Background:Management of obstructive hydrocephalus is an important issue for the reduction of mortality and morbidity.Objectives:The aim of the present study was to assess the early surgical outcome of endoscopic third ventriculostomy (ETV) in the management of obstructive hydrocephalus.Methodology:This randomized controlled trial was conducted at the Department of Neurosurgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from April 2009 to September 2010 for 1½ years. All patients presenting with obstructive hydrocephalus with the obstruction at or distal to the third ventricle and age 6 months and above were included in the study population. All the patients were divided into two groups named as Group A (experimental group) who were treated with ETV and Group B (control group) who were treated with ventriculoperitoneal shunt (VPS). The early surgical outcome was defined as outcomes within 1 month following surgical interventions. Pre- and post-operative outcomes of this study were measured.Results:A total number of sixty patients were recruited from which thirty patients were in Group A and the rest thirty patients were in Group B. The mean postoperative head circumference was 43.4 ± 7.1 cm and 47.8 ± 5.6 cm in VPS and ETV surgery, respectively (P ≤ 0.01). Postoperative vomiting was improved 24 (92.3%) in Group A and 23 (88.5%) in Group B (P < 0.05). Postoperative infection occurred in 1 (3.3%) case in Group A and 8 (26.7%) cases in Group B (P < 0.05). The success of the operation in Group A and Group B included 25 (83.3%) cases and 12 (40%) cases, respectively (P < 0.05).Conclusion:Early surgical outcome following ETV is better than VPS surgery in patients with obstructive hydrocephalus.

Background: Hydrocephalous can occur at any age. Objectives: The purpose of the present study was to see the Demographic Characteristics and Etiology of Hydrocephalus Patients. Methodology: This cross sectional study was conducted in the Department of Neurosurgery at Bangabandhu Sheikh Mujib Medical University, Dhaka from April 2009 to September 2010 for a period of one and half year. Patients presented with obstructive hydrocephalus at any age with both sexes were included as study population. Detailed socio-demographic history as well as the associated etiological factors was recorded in pre designed data collection sheet. Result: A total number of 60 obstructive hydrocephalous patients were recruited for this study after fulfilling the inclusion and exclusion criteria. The mean age with SD was 17.95±19.15. Acquedctal stenosis was the most common etiology of hydrocephalous which was 31(51.7%) cases followed by posterior fossa midline tumour, CPA tumour and pineal region tumour which were 14 (23.3%) cases, 9(15.0%) cases and 6(10.0%) cases respectively. Conclusion: Obstructive hydrocephalous is most commonly found in younger age group which is caused by acquedctal stenosis. [Journal of National Institute of Neurosciences Bangladesh, 2015;1(2): [47][48][49]

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Background: Extradural Haematoma can occur in different reasons. Objective: The purpose of the present study was to see the factors influencing the surgical outcomes of extradural haematoma. Methodology: This cross-sectional study was conducted in the Department of Neurosurgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2010 to June 2011 for a period of one year and six months. All patients presented with traumatic head injury having extradural haematoma in any age with both sexes who were underwent surgical or conservative management were selected as study population. The etiologies of head injuries were recorded. Result: Eighty (80) patients of traumatic head injury within and after 24 hours of head injury were enrolled in this study. In this study road traffic accident was the most common mode of injury which was 51(63.8%) cases followed by fall from height and assault which were 16(20.0%) cases and 13(16.2) cases respectively. Majority patients were recovered in good condition either surgery or conservative management which was 50(62.5%) cases. However, the moderate disability was reported in 17(21.2%) cases. Severe disability was found in 8(10.0%) cases. Persistent vegetative state was found in only 2 cases in conservative treatment. Death was found in 3(3.8%) cases. Conclusion: In conclusion road traffic accident is the most common mode of injury among the study population that causes extra dura haematoma which has the role as factors that influence the outcomes of the patients. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 65-68

Background: Diagnostic validity of different tests for the detection of spontaneous subarachnoid haemorrhage is an important issue. Objectives: The purpose of the present study was to validate 3D-Computed tomographic angiography in spontaneous subarachnoid haemorrhage. Methodology: This cross-sectional study was carried out in the Department of Neurosurgery and Cath Lab of DMCH in collaboration with private diagnostic centre from September 2013 to February 2015 for a period of six (06) months. Adult patients diagnosed as a case of spontaneous SAH based on clinical features and confirmed by plain CT evidence of subarachnoid blood were included as study population. Patients having current history of trauma, poor clinical grade and agitated patient, patient with renal insufficiency, known allergy to iodinated contrast agent and patients who were not willing participate in the study were excluded from this study. Then both CT angiography and DSA were performed to detect cause of bleeding and to make a treatment planning. In this study DSA was considered as reference standard for evaluation of CTA. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CTA were calculated per patient basis and per aneurysmal basis. Result: A total number of 37 patients presented with spontaneous subarachnoid haemorrhage were recruited for this study. The mean age of patients was 58.53±7.54 years. Sensitivity and specificity in depicting intracranial aneurysms were, 93.75% and 100% respectively on a per-patient basis. Positive predictive value and negative predictive value of CTA are 100% and 71.43% respectively. CTA had shown 94.59% accuracy in detection of intracranial aneurysm. Sensitivity and specificity in depicting intracranial aneurysms were 94.74% and 100% respectively on a per-aneurysm basis. Positive predictive value and negative predictive value of CTA are 100% and 71.43% respectively. CTA had shown 95.35% accuracy in detection of intracranial aneurysm. Conclusion: In conclusion CTA has high detection capacity of aneurysm among spontaneous subarachnoid haemorrhage patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 47-52