Factors affecting mortality extradural haematoma

In a prospective study to analyze the affects of various factors on mortality from extradural haematoma, 100 consecutive patients presenting to the department of neurosurgery Lahore General Hospital were studied. The long distances patients had to travel and the time spent to reach our hospital was calculated. Forty seven% patients belonged to the 2nd and 3rd decades and males were 91%. The over all mortality was 23%. A delay in surgery was the primary cause of this high mortality. It was seen that the better pre-operative GCS and conscious level, were associated with better outcome. Associated intradural lesions and old age worsened the prognosis. Avoidable errors in management and post-operative systemic complications also claimed some lives

Intracr anial fungal granulomas: therapeutic considerations

Intracranial fungal granulomas are a rare entity. Extensive search of the national and international literature has revealed few reports. Despite newer imaging techniques and advancements in surgical and medical therapy, mortality remains very high. Delay in diagnosis due to non-specific presentation, failure to achieve complete surgical removal and delayed institution of antifungal therapy may be the contributing factors, however other factors need to be determined. Recently we have encountered three cases of fungal granulomas and observed that unlike other intracranial tumors, fungal granulomas do not distort the parenchymal architecture. The leave a tendency to spread along the base from one lobe into the other. These features may help to make a pre-operative diagnosis, proper surgical planning, early institution of antifungal therapy and may lead to a decrease in mortality rates