ABSTRACT
Objective@#Analysis of our traumatic brain injury data, reviewing current literatures and assessing planning valuable decision making in frontal sinus fracture for young neurosurgeons. @*Methods@#Hospital data base for head trauma was retrieved after board permission for retrospective analysis of cases admitted from 2010–2020. Patients with frontal sinus fractures and head trauma were identified according to a flow chart. Variables of the study included patients' demographics, mechanism of injury, incidence of cerebrospinal fluid (CSF) leakage, types of associated injuries, imaging findings and operative techniques. @*Results@#Three-hundred eighty two patients were eligible to be screened in our study and represented the sample size under investigations in the following sections, 206 (53.9%) of patients were treated conservatively while 176 patients (46.1%) were identified as having an indication for surgical intervention. Eighty-four percent of patients were males. The mean age was 36.2±9.4 years (14–86 years). Depressed skull fracture was commonly associated injury (17.61%). Leakage of CSF was found in 32.95% of patients. @*Conclusion@#Frontal sinus fracture is not an easy scenario. It harbors many proportions and deliver many varieties in which, deep understanding of anatomy, naso-frontal outflow tract status, CSF leakage and neurological injury are of important points in decision. Our institutional algorithm provide rapid, accessible and applicable treatment protocol for resident and young neurosurgeons which minimizes consultations of other specialties.
ABSTRACT
Background: for many years, posterolateral fixation for lumbar spondylolisthesis by using pedicle screw has been the standard procedure for lumbar spondylolisthesis. For increasing fusion and anterior support, the interbody fusion, either with cage or bone, were used by many surgeons, one of the most disappointing complications of pedicle screw fixation is broken screw
Aim: it was to compare the number of cases with a broken screw in case of interbody fusion and control group
Patients and Methods: This is retrospective cohort study in six years comparing between two groups: Group I posterolateral fixation [PLF], Group II posterolateral interbody fusion [PLIF]. it analyzed 26 cases of broken screw occurred in six years from 2010 to 2016 which were done in Nasser Institute by the same surgeon and same system
Results: twenty-six cases were reviewed, the mean age was 44.6 years, female : 6/26 [23%], male : 20/26 [77%],mean weight: 74.8 kg, site for broken screw: [L1: 4 patients - L2: 2 patients - L3: 2 patients - L4: 4 patients - L5: 6 patients - S1: 8 patients], 6 patients had broken screws following trauma, while 20 patients were found spontaneous, all patients were found intraoperatively to have posterolateral fixation, they underwent redo screw fixation,18 patients underwent redo screw fixation with posterolateral interbody fusion [PLIF] while the other 8 patients underwent redo screws fixation with posterolateral fixation. All patients with PLIF didn't come back with broken screws, while 2 patients with posterolateral fixation came back with broken screws again
Conclusion: posterolateral interbody fusion [PLIF] may have a rule in preventing broken screw in the management of lumbar spondylolisthesis
ABSTRACT
Background: Etiologies of hydrocephalus are many and sometimes it can be attributed to be multifactorial in origin. Presence of known cause of hydrocephalus like fourth ventricular pathology may mask foramenal stenosis. Diagnosis of unilateral and bilateral stenosis of foramen of Monro should be included in the treatment plan in hydrocephalus. A case report of a 9 months-old boy presented with delayed milestones of development and an increase in head circumference. The patient has been diagnosed as hydrocephalus and associated Dandy-Walker malformation. Ventriculoperitoneal shunt was inserted successfully but drained only one lateral ventricle. The association of isolated lateral ventricle with Dandy-Walker malformation is due to stenosis of foramen of Monro. Our case report is unique due to association between foramen occlusion and Dandy-Walker malformation