Study of cerebral perfusion by SPECT scanning in hydrocephalus: Pre and post shunt surgery

The study of cerebral perfusion by SPECT scanning using technetium-ethylene cysteine dimer [[99m] Tc-ECD] with dedicated brain radiotracers was performed in 28 patients, before and after shunt operation to predict the influence of various parameters with the increase in regional cerebral blood flow [rCBF]. Preoperative ventricle size was assessed according to the "Evan's criteria' and pre and post shunt SPECT images were compared qualitatively, based on colour coding to assess the rCBF in the area of interest. Eighteen patients were from paediatric age group and 10 were adults. Eleven patients were having congenital hydrocephalus and 13 patients with tumours. Moderate ventirculomegaly was observed in 20 [90.4%] patients with decreased ventricle size, as compared to 3 out of 7 [43%] patients whose ventricle size remained unchanged following VP shunt. The overall improvement in cerebral perfusion was observed in 22 [78.5%] patients. The important predictors of improvement in perfusion were duration of symptoms and decreased ventricle size in postoperative CT scanning, following VP shunt

Prognostic value of admission serum albumin levels in patients with head injury

Head injury is major cause of disability and death in the society, however no effective biochemical prognostic markers are available. To assess the prognostic significance of admission serum albumin levels in patients of head injury. Prospective cohort study with control group. Within 24 hours of head injury, 154 patients underwent serum analysis for albumin along with 38 normal volunteers, studied in relation to various factors and subsequently followed-up. Statistical analysis was made with SPSS software, p<0.05 was considered significant. Mean serum albumin in head injury and control were 3.24 and 4.15 g/dL respectively [p<0.001]. Admission albumin had significant positive correlation with Glasgow coma score [GCS] [p<0.001]. Hypoalbuminemia [

Post traumatic bilateral facial palsy causing severe psychosocial impairment

Bilateral facial palsy is a relatively uncommon condition and its early identification after head injury can be particularly challenging. It is often not realized that it can be also extremely debilitating in terms of psychosocial functioning. We report a 35-year-old male who fell down while trying to alight from a moving train and lost consciousness for 30 minutes. It was later during the course of his hospitalization for observation that his bilateral facial palsy was recognized. Due to poor feeding because of compromised oral function and inability in expressing emotions, he had significant impairment of psychosocial functioning. He was particularly concerned about his complete inability to smile and as a result, was reluctant to go back to work and socialize with friends

One-stage surgery for dorsal meningomyelocele and ACM Type II with stridor: a neurosurgical emergency

A 10-month-old female child, with a case of dorsal meningomyelocele and Chiari II malformation, presented with severe stridor and respiratory distress, needing mechanical respiratory support. Patient was taken for an emergency neurosurgical intervention. Combined surgeries of long segment laminotomy, foramen magnum decompression, and repair of meningomyelocele with insertion of a low-pressure ventriculoperitoneal shunt were performed in one sitting. Patient rapidly improved and was discharged on 10[th] postoperative day

Sellar-suprasellar hyperdense epidermoid

A 37-year-old male presented with insidious onset of painless progressive impairment of vision in both eyes for the last four months. A cranial computerised tomography scan revealed hyperdense mass in sella extending to suprasellar region. He underwent transsphenoidal decompression. Operative findings and subsequent histopathology study revealed epidermoid cyst. The difficulty in preoperative diagnosis and uncommon presentation is highlighted

Unusual presentation of retained bullet

We report a case of retained bullet in the intracranial cavity, in a patient who sustained a gunshot injury in 1989. patient developed features of hypothalamic dysfunction two years following bullet injury. He was admitted to our hospital thirteen years after injury with persistent hypothalamic disturbances and a tendency to fall towards the right side while walking

Pituitary adenoma with trigeminal neuralgia

Pituitary adenoma with parasellar extension ma invade into cavernous sinus leading to involvement of traversing cranial nerves, but isolated trigeminal neuralgia as a presentation of pituitary adenoma is very uncommon. We report a case of pituitary adenoma, presenting with intractable trigeminal neuralgia as the only complaint. The radioimaging study revealed pituitary macroadenoma. Symptoms completely disappeared following transsphenoidal decompression of the tumour