Background: Share our experiences with a series of surgical removal of cerebellopontine angle with retrosigmoid suboccipital procedure. Materials and Methods: It was a retrospective study of 48 patients (mean age, 45 years) with Cerebellopontine Angle tumors (predominantly acoustic schwannoma) who underwent surgical removal and one year post-operative follow up. Results: Hearing improvement about 50% of patient. Facial nerve function as measured by the House Brackmann system was recorded in all patients 1 year following surgery: 35% had a score of 1 or 2; 25% had a score of 3 or 4; and 8% had a score of 5 or 6. Rest of the patient full recover Two death occurred during this study. There was one cerebrospinal fluid leak, and two patients were diagnosed as having bacterial meningitis. Complete gross tumor removal was not achieved in five patients (10%). Two cases had wound infections. Conclusion: The retrosigmoid suboccipital procedure was used in our series for removal CPA tumors, and outcome was good in this series. Bang. J Neurosurgery 2020; 9(2): 117-220

Aim: We prospectively recorded the clinical features, radiological features, surgical approaches & findings, postoperative follow up & ultimate neurological outcome of upper cervical spinal schwannomas and then we evaluated the records retrospectively. Materials and Method: 30 upper cervical spinal schwannomas patient who underwent surgery (microneurosurgically) from 2007 to 2014 in the department of neurosurgery Dhaka Medical College and private hospitals are included in this retrospective study. After operation all patients were followed up regularly both clinically and neuro-radiologically. Results: Out of 30 cases 16 male and 14 females. The male to female ratio was 1.4: 1, Age range from 8 to 60 years with mean age 35 Years. Most of the patients are in middle years age group The mean duration of symptoms at the time of presentation was 32 months (range 06 months-5 years). Four schwannomas were completely extradural, fourteen were intradural and rest twelve were intradural or hourglass type (both extra and intradural) as identified during surgery. The posterior midline approach was used in all patients. A C2 hemilaminectomy or C2 laminectomy with or without cutting of posterior arch of atlas was used for most intradural and large in terdural C2 schwannomas. Tumor removal was complete in all cases. Preservation of the nerve root fibers was not possible in 18 cases and was possible only in 12 cases. In one patients CSF leak developed after operation. One patient who had severe myelopathic features with bed sore failed to improve and expired 5 months after operation. Rest of the patients showed postoperative improvement in their preoperative symptoms and returned to their normal life by the end of sixth month. There was one tumor recurrence in any patient till last follow up. Conclusion: Proper 3-D anatomical orientation & physiological knowledge, deep neuro-radiological observation, pathological appreciations and micro-neurosurgical skill and expertization can make the surgical management of these tumors ( in a surgically complex site) simple with gratifying result (i.e.neurological outcome) without extensive bone removal or soft tissue manipulation through a standard midline posterior approach. Bang. J Neurosurgery 2019; 9(1): 44-48

Background: A chronic subdural hematoma (CSDH) is a collection of blood and blood breakdown products between the surface of the brain and its outermost covering the dura for more than 21 days. The elderly patients are more likely to develop a subdural hematoma, particularly from trivial trauma. CSDHs have been evacuated by burr holes, twist-drill craniotomies and craniotomies. The treatment of chronic subdural haematoma by burr hole drainage has been performed usually without using a closed drainage system, the problem of intracranial air entrapment still persists and can cause a deterioration in the level of consciousness or seizures in the postoperative period. We wanted to compare the effects of patient with drain and those without drain. Objectives: our study is to compare the clinical outcome of CSDH with or without drain. Methods: This prospective study was carried out at CMH Dhaka from January 2017 to July 2018; total 70 cases were investigated for the effectiveness of subdural drain. Cases were randomly allocated in two groups. Data were collected by specially designed questionnaire and analyzed by SPSS. Results and Observation: 70 patients of CSDH were included in this study out of which 25 underwent burr hole with closed system drainage and 45 underwent burr hole without closed system drainage. They were divided into Group A and B, respectively. Among the total number of patients 14 (20%) had shown recurrence. Out of 14 patients, 12 belong to Group B (86 %) and 2 belong to Group a (14 %). Conclusion: It is concluded that, those with a closed system drainage recurrence rate is significantly lower than with burr-hole evacuation alone. Bang. J Neurosurgery 2019; 9(1): 26-32

Background: Motor bike is a popular two wheeler vehicle in Bangladesh especially among young generation, newly married couple and service holders. It is also popular vehicle among female NGO workers. Female like to travel on motor bike along with life partner or with guardian hanging their both legs on one side of seat increasing the tendency to fall down from motor cycle due to imbalance body weight during turning the road or crossing the uneven road or sudden increasing the speed of the motor bike or crossing on a speed breaker. Aims: Encourage female to travel on motor bike hanging their legs on both sides of the seat to maintain the body weight balance for reducing the mortality and morbidity of RTA. Methods: All the female patients admitted in neurosurgery ward having motor cycle accident from January/2019- December/2019 were included in this study. Results: There is a strong association between fall from motor cycle (RTA) and hanging two legs on one side in female motor cycle traveler. Conclusions: female should travel on motor cycle hanging their legs on both side of seat to avoid avoidable head injury due to RTA. Bang. J Neurosurgery 2020; 10(1): 33-38

Objective: To present this series of surgically treated tuberculum sellae meningiomas with particular regard to visual compromises Methods: A retrospective analysis was done on 28 patients (21 females) with meningiomas originating from the tuberculum sellae who underwent surgery between 2010 and 2019. The standard surgical approach of pterional craniotomy. Twelve meningiomas extended posteriorly onto the diaphragma sellae, 13 anteriorly to the planum sphenoidale, and 3 to the anterior clinoid process. 21 tumours involved the optic canal, one bilaterally. Follow up ranged from 6 to 12 months. Results: Total microscopic resection was achieved in 28 patients. Median tumour size was 3.2 cm. Postoperatively, visual acuity improved in 19 patients and deteriorated 3. Preoperative and postoperative visual acuity worsened with increasing duration of preoperative symptoms and with increasing age. Extension into the intraconal space was a negative predictor. Recurrence occurred in one cases. One patients died from causes unrelated to the tumour. Conclusions: In the majority of patients with tuberculum sellae meningiomas, total resection may be achieved through a pterional approach with minimal complications. Bang. J Neurosurgery 2020; 10(1): 39-44