Introduction: This study was conducted to analyze clinico-radiological profile of traumatic basal ganglia hematoma and identify its prognostic factors. Methods and Materials: A prospective study was conducted in the Department of neurosurgery, Trauma center of Banaras Hindu University from September 2016 to March 2020. All patients with traumatic basal ganglia hematoma based on admission CT scan were enrolled and their demographic, clinical, radiological details were maintained till the time of discharge and subsequent follow up. Follow up period was a maximum of two years. Results: Out of 41 patients of traumatic basal ganglia hematoma, 68% of cases were males in their third decade. Road traffic accident (76%) was the major etiology. 32% had severe head injury, 78% had hemiparesis at admission and 58% patients required ventilatory support. The mean volume of clot was 15.46 millilitres. Only 24% cases had isolated traumatic basal ganglia hematoma. Advance age, associated intraventricular hemorrhage, ventilator dependence, large hematoma (volume >20 millilitres) and poor Glasgow coma score at admission were significant prognostic factors (p<0.05). Conclusion: Traumatic basal ganglia hematoma is a rare entity. Advance age, large volume of hematoma, associated intraventricular hemorrhage, poor Glasgow coma score at admission and ventilator dependence are poor prognostic factors.

Objective To estimate the level of myelin basic protein (MBP) and look for its validity in outcome prediction among mild-to-moderate head injury patients. Materials and Methods It was a prospective study done at the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University from Jan 2018 to July 2019. All patients who presented to us within 48 hours of injury with mild-to-moderate head injury with apparently normal CT brain were include in the study. The serum sample were collected on the day of admission and 48 hours later, and patients were treated with standard protocols and observed 6 months postdischarge. Results Of the 32 patients enrolled, we observed mean MBP level was higher for severity of brain damage, but not associated with age, mode of injury, and radiological diagnosis. Mean MBP levels were not statistically associated with Glasgow coma scale (GCS) score at admission but was correlated to outcome with p < 0.05, with sensitivity of 50% and specificity 72%, that is, patients with good outcome have lower mean MBP levels. Conclusion MBP as per our analysis can be used as a prognostic marker in patients with head injury. It is not the absolute value rather a trend showing rise in serum MBP levels, which carries a significant value in outcome prediction.

Context: Brain abscess is a suppurative process within the brain parenchyma, which remains a challenge for clinicians. Surgical excision or aspiration combined with prolonged antibiotics (usually 4–8 weeks) or only conservative management remains the treatment of choice. Aims: The purpose of this study is to analyze the epidemiology of brain abscess and to determine the potential factors leading to better outcomes. Settings and Design: This was a retrospective analysis of 93 patients undergoing various treatment options for brain abscess in a tertiary care center. Materials and Methods: Their preoperative status, etiology, and microbiological and clinical outcomes were analyzed. Statistical Analysis Used: Statistical analysis was done by Chi-square, one-way analysis of variance, and post hoc Newman–Keuls multiple comparison test wherever applicable using SPSS software. Results: Among 93 brain abscess cases, only 21 cases had a diameter <2.5 cm. Among them, conservative treatment was done for 38% of patients (8/21), aspiration for 47.6% (10/21) of patients, and excision for only 3 (14.2%) of cases. About 37.5% (3/8) persons among these conservatively managed patients had recurrence. None of the patients of <2.5 cm abscess having surgical management had recurrence or any new neurological deficits postsurgery during the 6-month follow-up. Conclusions: There was a significantly high recurrence among the nonsurgically treated patients with lesions <2.5 cm and there was no recurrence or neurological deficit after aspiration among these patients. Probably, aspiration has better results among these patients contrary to previous recommendations of antibiotic therapy alone.

Introduction: Traumatic cerebral contusion is one of the leading cause of morbidity and mortality in Neurosurgery. Patients can be either treated conservatively or surgically. Many patients who are treated conservatively may have CT scan progression and need surgery secondarily. This retrospective study was designed to study the clinical presentation and interventions predicting CT progression of hematoma and final outcome. Material and Methods: The study was conducted from April 2017 to December 2019 on all the patients of traumatic cerebral contusions, diagnosed by CT scan. Patients received either conservative treatment initially or underwent upfront surgery, and had at least one other CT scan during the acute hospitalization. Patients clinical history, CT progression and any intervention were noted. The patient’s disposition status was classified as discharged home, or to another institution, or whether the patient died. Results: Among the total 448 patients, 78.5% patients required surgery at presentation. 53.3% had a CT progression after repeat CT scan, among them 109 (48.8%) were operated. CT progression was seen more frequently in patients with coagulation abnormalities. Among patients with history of antiplatelet medication receiving platelet therapy, only 31% patients had CT progression. Patients who has poor initial GCS (Glasgow coma scale), underwent tracheostomy and had secondarily operated due to CT progression were discharged late. Conclusion: Coagulation defects was an important risk factor for CT progression. Platelet replacement therapy significantly decreased surgical intervention in patients with antiplatelet therapy. Poor initial GCS, secondary surgery and tracheostomy lengthened the hospital stay.