No abstract

The reported incidence of post-traumatic hydrocephalus (PTH) in literature varies from 0.7?29%. It is a treatable complication of head injury and presents with different clinical syndromes. We manage 38 cases of post-traumatic hydrocephalus in our hospital between January 2009 and April 2010. Clinicoradiology was studied at initial trauma, and at presentation with symptoms suggestive of increased ICP. Post ventriculo-peritoneal shunt outcome was analyzed. Sixty-eight percent cases were of severe head injury. Contusions (73.6%) and SAH (50%) were the most common CT findings. Sixty-five percent cases had been managed by decompressive craniectomy at the time of initial injury. Deterioration in consciousness (57.8%) and hemiparesis (26.3%) were most common presenting features of PTH, usually after 65?38 days (mean?SD) of initial injury. Patients were managed by antibiotic impregnated ventriculo-peritoneal shunt. Shunt revision and infection rates were 18.4% and 12.8% respectively. Thirty cases (78.9%) improved, 2 (5.2%) showed no improvement and 6 (15.7%) died. PTH is a treatable complication of head injury with a favorable outcome and therefore should be aggressively managed by CSF shunting.

Background: Aneurysmal bone cysts are rare occurrences in the cervical spine. Surgical treatment in pediatric patients is a challenge. Complete tumor resection offers the best chance for cure.Description: Diagnosis and surgical management of an expansile aneurysmal bone cyst of the cervical spine involving all three spinal columns in a 10-year-old boy.Results: Surgical treatment included tumor excision and circumferential fusion, and produced no neurological or vascular sequelae. This approach minimizes the risk of recurrence and the possibility of postoperative spinal instability.Conclusion: Spinal instability is preferably addressed with reconstruction and stabilization. Cervical aneurismal bone cyst lesions are ideally treated with complete resection to minimize the chance of recurrence. In pediatric cases, defects created by resection should be corrected by fusion to minimize the risk of postoperative instability and growth abnormality.

Background:Ganglioglioma is a common seizure associated tumor. The goal of this study was to observe the postoperative outcome in patients with gangliogliomas.Material and Methods:A total 24 patients with gangliogliomas who underwent surgery at our institute from 2008 to 2011 were included. There were 13 males (54%) in our study. A retrospective analysis for the demographic profile, surgery and outcome was performed using STATA software. Literature on this subject was also reviewed, MEDLINE and PUBMED databases were searched.Observations:Sixteen patients presented with signs and symptoms of raised intracranial pressure and 12 patients had seizure disorder. Average age at surgery was 20 years (range 7-50 years). Twelve each were located in the temporal lobe and extra-temporal location. Intra-operative electrocorticography (ECoG) alone in three and image guidance alone were used in two patients, respectively. Both ECoG and image guidance were used in one patient and none of them was used in 18 patients. Gross total resection was achieved in 17 patients. After a mean follow-up of 1.6 years (range 3 months to 2.5 years), out of 12 patients with preoperative seizures, 10 (83.3%) were seizure free (Engel class-I) and 2 (16.6%) belonged to Engel class-II. None of the factors, including age at surgery, seizure duration prior to surgery, type of seizures, use of intra-operative ECoG and image guidance, extent of tumor resection, and surgical strategy proved to have significant correlation with postoperative seizure outcome.Conclusions:Surgical treatment is effective and safe for patients with gangliogliomas. Neither intra-operative ECoG nor image guidance necessarily leads to better seizure control, although they are useful adjunct for achieving safe and complete tumor resection.

Authors present an unusual case of anal extrusion of peritoneal end of ventriculo-peritoneal shunt in a 2-year-old male child. Pertinent literature is reviewed regarding this rare complication of a very commonly performed neurosurgical procedure.