Association between ECG Abnormalities and Severity of Intracranial Lesions - Hospital based Study

Introduction: Severe strokes, particularly subarachnoid bloodloss is frequently seen with a variety of electrocardiographicalterations. Also, various primary cardiac conditions, likemyxoma, endocarditis, mural thrombus and atrial septal defectalong with deep vein thrombosis, could also lead to cerebralemboli; heart block, arrhythmias and decrease in cardiacreturn, that may lead to cerebral ischemia. The present studywas conducted with the aim to determine association betweenECG abnormalities and intracranial lesions.Materials and methods: The present prospective studyincluded 50 subjects with raised intracranial pressure ofvarious intracranial lesions admitted to the Rajindra hospitaland visiting OPD of medicine/ neurology department. Astandard 12 lead ECG consisting of three bipolar limb leads,three unipolar limb leads and 6 unipolar chest leads was taken.ECG was first recorded within 24 hours of hospitalization andthen repeated on alternate days during first week and thereafterweekly till discharge. Probability value of more than 0.05 wasregarded as non significant.Results: There were only 1 case of p wave variationamongst 21 patients of CVA. There was no case of P wavevariation amongst patients of meningitis, ICSOL, TIH andhydrocephalous. There were 20% (n=10) cases with STsegment abnormality and rest 80% (n=40) did not demonstrateany ST segment abnormality. There were 3 cases of CVA outof 21 that had abnormal T wave. 1 out of 6 cases of meningitishad abnormal T waveConclusion: In our study, p wave, q wave showed nosignificant difference in intracerebral lesions. There were only20% cases with ST segment abnormality

Endoscopic Third Ventriculostomy in Hydrocephalus: An Institutional Experience in Tertiary Care Centre

Introduction: Hydrocephalus is a clinical condition in which anexcess of CSF fluid accumulates within the ventricular systemof the brain. The treatment of hydrocephalus depends onpatient’s clinical condition and etiology. Neuroendoscopy isbecoming more widely used for diagnostic and therapeuticpurposes of many different conditions including treatment ofhydrocephalus.Materials and Methods: This prospective study of 52 patientswas carried to analyze the safety and efficacy of EndoscopicThird Ventriculostomy (ETV). 24 cases of obstructive and 28cases of communicating hydrocephalus underwent ETV.Results: Most (43%) of the patients were less than 10 years ofage. 59% of patients having obstructive hydrocephalus andonly 28% of patients having communicating hydrocephalus hadgood outcome.Conclusion: ETV should be considered as first line oftreatment in patients of obstructive hydrocephalus.

Epidemiological Analysis Of Ventriculoperitoneal Shunt For Hydrocephalus

AIM: To identify the spectrum of patients for whom cereospinal fluid diversion is done and to study the pattern of presentation based on clinical criteria and symptomatology and radiological investigation . To study the indications for the ventriculoperitoneal shunt and the further course in the hospital from admission to discharge including the complications in the study period designated from January 2013 to December 2014 which spans 2 years and followed up the cases for around 6 months. OBJECTIVES : To study the indications of the cereospinal fluid diversion procedure and the course of the patient from the time of admission to discharge. This includes the presenting symptoms, radiological investigation, the admitting GCS (Glasgow Coma Scale) , cereospinal fluid study and the condition at discharge and complications . MATERIALS AND METHODS : It is a retrospective and prospective analysis of 100 patients in a tertiary care centre from January 2013 to December 2014 for a span of 2 years. OBSERVATION AND RESULTS:Out of the hundred patients who underwent ventriculoperitoneal shunt 59% were done among paediatric patients and 41% were done on adult patients and 77% underwent emergency ventriculoperitoneal shunt and 23% underwent elective VP Shunt. There is no significant short term outcome difference based on the side of shunt (either left or right). CONCLUSION : The incidence of hydrocephalous appears to be more in the paediatric population. Early emergency shunting of hydrocephalous carries good prognosis especially if the admitting GCS is 12 or above.