Pattern and Practice of Paediatric Neurosurgical Procedures- An analysis of one year initial experience at resource challenged setup of Children Hospital, Faisalabad.

Abstract

Objective
 To study the Pattern and Practice of Paediatric neurosurgical procedures during one year among patients presenting to Children Hospital, Faisalabad.
 Materials and Methods
 Retrospective case series of 778 consecutive cases done in Paediatric Neurosurgery Department, Children Hospital, Faisalabad over the period of one year (October 2019- November 2020). Patients of age less than 15 years, any gender, admitted in Paeds Neurosurgery ward for management were included and studied for their demographic data hospital stay, procedure done and outcome.
 Results
 A total of 778 patients who required some neurosurgical intervention were admitted, 725 underwent various types of procedures and remaining were treated conservatively. 320 (44.14%) were male and 405 (55.86%) were female. Age range was 20 days to 13 years. The most common diagnosis was hydrocephalous, and then was Meningomyelocele (MMC). First three common procedures performed included monitoring of Cerebrospinal fluid (CSF) in 36% cases, Placement of shunt (21%), and placement of external ventricular drain (EVD) in 13% cases of cerebrospinal fluid ( CNS) infections in patients of hydrocephalous.
 Conclusion
 Pattern of presentation of paediatric neurosurgical cases take in almost all types of diseases like neural tube defects, hydrocephalous, cranial trauma, tumors, cysts and infections but surgical procedures in routine practice in Faisalabad district cover mainly hydrocephalous and its complications. Endoscopic or advanced procedures are not commonly practiced due to multiple factors but existing constrains do not prevent best management of paediatric neurosurgery patients.
 Key Words: Paediatric neurosurgery, Neurosurgical procedures, Children hospital, Faisalabad