ABSTRACT
OBJECTIVE: Patients of Chronic subdural haematoma can present with only subtle cognitive impairment without any motor deficit. It is hence imperative for the treating clinician to be aware of this entity. The aim of the study was to identify any statistically significant improvement of cognitive functions following burr hole evacuation of Chronic SDH especially in the elderly patients. METHODS AND MATERIAL: A Prospective observational study of 30 patients of CSDH, from Jan 2015 to Dec 2016 was done at a tertiary level Armed Forces Hospital. The study had 23 male, 07 female, with age ranging from 7-85 years. The cognitive function of each patient was assessed at admission and 24 hours after surgery by MMSE. Radiological confirmation was done by CT head. Standard two burr holes were made and hematoma evacuated. The clinical, cognitive assessment and radiological data were collected and analysed. RESULTS: There was no statistical significance preoperatively between age and pre operative cognitive impairment, headache, hemiparesis, dysarthria (P>0.05). We however found a statistically significant improvement postoperatively in cognitive impairment, headache (P= 0.00), motor deficit (P=0.01) and dysarthria (P=0.046). CONCLUSION: The clinical features of dementia and other neurodegenerative disorders simulate CSDH in the geriatric population. These patients should have early neuroimaging and prompt surgical intervention to alleviate cognitive deficits.
ABSTRACT
Prostate carcinoma presenting as symptomatic metastases to atlantoaxial spine is extremely rare. Spastic quadriparesis due to pathological fracture of odontoid as the only initial manifestation without symptoms of primary malignancy is rarer still. We report a 64-year-old male who presented with progressive spastic quadriparesis along with urinary retention of 3 weeks duration. Computed tomography and magnetic resonance imaging cervical spine and craniovertebral junction showed type III pathological fracture of odontoid with anterior translation of C1 with spinal cord compression. Biopsy from an enlarged prostate showed adenocarcinoma of prostate. The patient was managed conservatively from neurological aspect as he refused for any surgical intervention.
