Biochemical changes in cerebrospinal fluid of patients with hydrocephalus developing after closure of fontanels

In order to throw more light on the biochemical changes in CSF of patients developing hydroccphalus after closure of the fontanelle.CSF samples were-obtained from 42 of those patients during insertion of shunt devices. Ten apparently normal young patients who underwent minor surgical procedure under spinal anaesthesia were selected as controls and CSF samples were taken from them before injection of anaesthestic agents.Total oxypurines, 5-hydroxyindole acetic acid [5-HIAA], lactate dehydrogenase [LDH], aspartate transaminase [AST], glutamate dehydrogenase and aryl sulfatase were determined in CSF of patients and controls. The levels of all indices were significantly increased in patients compared with controls. Patients with malignant aetiologies of hydrocephalus exhibited significantly higher levels of 5-HIAA. glutamate dehydrogenase and lower aryl sulfatase levels compared with patients due to benign causes mereover patients with infratentorial tumors had,significantly higher levels of 5 HIAA and glutamate dehydrogenase and insignificantly higher levels of total oxypurines and lactate dehydrogenase, but the levels of aryl sulfatase was significantly decreased. From the present work we can conclude that these indices can be used as indicators for the severity and outcome of hydrocephalic process as well as differential diagnosis

Outcome form severe head injury in upper Egypt

This study was conducted on 72 patients with severe head injury admitted to Assiut University Hospital during the period from June, 1987 to October, 1988. The cause of injury was outlined. Clinical assessment and continuous evaluation were done by Glasgow coma scale [GCS]. Patients with GCS more than 8 were excluded from this study. CT was the main investigatory aid for patients in this series. Patients with initial GCS 7 had better prognosis than those with initial GCS 5 or less, whereas those with initial coma scale "3" carried the worst outcome. As regards the CT findings, the worst outcome was in cases that showed diffuse brain continuations and/or lacerations [death rate 43.8%]. While cases with free C-T brain scanning showed the best prognosis [death rate 12.5%]. The total mortality rate in this series was 37.5%

Sequelae of surgical repair of myelomeningocele

This study included 42 cases of lumbosacral meningomyelocele, treated surgically in the neurosurgical department in Assiut University Hospital through a period of 1 year. All patients in this series were evaluated as regards the age of presentation, extent of malformation, neurological deficits, as well as the mortality and morbidty of surgical intervention and the neurological status after surgical repair