Management of occipital encephalocele

The clinical records, hematological and radiological investigation and operative notes of five patients [four females and one male] operated on were done. All cases were full-term newborns with a weight ranging from 2.270 to 3.552 g. The patients' mothers mean ages were 24.4 years [19-32 years]. A surgical intervention was done for all cases, an elliptic skin incision surrounding the occipital encephalocele was made along a vertical axis. The ellipse was performed narrow enough to allow skin closure at the end of the procedure, but broad enough to resect the total of the encephalocele. Ventriculo-peritoneal shunt operation was done for three cases that had hydrocephalus, but the other two cases had no hydrocephalus and did not develop after the operation. All cases discharged without any neurological deficit

Treatment of subdural empyema

The clinical records and the hematological, biochemical and radiological investigations as well as the operative notes of 11 patients operated upon for subdural empyema were evaluated. The most common sites of primary infection were the paranasal air sinuses in five patients, the middle ear infection in three patients, complications of meningitis in two patients and no apparent source could be identified in one patient. With an early diagnosis by contrast-enhanced CT and urgent surgery, excellent results can be achieved by burr hole placement or small craniotomy and this approach was recommended as an easy and safe choice

Study of abnormal coagulation profile in brain tumor patients during surgery

The perioperative time pattern of routine coagulation parameters and the specific hemostasis activation marker D-dimer in 24 consecutive patients [nine females and fifteen males] undergoing elective surgery for brain tumor removal were estimated. Computerized tomography scans and/or nuclear magnetic resonance images were routinely obtained preoperatively to detect tumor size, location and intracranial bleeding. Blood samples were drawn at baseline one day before surgery and again after the scalp incision was closed as well as one and seven days postoperative in 1: 10 volume of 3.8% Na, citrate, centrifuged at 2200G and C and the supernatant plasma was apportioned. Prothrombin time [PT], aPTT and fibrinogen were measured on a coagulometer and fresh samples of antithrombin III [AT III] on analyzer. Levels of cross-linked fibrin degradation products [D- dimer] were measured by enzyme-linked immunosorbent assay from thawed samples stored at -70 C for a maximum of two month