RESUMEN
Background: Chronic subdural hematoma [CSDH], a common type of intracranial hemorrhage and one of the most common clinical entities encountered in daily neurosurgical practice tends to occur in elderly patients
Objective: To determine the frequency and risk factors of chronic subdural hematoma recurrence after burr holes surgery
Patients and Methods: This descriptive cross sectional study was conducted in neurosurgery department Nishtar Hospital Multan from 1[st] January 2013 to 31[st] December 2013. All the patients diagnosed as CSDH, confirmed on computed tomography [CT] and treated by hematoma evacuation and drainage through cranial bur hole during the study duration were included in the study. Routine computed tomography [CT] was performed in all the patients, the day after the surgery, one week after the surgery, two months after the surgery and all the patients were followed up to three months after the surgery. Preoperative and postoperative CT findings were compared to calculate the recurrence rate. Data was entered and analyzed by using SPSS version 17. P-value = 0.05 was considered significant
Results: There were 72.64% male and 27.36% female patients. 78.31% patients were = 70 years age and 21.69% below 70 years. CT demonstrated CSDH as hypo dense to cerebral parenchyma in 49.05%, isodense in 29.24% and hyperdense in 21.71%. Recurrence of chronic subdural hematoma after the bur holes craniotomy was observed in 10.8% [12] patients. Major risk factors identified for recurrence were age = 70 years and re-expansion of the brain after the surgery
Conclusion: It is concluded that recurrence of chronic subdural hematoma after burr holes evacuation is directly related with age and re-expansion of the brain after surgery
RESUMEN
To investigate the frequency and patterns of Magnetic Resonance Imaging [MRI] for disk degeneration in adolescence and young adults, in lumbosacral spine. Cross-sectional study. This study was carried out at Department of Diagnostic Imaging in Nishtar Hospital, Multan during January 2012 to December 2012. One hundred patients presented with low back pain and were advised MRI, participated in the study. Demographics were assessed by using a questionnaire and their lumbar disk T2 maps were quantified via sagittal imaging protocols at 1.5T.MRI was reported by two radiologists separately. Data was analyzed by using SPSS [v. 16] as well as manually. P values less than 0.05 were considered significant. The frequency of disk degeneration was found to be 44%. Mean age of the patients was 19.47 +/- 2.19 years. Mean duration of pain was 6.93 +/- 1.49 months. Most patients [53%] have multilevel involvement with 3l% having disease at L4-L5 level. Other significant MRI findings included disc bulge [central 46%, paracentral 29%], thecal sac compression 75% and exiting nerve root compression in 54% along with ligamentus hypertrophy 19%. The statistically significant association [p < 0.009] between desicatory changes and nerve root compression and between Pfirrmann grades and radiculopathy [p < 0.01] were noted. Frequency of disco-vertebral degenerative disease is significant in juveniles presenting with low back pain. So, any patient especially with chronic low back pain should undergo MRI spine for early diagnosis of degenerative disease. Moreover multilevel involvement and signs of radiculopathy are also significant