Study of Generalized Anxiety Disorder in Traumatic Brain Injury.

Objective: This cross-sectional study was design to investigate prevalence and risk factors of generalized anxiety disorder in traumatic brain injury (TBI). Materials and Methods: The Group studied consists of 204 patients of mild and moderate TBI between 14- days to one-year post injury. Demographic characteristics of the participants were assessed on a self-designed semi structured performa. Interviews focused on assessment of severity of TBI, generalized anxiety disorder (GAD) and quality of life (Qol) using GCS, GAD-7 and WHOBREF-QOL respectively. Results: Total 204 patients were included. 11.76% participants were found to have generalized anxiety disorder. None of the demographic variables were associated with GAD except injury severity. Mild TBI patient (75.00%) had higher occurrence of GAD than the moderate cases (25.00%). GAD patients also had poor Qol than those without GAD in all domains except physical and social health domain. Neuroanatomical localization was also correlated with GAD. Left frontal contusions were the most common (37.50 %) lesions associated with GAD. Conclusion: GAD is commonly associated, yet under diagnosed clinical entities in head injury and have tremendous impact in overall outcome measures. Every patient of head injury warrants psychiatric evaluation and concomitant treatment if required to ensure the attainment of not only neuroanatomical intact but overall productive and qualitative life vindicating the holistic and multidisciplinary treatment approach.

Medulloblastoma in adults--clinical observations and results of treatment.

Ten cases of medulloblastomas, in patients above the age of 15 years, were treated during a 11 year period. These constituted 18 percent of all medulloblastomas and 1.2 percent of all primary brain tumours in adults during the same period. The majority of patients (80%) were between 16 and 25 years of age, and 80 percent were male. Half the patients presented within three months of the onset of symptoms. The usual clinical presentation was with features of raised intracranial pressure and cerebellar involvement. A lateral location of the tumour and its desmoplastic variant were common. Three patients survived more than five years. The desmoplastic variant and a gross total resection of the tumour favourably affected the prognosis. Posterior fossa recurrence was the chief cause of therapeutic failures. All the recurrences developed within three years of the initial diagnosis, and were fatal within six months of their detection.