Objective: Through this study, we sought to evaluate the management of posterior fossa extradural hematoma (PFEDH). Methods: An observational study was conducted at the Neurosurgery Department of Lady Reading Hospital in Peshawar from January 2015 to December 2020. All patients who had a traumatic acute extradural hematoma (EDH) of the posterior fossa were included, irrespective of age and gender. The clinical predictors and outcomes were assessed, including the CT-scan findings and Glasgow Coma Scale (GCS) score. Results: A total of 104 cases with posterior fossa extradural hematoma were identified from 1252 extradural hematoma patients admitted during the study period. The mean age of the enrolled patients was 18.17 ± 14.31 years. Most of the patients were male (65.39%) and belonged to the pediatric age group, i.e., < 15 years (60.6%). CT scan brain was done in all the cases for diagnosis. In 68.3% of cases, an associated occipital bone fracture was observed. Surgery was done in almost 71.2% of cases, and most of the patients experienced good recovery after surgery, as indicated by the GOS score. Linear regression model revealed that treatment (β=-0.20, p=0.038), time duration between surgery and trauma (β=0.43, p=0.000) and GCS category (β=-0.47, p=0.000) were significantly associated with PFEDH outcomes. Conclusion: In conclusion, PFEDH was frequent among males and the pediatric age group. Serial CT brain is highly recommended in all suspected cases for early diagnosis. doi: https://doi.org/10.12669/pjms.39.1.6408 How to cite this: Sharafat S, Azam F, Khan Z. Posterior fossa epidural hematoma: A 6-year management experience. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6408 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective:  To determine the patterns, frequency and gender dominance in pediatric trauma presenting to Neurosurgery Department in a tertiary care hospital. Material and Methods:  This retrospective study was conducted in Department of Neurosurgery, Lady Reading Hospital, Peshawar. The medical records of all patients (0 – 15 years) with trauma admitted in our unit were analyzed retrospectively.Demographic details of the included subjects were noted down. Results:  A total of 448 patients were included in our study; 308 males and 140 females. Patients with 0 – 5 years were 40%, 6 – 10 years were 38% and 11 – 15 years were 22%. Extradural hematoma (28.12%) preceded depressed skull fracture (20.08%), followed by linear fractures (17.85), subdural hematoma (7.58%), contusions (5.80%) and subarachnoid hemorrhage (5.35%). Patients with diffuse axonal injury accounted for about 4.91%. Only 2 cases of cervical injury were noted. Conclusion:  The number of boys was comparatively greater than girls. Most of the patients were in the age group of 0 – 5 years. Ratio of extradural hematoma was the highest among all the injuries.

The objective of the study: To determine the statistical importance of each predicted factor in terms of prognosis for patients with ruptured MCAAs, we focus on those who have had surgical treatment for their aneurysms. Materials and methods: A total of 104 patients with ruptured MCAAs were examined in this retrospective analysis, which covered the years 2018 through 2020 and was conducted by the Neurosurgical Department at MMC Hosptial Mardan , pakistan . Patient characteristics (age, sex, comorbid conditions), aneurysm location (proximal, bifurcation, or distal), aneurysm dome size (small, large, or giant), aneurysm size at the time of surgery (ultra-early, early, or delayed), and Intracerebral Hemorrhage (ICH) volume are all assessed as potential predictors. Mean, standard deviation, covariance, and correlation were determined for each parameter (through the linear regression model). Results: The World Federation of Neurological Surgeons (WFSN) grading system was used to evaluate each patient's clinical status; a score of 5 indicated excellent quality in 37 (35.3%), while a score of 4 indicated a fair rate in the remaining 28 patients.

Objectives: To determine the success rate and complications of primary endoscopic third ventri-culostomy (ETV) in infants with obstructive hydrocephalous. Methods: This case series was conducted at the Department of Neurosurgery, Medical and Teaching Institute, Lady Reading Hospital Peshawar from July 2016 to June 2018. All consecutive patients with age less than one year who underwent ETV for primary obstructive hydrocephalous, of both gender, were included in the study. The patients were followed up to six months after surgery. The data was entered in a specially designed Performa. Patients’ data was analyzed using SPSS version 21.0. Results: We had total 21 patients with age less than one year during the study period. Male patients were 11 (52.4%). Success rate of ETV at six months of follow up was 12 (57.1%). Post-op complications observed were in 9.52% (2/21) cases. One patient had cerebrospinal fluid CSF) leak and the other had significant bleed. Conclusion: ETV is successful in 57.1% of infants with obstructive type of hydrocephalous. The post op complications in case of ETV are lower than Ventriculo-peritoneal shunts. Therefore, ETV can be offered to infants having obstructive hydrocephalous. doi: https://doi.org/10.12669/pjms.38.1.4097 How to cite this:Sharafat S, Khan Z, Azam F, Ali M. Frequency of success and complications of primary endoscopic third ventriculostomy in infants with obstructive hydrocephalous. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4097 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.