Chondroma of cerebral falx: a rare intracranial diagnosis

Chondromas are benign tumors which mostly occur in extremities but also sometimes in the cranium. Intracerebral chondroma is rare condition. Most intracranial chondromas arise from skull base, but chondroma of falx origin is a rare entity and mostly occurs in relation with syndromic disorders such as Mafucci's syndrome or Ollier's syndrome. Here, we report a rare case of falcine intracranial chondroma in a young man who presented with headaches and weakness of lower extremities and no signs of any syndromic disorder. The purpose of this case report was to raise awareness about intracranial chondromas. Chondroma should be considered in the differential diagnosis of calcified masses arising from the falx

Aneurysmal subarachnoid haemorrhage: outcome of aneurysm clipping in elderly patients and predictors of unfavourable outcome

To determine the outcome of treatment of microsurgical clipping in elderly [60 - 70 years] patients with aneurysmal subarachnoid hemorrhage and determine the predictors of poor outcome. Longitudinal analytical study. Nishtar Hospital, Multan, Mayo Hospital, Lahore, Department of Neurosurgery, Lahore General Hospital, Lahore, from January 2000 to January 2010. Elderly patients [60 - 70 years] with ruptured cerebral aneurysm were enrolled and graded on the basis of World Federation of Neurosurgeons Scale [WFNS]. Aneurysm sac obliteration was done in all the patients with microsurgical clipping. Postoperatively, the patients were assessed upto 3 months for outcome parameters i.e., neurological deterioration [based on WFNS grade and modified Rankin scale as favourable [mRS score <-2] and unfavourable [mRS score > 2]. The factors associated with unfavourable outcome were also noted which included age > 65 years, poor initial WFNS grade, and the occurrence of ischaemia. The mean age of the 48 patients was 65 +/- 5.45 years. There were 31 [64.6%] male and 17 [35.4%] female patients. Postprocedural neurological deterioration occurred in 23 patients [47.9%] related to ischaemia in 14 [29.16%], rebleeding in 1 [2%], and hydrocephalus in 8 [16.66%]. At 03 months, the outcome was favourable in 25 patients [52.08%] and unfavourable in 23 [47.91%]. In old patients, careful pre-operative assessment, interdisciplinary approach and meticulous tissue handling during aneurysm clipping may decrease the unfavourable outcome

Anterior cage fixation for dorsal spine injuries - one year study

This study was conducted during the year 2004 at Lahore General Hospital, Unit 1, department of Neurosurgery. We operated on 37 patients for thoracic cage interbody fixation after trauma. Age range was from 15 to 70 years. Maximum number of cases [41%] was between 21-30 years of age. Male involvement was seen in 29 [79%] patients. Majority [65%] belonged to rural community and agriculture and industry were the major setup of injury. Majority belonged to poor socioeconomic class i.e., 83% [31]. Level of injury was 37% upper dorsal spine, Main fracture types were burst fractures, compression fractures and fracture dislocations. Correction of deformity was achieved in majority of cases. Associated chest injuries were seen in 28% cases. Timing of surgery was as early as possible but it ranged from 2 hours to as long as 3 months. Neurological deficit ranged from complete paraplegia to power grade 4. Complications of the procedure are cage displacement in 6%, loosening in 5% and infection in 8%. Neurological statu s improved in 88% while kyphosis improvement occurred in 77% of the patients. Anterior cage fixation is a safe and effective treatment method for traumatic dorsal spine instability involving vertebral bodies