ABSTRACT
Background & objectives: Cerebral contusion (CC) results in a release of catecholamines, autonomic dysfunction and neural stimulation that can lead to a number of cardiac adverse events, so it is critical to determine these. So the objective of this study was to investigate the prognostic significance of electrocardiographic changes, particularly the effects of a prolonged corrected QT (QTc) interval in CC. Methods: In this retrospective cohort study, 110 patients with CC were evaluated. Age, sex, concomitant diseases, Glasgow Coma Scale on admission, radiological assessment of the contusion (location, size, course and presence of cerebral oedema), need for surgical intervention, length of hospital stay and the extended Glasgow Outcome Scale (GOS-E) were statistically analysed within the QTc interval by routine electrocardiography (ECG) on admission. Results: The prolonged QTc interval was found to be associated with a higher incidence of cerebral oedema and a significantly higher risk of needing surgery. Patients with a prolonged QTc interval had a significantly larger contusion volume, greater midline shift and longer hospital stay, so their GOS-E score was significantly lower. A prolonged QTc interval on admission resulted in a hospital stay of more than eight days (sensitivity: 0.97 and specificity: 0.86), a higher risk of midline shift of more than 0.45 cm (P=0.006, sensitivity: 0.80 and specificity: 0.99) and a GOS-E score of <7 (sensitivity: 0.97 and specificity: 0.85). Interpretation & conclusions: ECG changes on admission showing a prolonged QTc interval have prognostic significance in CC. This simple and easily applicable information should be taken into consideration at the time of clinical decision making which may prevent an adverse events survivor.
ABSTRACT
AIM: To reveal the relation between postdiscectomy syndrome and foraminal stenosis due to height loss of disc level in patients operated for one-sided L5-S1 disc herniation. MATERIAL AND METHODS: 100 operated patients due to L5-S1 one-sided disc herniation were included. Mean age was 46.60 years (±10.52 years). Foraminal height, width, and intervertebral disc height were measured via CT. The diameters were compared preoperatively and postoperatively. The relation between the measurements and clinic findings was investigated. RESULTS: Six months after discectomy, for the operated side, the mean foraminal height decreased from 16.78 ± 1.75 mm to 14.43 ± 1.62 mm (p 0.05) and the mean foraminal width decreased from 6.30 ± 1.43 mm to 5.34 ± 1.56 mm (p 0.05). According to the correlation test, for the operated side, a statistically significant relationship was observed between the decrease in foramen height and leg pain visual analog scale (VAS) score. Moreover, a statistically significant relationship was observed between the decrease in the posterior side height of the disc level and the leg pain VAS score. CONCLUSION: Overall, after microdiscectomy, as the height of the foramen decreased, leg pain also increased. Moreover, the decrease in the posterior side height of the disc level was associated with an increase in leg pain. Therefore, over time, the collapse of the disc distance decreases the foramen height, which causes leg pain. After microdiscectomy, in patients whose leg pain was relieved at first but started again after a time, the foramen and disc level diameters should be checked.
