Bilateral thalamic haemorrhage is an unusual complication of burr hole drainage surgery. We present the case of a patient with this rare postoperative complication of bilateral thalamic haemorrhage following burr hole drainage of a chronic subdural hematoma.
BACKGROUNDPosterior reversible encephalopathy is a proposed clinico-neuroradiological entity characterised by headache, altered mental status, cortical blindness, seizures, other focal neurological signs and a diagnostic magnetic resonance imaging. A variety of different aetiologies have been reported like hypertension, pre-eclampsia/eclampsia, uraemia and porphyria. With early diagnosis and prompt treatment, the syndrome is usually completely reversible. We report a case of PRES in a patient with elevated blood pressure. Clinicians as well as radiologists must be familiar with this clinically frightening, underdiagnosed condition to assure timely diagnosis and treatment to prevent persistent deficits.
BACKGROUND Trauma is one of the most common causes of death and lifelong disability in early decades of life, of which majority of cases are neurological trauma. TBI is becoming the most common and devastating problem due to exponential growth in population and increased vehicle use. Head injuries due to road traffic accidents (RTA) are the second most common cause of death, only next to cancer. The present study was observational, prospective study undertaken to evaluate the correlation between CT scan findings and level of consciousness in patients following acute craniocerebral trauma. The aim of this study is to correlate the CT scan findings and level of consciousness and to observe the outcome of the patient with single and multiple lesions. MATERIALS AND METHODS The study was conducted in Department of Neurosurgery, Krishna Medical College and Hospital. All the patients presenting to the hospital with history of head injury and admitted to Department of Neurosurgery were included as study population. Of all patients admitted with head injury and polytrauma, a careful history was collected from the patient and/or attendants to reveal the mechanism of injury and the severity of trauma. The patients were then assessed clinically to evaluate their general condition and the local injury. Glasgow coma scale, Glasgow outcome score and CT findings were evaluated. Statistical analysis-The statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21 for Windows. RESULTS It was observed that majority of patients were in the age group of 21-40 years (55.65%) followed by 41-60 years (20%). The majority of patients were males (71.43%) and females were 28.57%. Patients had higher RTA incidences (72.40%) followed by fall (22.22%) and assault (5.38%). In the clinical findings, majority of patients presented with vomiting (67.20%) followed by loss of consciousness (38.74%). The other clinical presentation includes ENT bleeding (24.46%) and convulsion (18.34%). The history of alcohol consumed was given by 23.48% of patients. It was observed that majority of patients were having abnormal CT findings (80.74%) and only 19.26% patients had normal CT findings. The most common brain lesion among patients was cerebral contusion (46.74%) followed by subdural haematoma (22.11%), inter-parenchymal haematoma (12.34%), subarachnoid haemorrhage (14.17%), skull fractures (8.06%) and midline shift (30.28%). It was observed that majority of patients had mild injury (73.72%) followed by severe type (16.34%) and moderate injury among 174 (9.94%) patients. According to outcome of brain injury, the majority of patients had good recovery (73.89%). The death was observed among 198 (11.31%) patients. It was observed that epidural haematoma, subdural haematoma, inter-parenchymal haematoma, SAH and IVH showed statistically significant relation with level of consciousness, (p < 0.05). It was observed that pneumocephaly and midline shift showed statistically significant relation with level of consciousness (p ...
BACKGROUND Spontaneous intracerebral haemorrhage produces devastating neurological disability and is by far the most untreatable form of stroke. ICH is mainly managed medically. To date there are no studies to prove that surgery has better outcome in deep scatte red ICH than medical treatment alone. Stereotactic aspiration of haematoma and urokinase treatment is a minimally invasive method, which gives excellent radiological and good clinical outcome. This procedure is simple, less expensive and less invasive than formal craniotomy.
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