic nerve transection and repair was performed in 50 inbred female Wistar albino rats divided equally in two groups. In the test group the gap was filled with BM-MNCs obtained from the two male rats and fibrin sealant, while in the control group only fibrin sealant was used. Sciatic nerve was harvested at 15 days and at 60 days interval. Parameters of regeneration were assessed at anastomosis (G), intermediate distal (C), and distal site (A). Semi-quantitative (histopathological) and quantitative (morphometric) parameters were analyzed.Results:At 15 days there was a statistically significant difference found in mean axon diameter, mean nerve thickness and myelin thickness at the repair site (P < 0.05). However, in the distal areas, the axons were sparse and myelin rings were very thin in both the groups. At 60 days, the difference in above-mentioned parameters was statistically significant at the distal most sites. FISH assay confirmed the presence of Y chromosome, confirming the presence of BM-MNCs from the male rats.Conclusions:Transplanting BM-MNCS at the site of peripheral nerve injury leads to significantly better recovery. These differences were evident at the repair site and at the intermediate distal site at 15 days and at the distal most sites at 60 days. With practically no ethical issue regarding their isolation and application, they can be easily used for clinical trials.
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