Posterior Fossa Haematomas outcome Following Surgical Evacuation: A Prospective Study
Journal Title: International Journal of Neurology and Neurosurgery - Year 2018, Vol 10, Issue 2
Abstract
Objective: To evaluate the various outcome variables in posterior fossa haematomas following surgical evacuation. Methods: This is a prospective study done from August 2013 to February 2016 done on 68 patients with posterior fossa EDH, traumatic cerebellar haematomas, brainstem contusions, spontaneous cerebellar haematomas, sub dural haematomas were initially resuscitated, examined and graded according to GCS. The patient was thoroughly investigated and underwent conservative management and surgical evacuation and outcome parameters were measured. Results: The patients admitted were evaluated with the preoperative GCS, of which the score of 812 with good outcome is present in 10 patients (66%) (P value0.0414), and the haematoma size and volume was measured showing a good outcome in 9 patients (69%) (P value0.0490) and 5 patients (83%) (P value0.0493) of haematoma size of < 4cm and volume of < 15ml. The patient’s outcome was also measured by effacement of 4th ventricle, as the good outcome was seen in 14 patients (73%) (P value0.0161). External ventricular drinage was performed in 14 cases of associated hydrocephalus. Significant no. of patients (17) had a GOS of 5 at disharge and followup. The mortality rate of the study was 14%. Conclusions: The preoperative GCS, clot size, clot volume and configuration of the fourth ventricle on CT scans is a useful sign and valuable in measuring the oucome of the patient to apply the various and the best management protocol. These outcome variables can definitely change the mortality and morbidity in posterior fossa haematomas.
Authors and Affiliations
Lakshman Rao Akyam
Isolated Sacral Nerve Root Ependymoma
Ependymomas commonly arise from conus medullaris, cauda equina and filum terminale. Ependymoma involving single nerve root is rare. We report a case of young male with disabling low back pain without motor- sensory defic...
Feasibility of Extended Conservative Approach in Management of CSF Rhinorrhea
Context: CSF rhinorrhea is a potentially devastating condition which if left untreated leads to significant morbidity and mortality so timely and appropriate intervention is needed.Aims and Objectives: To determine feasi...
Retrograde Partial Migration of Ventriculo-Peritoneal Shunt With its Chamber: Review of Causative Factors and Its Prevention
Distal migration of shunt is a very common occurrence. Proximal migration of shunt is rare and possible pathophysiological mechanisms to explain this unusual complication is rarely attempted. A 5-month-old child shunted...
Clinical Profile, Risk Factors for Presenting Seizures in Cerebral Vein and Dural Sinus Thrombosis
Introduction: Seizures in CVT can be divided into presenting seizures and early seizures. Presenting seizures are those that occurred at or before confirmation of CVT diagnosis. There is paucity of data in literature abo...
Incidence of Traumatically Induced Vertebral Artery Occlusion Associated with Cervical Spine Injuries: Prospective Study Using Magnetic Resonance Angiography
Background: Although the vertebral artery injuries (VAI) associated with cervical spine trauma are usually clinicallyoccult, they may cause fatal ischemic damage to the brain stem and cerebellum. Methods: We performed a...