Introduction: ToRCH is an acronym for four congenital infections that are sometimes difficult to distinguish: Toxoplasmosis, Rubella, Cytomegalovirus (CMV), and Herpes Simplex Virus (HSV). This group of organisms produces serious Central Nervous System (CNS) and other infections, which are potentially preventable and treatable. Methods: Neonates and infants with hydrocephalus (N = 65) identified via the outpatient department of the National Institute of Neurosciences and Hospital (NINS&H), were prospectively screened for ToRCH antibodies. Hydrocephalus secondary to Tumor or Trauma was excluded from this study. Results: Evidence of 75.38 % (p = <0.05) patient was positive for TORCH antibodies. Toxoplasma Gondi (T. Gondii) IgG 18.5 % ( p= <0.05 ), CMV IgM 9.2 % (p = <0.05), CMV Ig G47.7% ( p = <0.5), Rubella, and HSV 1 & 2 antibodies were also identified. Conclusion: The vast majority of cases of neonatal hydrocephalus at one institution was post-infectious in etiology and related to ToRCH infections. Many of these cases could be prevented with improved screening and treatment. While study of a single institution may not be the representative of the entire population, further study and implementation of a standardized screening protocol would likely benefit this population. Bang. J Neurosurgery 2020; 9(2): 121-125

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: The successful correction of frontonasal encephaloceles was shown to depend on a detailed understanding of the pathological anatomy, careful planning of the bone movements to correct these deformities, and attention to detail regarding the placement of scars, positioning of the medial canthi and the nasal reconstruction. Objective: We reviewed our experience at the paediatric neurosurgery department of national institute of neurosciences, Dhaka, Bangladesh and discussed our evolution toward a definitive, single-stage correction, including refinements. Methodology: This was a clinical trial which was conducted in the Department of Paediatric neurosurgery at National institute of Neurosciences & Hospital, Dhaka, Bangladesh fromMay 2014 to April 2019 for a period of five (05) years. Paediatric patients with frontonasal encephalocele were operated. Post-operative outcomes were observed. Result: A total number of 6 patients were operated. All were under 1 year. 3 were male and 3 were female. We operated 6 cases of successful one stage operation for frontonasal encephalocele in very young children. A good cosmetic result had been achieved after operation. Conclusion: In conclusion, a one-stage repair with both a transcranial and external approach is effective surgical management for the frontonasal encephalocele paediatric patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 111-117

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