Background: Serum albumin is routinely measured; cheap and easily available test even in remote areas laboratories. Albumin is the major protein of human plasma and one of the negative acute phase reactants reported to fall as a component of metabolic response to injury or infection, independent of the nutritional status. Even though this has also been noted in patients with head injury and its overall significance with respect to neurological outcome following head injury are yet to be established.Aims and Objectives:  To assess the role of serum albumin in outcome of head injury patient.Material and Methods:  This is a prospective case control study. Total 200 cases of traumatic brain injury [152 male and 48 female] were studied in NRS Medical College, Kolkata from September 2012 to October 2013. Serum albumin estimation, along with clinical and radiological data was collected. Serum albumin was compared between among various subgroups and outcome was assessed by Glasgow Coma Scale at 6 months.Results: In present study 86(43%) patients  having hypoalbuminemia (< 3.5gm/dl)  and falling trend in admission serum albumin levels from day 1 to 10th   day with decrement in GCS was statistically highly significant (p < 0.001) as hypoalbuminemia  was noted in 68%, 39.65 and 33.43%  patients with severe, moderate and mild head injury respectively. The present study  was showed  that female TBI patients having less no. of hypoalbuminemia compare to male as 77.7%, 45.4%, 31.4% male and 42.8%, 28.5%, 27.2% female having hypoalbuminemia (< 3.5gm/dl) in severe, moderate and mild head injury respectively and statistically significant  difference in severe and moderate group.Conclusion: The serial estimation of serum albumin in traumatic brain injury patients provides the treating doctor an insight in the prognosis of the patient so that they can be managed aggressively.Asian Journal of Medical Sciences Vol.7(4) 2016 31-38

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Background: Spinal tumor is a common cause of morbidity in otherwise healthy population, timely diagnosis and treatment of spinal tumor gives excellent outcome. Aims and Objective: We report experience and clinical outcomes of 75 cases with Intradural extramedullary meningiomas operated in last 21 years. Materials and Methods: All the patients were clinically assessed with Nurick’s Grading (both pre and post operatively). MRI was the main armamentarium for operating planning. In all the patients dural attachments were coagulated without any dural excision. Results: Out of 75 patients, 65% were female. Peak incidence was noted in 4th & 5th decade and majority of patients having tumor in the thoracic spine and lateral to the cord. The entire patient showed remarkable clinical improvement according to Nurick’s grade. Total removal was achieved in 69 (90.2%) patients. Two patients had re-growth of tumor in 1 yr. follow up. No postoperative mortality noted in the present series. Conclusion: Spinal meningioma excision without dural resection did not show any increase in recurrences.

Objective?Simultaneous multiple epidural hematomas (EDHs) are very rare and are associated with high mortality. The purpose of this study is to identify the clinical features, varying mechanisms that may be responsible for production of these hematomas, location of hematomas, and outcome of simultaneous multiple EDHs. Methods?Our study consisted of 528 patients who were admitted in our emergency department with diagnosis of traumatic brain injury (TBI) over a period of 14 months from September 2012 to October 2013 and retrospective analysis of all cases with EDH, particularly those with simultaneous multiple EDHs was done. All the patients were carefully examined clinically, Glasgow Coma Scale (GCS) was noted, plain computed tomographic scan (CT scan) was done and managed accordingly. Results?We came across six cases of multiple EDHs which accounted to 1.13% of all TBI. All of the cases except one were diagnosed within the first 6 hours. The GCS was used for neurological evaluations on admission and during hospital stay. A CT scan was done in all cases. Five patients underwent surgical intervention and one was managed conservatively. Two patients expired due to pre- and postoperative complications. Conclusion?EDHs are serious manifestation of TBI, of which multiple EDHs are even worse. These are life-threatening conditions. Early recognition and treatment can save a precious life. Widespread use of CT scan leads to early diagnosis before deterioration of the neurological status and affects the outcome of surgery.