Objective:  The most prevalent type of skeletal TB, which accounts for nearly half of all cases, affects the spinal column. Regarding pain, neurological deficit, and spinal instability, the study sought to determine the surgical outcome of spinal tuberculosis. Material and Methods:  This study was conducted in the Department of Neurosurgery, Ayub Teaching Hospital. A total of 42 patients with ages ranging from 24 – 66 years were included in the study. Information about the patient was gathered to determine indications (neurological impairments) about the ASIA Grading Scale and frequently affected areas. Results:  Commonest location was a thoracolumbar junction in 42.8%, followed by the lumbar spine in 23.8%. The pain was found in all subjects. The main indication of surgery was neurological deficit which is seen in 57% of patients followed by spinal instability or deformity in 16.6% of patients and patients with failed chemotherapy in 4.7% of patients. The preoperative KA was between 30 – 60º with a mean of 43.06 ± 4.11 degrees and 9.45 ± 3.99 degrees for postoperative KA (p-value < 0.0001). Most fixations of the cord were done through a posterior approach that was in 83.3% of patients. The neurological improvement according to ASIA grading was seen in 95.2% and no improvement was seen in 4.7% of patients upon 3 months follow-up. Conclusion:  Surgical treatment of the caries spine improves pain, lowers neurological compression, and successfully reverses deformities like kyphosis, resulting in better clinical results. It also helps to remove the Tuberculous burden from the body.

Objective:  The study compared the postoperative back pain VAS score in bilateral interlaminar and classic laminectomy techniques in patients with lumbar canal stenosis. Material and Methods:  This randomized controlled experiment was carried out at Ayub Teaching Hospital's Neurosurgery Department. 30 patients were in the bilateral interlaminar (BIL) group (A) and 30 were in the traditional laminectomy group (B). The bilateral interlaminar decompression technique was carried out utilizing the operating microscope. Both groups employed facet joint undercutting to reduce the 61-facet joint excision. All patients had postoperative CT scans to assess how well the decompression went. Postoperative VAS score was stratified to age, gender, duration of complaints, and duration of the procedure. Results:  In group A, the mean age of patients was 51.10 years while in group B, the mean age was 54.500 years. There was a male dominance of male patients in both groups. The baseline mean VAS score was 7.9 in group A and group B both. The duration of the procedure was 71.2 minutes in group A, and 104.7 minutes in group B. Mean postoperative VAS score was 5.4 in group A and 3.3 in group B. There existed a significant difference in mean postoperative VAS scores between groups concerning gender, the duration of complaints, and procedures. Conclusion:  In patients with lumbar canal stenosis, bilateral interlaminar allows for safe and adequate spinal canal decompression. Keywords:  Lumbar canal stenosis (LCS), Bilateral Interlaminar (BIL), Classic Laminectomy, Visual Analog Scale (VAS).

Introduction/Objectives: Th e central idea of our presentation is MCI -a conceptual and pathological entity defi ned by Petersen et al. in 1995 and still under debate, surrounded by a sustained attention mainly because it is a stage where suitable medical and nonmedical interventions could potentially be more successful by comparison with later stages in which the changes are more and more dramatic and less susceptible to be amended.Participants, Materials/Methods: Th e fi rst part of our paper attempts the actual issues of the debate upon MCI concept: its usefulness, defi nition, etiology, clinical appearance and evolution, heterogeneity of the assessment scores, scales and criteria of defi nition, conversion predictors, cohorts under study, research outcomes, treatment algorithms etc., as well as to its position in the aging and cognitive pathology matrices. As practical topics, the diff erential diagnosis, prediction, the epidemiologic and risk factors and the drug and non-drug, preventive and curative interventions are also called into discussion. A special attention is paid to the exceptional high complexity of biological and functional changes that determines the MCI heterogeneous appearance.Results: Th e outcomes of our epidemiological, risk factors and the rate of conversion to Alzheimer's Disease studies in a cohort of MCI patients, as part of the EADC's DESCRIPA Project, are also overviewed. Conclusions:Th e main conclusion is that the heterogeneities related to MCI could potentially be overcome by defi ning "clusters" of neuro-pathological, neuro-psychological and functional changes to be monitored in their dynamics, aside to the requirement of "personalized attempt" and ethical issues concerning MCI patients' evaluation and therapeutic intervention design. Introduction/Objectives: Disorders of consciousness is frequent in the acute stroke. Determine the severity of stroke and mortality in relation to the type of disturbance of consciousness in patients in the acute phase of stroke. OUTCOME OF PATIENTS WITH DISORDERS OF CONSCIOUSNESS IN ACUTE STROKEParticipants, Materials/Methods: We retrospectively analyzed 201 patients with acute stroke at the Department of Neurology, University Clinical Center Tuzla, in the period from July 1st to December 31st 2008. Th e stroke was confi rmed in all patients by computed tomography within 24 hours after hospitalization. Disorders of consciousness are divided into quantitative and qualitative. Assessment of disorders of consciousness is performed by Glasgow Coma Scale1 and and the Diagnostic and Statistical Manual of Mental Disorders -Fourth Edition2 after admission. Th e severity of stroke was determined by National Institutes of Health Stroke Scale3. Results: Fifty-four patients had disorders of consciousness in acute phase of stroke (26.9%). Patients with disorders of consciousness on admission (19.9 ± 9.5 vs. 7.9 ± 5.1, p < 0.001) and discharge (11.4 ± 10.5 vs. 4.3 ± 3.9, p = 0.003) had a more severe stroke than patients without disturbances of consciousness. Th...

Background/Objectives:  Chronic subdural hematoma commonly reported in neurosurgical practices. Variations are reported in neurosurgical practices regarding the treatment of chronic subdural hematoma (SDH). This study determined the outcomes of SDH with Drain and without Drain in terms of recurrence and effectiveness. Material and Methods:  A randomized control trial was conducted in the Department of Neurosurgery Ayub Teaching Hospital Abbottabad. Group-A patients were subjected to drainage of chronic subdural hematoma without drain and Group-B patients were subjected to drainage with drain. All patients were followed up to one month for recurrence of subdural hematoma like on CT-scan. Results:  Overall, the recurrence of chronic subdural hematoma in both groups was seen in 16.7% of patients and the procedures were effective in 83.3% of patients. In Group A, 79.6% of patients were successfully treated through burr hole with irrigation, while 20.4% of patients had recurrent chronic SDH. In Group B, only 13% of patients had a recurrence, while 87% of patients were successfully treated with burr with the closed continuous drainage system. An insignificant difference (p-value: 0.302) existed between groups for both types of procedures. Conclusion:  The patients who were treated with burr hole and irrigation of the subdural space with normal saline had high recurrence incidence than those with burr hole with closed continuous drainage system.