ABSTRACT
Background: There is no consensus in the literature on the effects of the development of hydrocephalus on survival and disability after intracerebral haemorrhage (ICH) and the benefits of external ventricular drainage (EVD). This study is planned to describe the role of external ventricular drainage in treating patients of spontaneous, either primary or secondary, intraventricular haemorrhage with hydrocephalus.Material & Methods:A hospital based prospective interventional study was conducted in the Department of Neurosurgery of Dhaka Medical College Hospital, which is a tertiary level hospital, from April 2016 to September 2017.Total 42 patients of spontaneous intraventricular haemorrhage, either primary or secondary, with hydrocephalus were selected for this study. All the collected data were entered into IBM SPSS software, Version 24. For statistical analysis, paired t-test to compare the preoperative GCS with postoperative GCS at 24 hours was done.Results:Among 42 patients, age range was 26-75 years with the mean age 65.2 � 10.87 years. Male were 26 (61.9%) and female were 16 (38.1%). Male-Female ratio was 1.625:1. No patient needed conversion of EVD into VP shunt. EVD drain became blocked in 5 cases which were managed accordingly. 5 patients developed ventriculitis among which 2 patients died and rest 3 improved with antibiotics.Conclusions:The results of present study shows that EVD has a good role in the treatment of spontaneous IVH with hydrocephalus when ICH volume is low (<30ml) and modified Graeb Score is low (?10 found in this in this study. Preoperative higher GCS or initial improvement in GCS or initial improvement in GCS at 24 hours positively correlates with Glasgow outcome scale which is an indication of good function outcome.
ABSTRACT
Objectives: The study was designed to evaluate the role ofMagnetic Resonance Imaging (MRI) to localize andcharacterize the MR imaging features of cerebellopontineangle (CPA) schwannomas and to compare withsurgical/histopathological findings.Methodology: Thirty eight patients of clinically suspected &MRI diagnosis cases of CPA Schwannoms were selected inthis cross sectional study in different places of Bangladesh{Mymensingh Medical College Hospital Mymensigh, Sher-EBangla Medical College Hospital, Barisal, Popular DiagnosticCentre Gazipur & Lab Aid diagnostic Centre Barisal. Surgery ofall MR diagnosed cases were done in Dhaka Medial CollegeHospital & National Institute of Neuroscience Hospital, Dhaka}during the period from April 2008 to August 2019. All patientsincluded in the study were subjected to detailed clinical historyand physical examination following which MRI was carried outon 1.5 Tesla & 0.3 Tesla MR machine and the standardprotocol consisted of T1WI, T2WI, DWI and FLAIR images inaxial, sagittal and coronal planes.Results: MRI was erroneous in giving provisional diagnosis ofschwannoma in two cases, which on subsequent surgery andhistopathology was found to be a meningiomas. The sensitivityof MRI for correctly diagnosing vestibular schwannoma was100 % and specificity was 92.86 % with a positive predictivevalue of 94.12 % and accuracy of 96.67 %. MRI is consideredas an excellent noninvasive investigation for CP angleschwannoma’s. It can identify the site and extension of thelesions as well as the characteristic signal.