No abstract

Background: Traumatic brain injury is common neurological emergency worldwide associated with high rates of morbidity and mortality. Marshall scoring system is one of the several scoring systems that uses initial computed tomography findings to predict outcome. This study aims to determine the role of Marshall scoring system in predicting early mortality in patients with Traumatic brain injury in Nepalese patient population.Methods: Patients admitted with diagnosis of Traumatic brain injury between August 2017 and July 2018 in our institution were studied prospectively. Clinical status of patient was noted and computed tomography scan of head was interpreted according to Marshall scoring system. Patients were monitored during the hospital stay and in-hospital mortality was correlated with different components of Marshall scoring system at discharge. Results: The most common cause of Traumatic brain injury was road traffic accident (45%). Severe Traumatic brain injury was noted in 17% of patients and commonest intracranial mass lesion was contusion (24%). Surgery was performed in 29% of patients. There was significant correlation between increase in Marshall score and mortality (p<0.001). Degree of midline shift (p<0.016), status of basal cisterns (p<0.001), and combination of mass lesions (p=0.005) were independent predictors of early mortality.Conclusions: Marshall scoring is highly reliable scoring system to predict early mortality in patients with Traumatic brain injury. Degree of midline shift, status of basal cisterns, and combination of mass lesions are independent parameters predicting early mortality in patients with traumatic brain injury.Keywords: Basal cistern; CT scoring system; marshall scoring system; traumatic brain injury

Intracranial complications of Chronic Suppurative Otitis Media(CSOM) are common. Brain abscess is the commonest intracranial complication. Traditionally, life threatening brain abscess was managed first and the causative otitis dealt later. However, with the aim of dealing with both at the outset, we have started treating these problems in the same anesthesia setting. Retrospective analysis of the consecutive patients treated simultaneously is presented.Nepal Journal of Neuroscience 13:19-22, 2016

Diastomatomyelia (DM) is a clinical condition in which the spinal cord is split into two portions by either a bony or a fibrous spur. Depending on the type of dural involvement, it is divided into type 1 and type 2. We recently came across a 9-month old child with a lumbar DM with syringomyelia who was managed successfully at our institute. We discuss the management of this patient in detail along with the description of its etiology, embryology, neurological manifestations, relevant investigations, and treatment implications to both patients and parents. To the best of our knowledge, this is the first case report of DM from Nepal in an infant with minimal symptoms.