Decompressive craniectomy for stroke : indications and results.

The role of decompressive hemicraniectomy in stroke victims is gaining popularity among neuroscientists as it is found to be beneficial in malignant infarction of middle cerebral artery (MCA) territory which results in massive edema and brain swelling. Recent articles have showed that this procedure not only reduces mortality but also improves the functional outcome. We report our experience of 32 patients, who underwent this procedure. We found a good outcome in patients in whom the procedure was done early and whose pre operative Glasgow coma scale (GCS) score was 8 and above. It offered no benefit in patients whose pre operative GCS was below 5.

CSF orbitorrhoea with tension pneumocephalus.

A seventy eight year old man sustained penetrating injury to right orbit about 15 years ago. Later he developed right orbital infection leading to phthisis bulbi. Two months before admission he developed CSF leak from the right orbit, tension pneumocephalous and meningitis. A rare case of CSF orbitorrhoea is reported here along with the discussion on mechanisms and management.