ABSTRACT
Objective: to know about the impending pathology in microvascular decompression for idiopathic trigeminal neuralgia
Methodology: this was a prospective observational study conducted in the Department of Neurosurgery, Lady Reading Hospital Peshawar, from 20[th] August 2012 to 25[th] august 2013. The clinical and the operative records of the patients were noted and demographics such as the age, sex, side of the lesion as well as the per-operative impending pathology i.e. compression by an artery, vein or distortion by adhesions or a combination of them compressing upon the trigeminal nerve root was recorded on a predesigned proforma. All patients undergoing surgery for idiopathic trigeminal Neuralgia were included in the study. Patients who had trigeminal neuralgia secondary to a mass lesion were excluded from the study. The data was expressed in percentages and was analyzed through SPSS version 16
Results: total of 55 patients in the study period fulfilled the criteria. There were 28 males and 27 females with a male to female ratio approaching 1:1. The age range was from 28 to 73 years with a mean age of 54.6 years. In 56.4% the pathology was right sided and in 34.5% it was left sided while in 9.1% it was bilateral [operated unilateral at the time]. The impending pathology was compression by an artery in 76.6%, by a vein in 21.6% or purely by adhesions in 1.6% of cases
Conclusion: compression by an artery is the most common pathology en-countered in the microvascular decompression for trigeminal neuralgia
ABSTRACT
Objective: to assess the frequency of intramedullary spinal cord tumours based on clinical and histological features
Materials and methods: this descriptive study was performed at the Department of Neurosurgery Lady Reading Hospital Peshawar, from 20[th] Jan 2003 to 19[th] Jan 2009. Treatment charts of patients with spinal tumours were reviewed and patients operated for spinal tumours were identified. A total of 30 patients out of 480 cases of spinal tumours with different intramedullary spinal tumours were considered in this study. Their frequency, clinical features, and histological reports were analyzed in different aspects
Results: there were total of 30 patients with mean age of 36 years and a wide range beginning as young as 6years. Seventeen patients [56%] were male and 13[43%] were female. Common presenting complaints were loss of sensation in 24 patients [80%], paresis in 20 patients [66%], altered sensation in 12 patients [40%], back pain 11 patients [36%] and sphincteric disturbances 9 patients [30%]. MRI spine was the main diagnostic tool and was done in 30 [100%] cases. Cervical spine was involved in 12 patients [40%], cervicothoracic 6 patients [20%], thoracic 10 patients [32%], conus 2 patients [08%]. Ependymoma was the most common intramedullary spinal cord tumour 20 patients [60%], while 07 [21%] patients had astrocytoma and 03[09%] had haemangioblastoma. We had follow up of 1 year with follow up visit after every 3 months. Superficial wound infection in 2 [6.66%] patients, CSF leak in 3[10%] cases.Worsening of neurodeficit in 3[10%] patients
Conclusion: ependymoma and astrocytoma constituted majority of cases. Intramedullary spinal cord tumours peak during 3[rd] to 4[th] decade of life
ABSTRACT
To determine the frequency of different levels of spinal involvement in patients operated for spinal tuberculosis. This observational study was conducted in the Department of Neurosurgery Lady Reading Hospital Peshawar from January 2008 to December 2010. In this study medical record of all patients operated for spinal tuberculosis were analyzed. The frequency of different spinal levels involved was determined. Patients were divided into five groups based on the involvement of different vertebral level i.e. cervical, upper dorsal, lower dorsal lumbar and sacral. Data stratified regarding age, sex and locality. Results were analyzed and presented in the form of tables, bar and pie charts by using SPSS software version 11 for analysis. A total of 81 patients with spinal tuberculosis were operated during this period. Their age ranged from 13 to 65 years. Patients presented with male to female ratio of 1.25 to 1. Per-operatively majority of the patients [i.e., 49.38%] had involvement of lower dorsal spine [D7 to D12], while 19.75% had involved cervical vertebrae, 22.22% involved upper dorsal spine that is from D1 to D6 while only 8% had lumbar vertebrae involved. Most of the patients had multilevel involvement, which is 70.37%. This study shows that most of the patients with spinal tuberculosis involve lower dorsal spine while lumbar area in very little and no sacral area involvement. We found that most of the time it was multiple level involvement rather than single vertebrae