Background: Management for simple hydrocephalus in low/middle income countries include insertion of a ventriculoperitoneal shunt (VPS) or performance of an endoscopic third ventriculostomy (ETV). Objective: This present study was carried out to compare presenting features, surgical management and outcomes for patients with simple and loculated hydrocephalus. Methodology: This case-control study was performed in the Department of Paediatric Neurosurgery at National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from July 2017 to June 2019. The patients with loculated hydrocephalus were included in the analysis and comparison made to case matched simple hydrocephalus controls. Presenting features, operative details, and outcomes measured by the Glasgow Outcome Scale- Paediatric (GOS) were recorded over a follow up period of one year. Results: A total number of 17 patients with loculated hydrocephalus were recruited for this study. Loculated patients underwent ETV (n=3), VPS (n=7), aqueductoplasty (n=1) and no procedure (n=6). Simple hydrocephalus patients underwent ETV (n=4), VPS (n=7), no procedure (n=2). Patients undergoing intraoperative irrigation had a mean GOS of 3 compared to a GOS of 6 in non-irrigated patients (p=0.0434). Mortality occurred in 9 patients (5 loculated HCP and 4 simple HCP). Mortality was seen to be higher in male patients (p<0.0001) and those with congenital aetiologies (p<0.0001). Conclusion: There is no statistically significant difference in mortality or GOS at follow up between the 2 groups. Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):112-120

An 11 months old male child, with congenital HCP presented with extrusion of shunt tube form the anus after defecation. He was managed by VP shunt 8 months back; 6 months later lower end was revised for obstruction. Lower end of shunt exteriorized and the distal end was cut and pulled out per rectally. Later ETV done patient discharged uneventfully.Key words: VP Shunt, Trans anal, Extrusion, Management, Outcome. Bang. J Neurosurgery 2022; 11(2): 138-140

Background: Brain abscess is a relatively uncommon but life-threatening infection in children. It can originate from contiguous site infections (eg, chronic otitis media, mastoiditis, sinusitis, meningitis), from distant pathologic states (eg, cyanotic congenital heart disease, chronic lung infections), after head trauma or neurosurgical procedures, or from cryptogenic sources. Predominant etiologic microorganisms vary depending on these predisposing factors. Proper selection of antimicrobial agents with good penetration of the central nervous system and with adequate coverage of both anaerobic and aerobic bacteria is critical for the medical management of brain abscess. Delay in surgical drainage can be associated with high morbidity and casefatality rates. Methods: The study was carried out at Department of Paediatric Neurosurgery, NINS&H, Dhaka from November 2017 to till date. Data collection sheet was used to collect the necessary information. Subjects was included from a NINS Pediatrics neurosurgery electronic registry. Structured questionnaire was used to collect the necessary information. Risks and benefits of this study were explained to the patient and patient’s legal guardian/parents in an easily understandable local language. Informed written consent was taken from each guardian before data collection. Results: Most of the patients were within >5 years age group 21 (38.3%). Second large were <2 years age group 19 (34.5%). According to gender. 33 (60%) patients were males and 22 (40%) patients were females. Distribution of subjects among OPD patients and admitted patients. 41 patients were admitted indoor among 55 patients. Predisposing factors were identified in 24 of 41 admitted cases. 11 abscesses developed in a child with cyanotic congenital heart disease (CCHD) and 2 occurred after head trauma. 2 abscesses were secondary to ear infections. In 28 patients, the abscess was drained through a burr hole, without the need for craniotomy; the other 4 underwent open craniotomy. 9 patients improved only with conservative management. Among the admitted patients, 34 patients were discharged from the ward in clinically stable conditions and 7 patients expired. Conclusion: Advances in the diagnosis and treatment of brain abscess and subdural empyema with neuroimaging techniques such as computerized tomography, magnetic resonance imaging, magnetic resonance spectroscopy, the availability of new antimicrobials, and the development of novel surgical techniques have significantly contributed to the decreased morbidity and mortality associated these infections. Bang. J Neurosurgery 2022; 11(2): 70-74

Background: There are no data so far relating posterior fossa brain tumors in pediatric age group in Bangladesh. We are dealing with this type of tumors regularly. So an attempt has been made to document these tumors in respect to their incidence in our country, mode of presentation, age and sex distribution, treatment offered to them and their complication and outcome. Methods: This study was conducted in the Department of Pediatric Neurosurgery, National Institute of Neurosciences and Hospital. It was a retrospective study and cases were collected from 2013-2020. Result: We dealt with 60 cases of posterior fossa brain tumors. Out of them 21 were medulloblastoma,19 pilocytic astrocytoma, 11ependymoma and rest are other tumors. Almost all patients presented with hydrocephalus and in most cases CSF diversion was done before definitive tumors surgery. Conclusion: This is only a partial picture of total posterior fossa tumors in pediatric age group. This type of study should be done in a larger scale and newer modalities of diagnostics should be widely practiced for a better post-operative treatment and better prognosis. Bang. J Neurosurgery 2021; 10(2): 182-184

Introduction: The surgical outcome of lumbar spinal stenosis is variable. Appropriate patient selection, surgical procedure, multi-level involvement, body mass index, mental stability, etc., are factors related to outcome. According to the patient's perspective, the Patient-Reported Outcomes Measurement Information System (PROMIS) gives clinicians and specialists admittance to dependable, substantial, and adaptable proportions of well-being status that evaluate physical, mental, and social prosperity. Objective: The purpose of this study is to identify the factors influencing the surgical success of patients with lumbar spinal stenosis. Methods: In this cross-sectional study, we have outlined the potential factors that have influenced the surgical outcome of lumbar spinal stenosis. A total of 146 patients were studied from 2010 to 2016. Results: In our study, the male and female ratio was 3:2. The mean age group was 60 years, range 50–70 years. The minimum follow-up was four years. PROMIS score was used to assess the outcome of surgery. We got the PROMIS score pre and postoperatively using online “orthotoolkit” questionnaires and calculated the patient's average scores. Decompressive laminectomy, laminotomy, unilateral approach-all procedures had similar outcomes. Conclusion: The outcome of surgical decompression is satisfactory, although various factors can be predictors of surgical failure. Our study suggests psychological issues, high BMI, comorbid conditions, multi-level surgeries are few that may predict poor outcomes. Highlights