Objective: To examine intracranial hypertension patients' spectrum, clinical features, and etiologies. Study Design: A Cross-sectional study. Place and duration of study: In the Department of Neurosurgery MMC Mardan from January 2019 to July 2020. Methodology: We used specific selection criteria to reduce the pool of IH patients from 67 to 32. Statistics and frequency distributions explain patients' demographics, clinical traits, and underlying reasons. Results: According to statistics, females (n = 30; 82%) with ages ranging from 21 to 35 (n = 13; 36%) and obesity (n = 2; 9%) were over represented. The most common clinical sign was headache (n = 18; 69%). On the other hand, idiopathic intracranial pressure had the greatest occurrence (44%). Conclusion: Women between the ages of 21 and 35 who are overweight or pregnant have an increased risk of developing idiopathic intracranial hypertension (IH).
Objective To assess the surgical anatomy and prevalence of intracranial aneurysms in patients with spontaneous subarachnoid hemorrhage. Materials and methods The current research investigated a total of 119 individuals from Peshawar, Pakistan. All the adult patients in the age range of 30 to 60 years, of both genders, presenting with spontaneous subarachnoid hemorrhage were included. A thorough history was taken, as well as a full, general, physical, systemic, and neurological examination was done. All individuals who arrived with a rapid onset of severe headache, with or without loss of consciousness, and had a CT scan showing spontaneous subarachnoid hemorrhage were included. All patients were subjected to CT angiography in the hospital to ascertain any intracranial aneurysm. CT angiography was done by a consultant radiologist (FCPS) having at least five years of experience. All the above-mentioned information, including age, diabetes, obesity, smoking, gender, and hypertension, was recorded in a predesigned proforma. Results The current study found that among 119 patients, 24 (20%) were of age 30-40 years, 44 (37%) were between 41 and 50 years, and 51 (43%) were of age 51 to 60 years; 73 (61%) were male and 46 (39%) were female; 67 (56%) were obese and 52 (44%) were not obese; 81 (68%) patients were hypertensive and 38 (32%) patients were non-hypertensive; 75 (63%) patients were diabetic and 44 (37%) patients were non-diabetic; 49 (41%) patients were smokers and 70 (59%) patients were non-smokers. Moreover, 96 (81%) patients had intracranial aneurysms and 23 (19%) patients did not have intracranial aneurysms. Conclusion As has been observed, the prevalence of intracranial aneurysms and surgical anatomy was 81% in individuals from Peshawar, Pakistan, with spontaneous subarachnoid hemorrhage.
Objective: To evaluate the frequency of pedicle screw displacement during free-hand technique in spinal fixing Material & Methods: This retrospective prospective study was carried out at Department of Neurosurgery Lady Reading Hospital Peshawar from June 2021 to December 2021. Total 90 patients were included. The screws were implanted utilising a free-hand placement technique. Facet joints and transverse processes were among the anatomical landmarks that were revealed. According to the level approached, the pedicle screw's entry location was selected. The insertion was done medially to the intersection of the origin of the transverse process and the lamina in the proximal thoracic spine and laterally to the pars interarticularis (T1 to T3). Results: 90 people in all were included in the trial. With a mean age of 37.5 years, the age varied from 15 to 60 years. Male to female ratio was 2:1, with 60 (66.7%) males and 30 (33.3%) females. Pedicle screws totaling 540 were inserted. 310 (57.4%) of the screws were placed at the lumbar spine, followed by 198 (36.7%) at the thoracic spine and 32 (5.9%) at the sacral spine. Conclusion: Pedicle screw cortical violation was found to be very high. Small pedicle breaches, however, have the potential to cause neurological lesions that can be reversed if the misaligned screws are fixed. Keywords: Freehand technique, Pedicle screw fixation, Spinal fracture
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