Pakistan Journal Of Neurological Surgery最新文献_第4页

The Influence of Epidural Steroids on Postoperative Pain and Hospital Stay in Patients Having a Single-Level Lumbar Discectomy 硬膜外类固醇对单节段腰椎间盘切除术患者术后疼痛和住院时间的影响

Pakistan Journal Of Neurological Surgery Pub Date : 2022-09-30 DOI: 10.36552/pjns.v26i3.769

Shah Khalid, Abdul Aziz khan, Faiza Khalid, Shahbaz Ali Khan, Abdul Majid

{"title":"The Influence of Epidural Steroids on Postoperative Pain and Hospital Stay in Patients Having a Single-Level Lumbar Discectomy","authors":"Shah Khalid, Abdul Aziz khan, Faiza Khalid, Shahbaz Ali Khan, Abdul Majid","doi":"10.36552/pjns.v26i3.769","DOIUrl":"https://doi.org/10.36552/pjns.v26i3.769","url":null,"abstract":"Objective: In this study, we looked at how intra-operative epidural steroids affected postoperative pain and stay duration in patients with unilateral single-level lumbar discectomy. \u0000Material & Methods: A randomized control trial was conducted at Ayub Teaching Hospital Abbottabad. Group A (n = 30) was given intraoperative epidural methylprednisolone, while group B (n = 30) was given normal saline only. The outcome was measured between the two groups in terms of postoperative pain (visual analog scale), time of mobilization, length of hospital stay, and duration to return to work. \u0000Results: At discharge, the VAS score in group A was 0.40 compared to 2.4 in group B (p = 0.000). At 2 weeks follow-up, the mean VAS score was 1.10 in group A in contrast to 1.4 in group B (p = 0.001). Patients who received local epidural methylprednisolone were mobilized after an average of 1 day, stayed for an average of 1.16 days, and returned to work following 18.2 days, whereas patients in the control group were mobilized after an average of 1.2 days, stayed for an average of 1.86 days and returned to work following 25.9 days. An incidental Dural tear occurs in 2 cases. \u0000Conclusion: Intra-operative epidural steroid is beneficial in reducing post-operative pain, hospital stay, and time to return to work. It allows early mobilization with enhanced recovery and few complications.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"107 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80961920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Comparison of Cerebrospinal Fluid Leakage in Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Adenoma with and without Sellar Floor Reconstruction 经鼻内窥镜经蝶窦手术治疗垂体腺瘤伴与不伴鞍底重建的脑脊液漏的比较

Pakistan Journal Of Neurological Surgery Pub Date : 2022-09-30 DOI: 10.36552/pjns.v26i3.763

Muhammad Naveed Majeed, Sumira Kiran, Tariq Imran Khokhar, Mubashir Malik, Zubair Mustafa Khan, Asif Bashir

{"title":"Comparison of Cerebrospinal Fluid Leakage in Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Adenoma with and without Sellar Floor Reconstruction","authors":"Muhammad Naveed Majeed, Sumira Kiran, Tariq Imran Khokhar, Mubashir Malik, Zubair Mustafa Khan, Asif Bashir","doi":"10.36552/pjns.v26i3.763","DOIUrl":"https://doi.org/10.36552/pjns.v26i3.763","url":null,"abstract":"Objectives: This study aimed to compare CSF leak in endoscopic endonasal TSS of pituitary adenoma with and without reconstruction of the sellar floor with no intraoperative CSF leakage.\u0000Materials and Methods: It was a randomized controlled trial of 116 patients of both genders diagnosed case of pituitary adenoma who underwent endoscopic endonasal TSS over 1 year. The cases were randomized into 2 groups. In Group A endoscopic endonasal TSS and the sellar floor, reconstruction was done while in Group B only endoscopic endonasal transsphenoidal surgery was done without reconstruction.\u0000Results: The patient’s mean age in group A was 40.7 ± 9.56 years, and in group, B was 41.9 ± 10.5 years. The gender distribution, for group A, males and females were 29 each (50%) and in group B, the males were 36 (62%) and females were 22 (38%). There were 52 (89.7%) cases of macroadenoma and 6 (10.3%) cases of microadenoma in each group. On the 1st postoperative day, CSF leakage was noted in 2 (3.4%) patients of group A, and CSF leakage was observed in 2 (3.4%) patients of group B. Results revealed no difference in CSF leakage between both groups. There were minor nasal complications in both groups.\u0000Conclusion: There is an equal chance of success with endoscopic endonasal transsphenoidal surgery (TSS) of pituitary adenoma with and without reconstruction of the sellar floor, concerning post-operative CSF leak, in patients who have no intraoperative CSF leak which enlarges the pool of options for treatment.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75561923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dengue Virus and Neurological Complications 登革病毒和神经系统并发症

Pakistan Journal Of Neurological Surgery Pub Date : 2022-09-30 DOI: 10.36552/pjns.v26i3.790

. Muhammad Anwar Chaudary, Saman Shahid

引用次数: 0

Predictors of Surgical Outcome Following Cerebral Contusion in Severe Head Injuries 重型颅脑损伤后脑挫伤手术预后的预测因素

Pakistan Journal Of Neurological Surgery Pub Date : 2022-09-30 DOI: 10.36552/pjns.v26i3.777

Shahzaib Tasdique, Diggaj Shrestha, Zainab Sarwar, Samra Majeed, Obaid ur Rehman, Waqas Mehdi, Azam Niaz

{"title":"Predictors of Surgical Outcome Following Cerebral Contusion in Severe Head Injuries","authors":"Shahzaib Tasdique, Diggaj Shrestha, Zainab Sarwar, Samra Majeed, Obaid ur Rehman, Waqas Mehdi, Azam Niaz","doi":"10.36552/pjns.v26i3.777","DOIUrl":"https://doi.org/10.36552/pjns.v26i3.777","url":null,"abstract":"Objective: There are controversies regarding the management of Cerebral Contusion. The study sought to identify parameters influencing the surgical outcome of individuals suffering from a brain contusion. \u0000Methods: A quasi-experimental study was conducted at the Department of Neurosurgery, Mayo Hospital Lahore, and 37 patients were included. The information on the mode/mechanism of injury, time of presentation, clinical presentation, and contusion type/location was collected. GCS (at 1st, 2nd and 6th weeks) and GOS were used for the neurological assessment of pre-operative and post-operative status. \u0000Results: The average age of presentation was 42.57 years. There were 21.6% female and 78.4% male patients. 64.9% presented with road traffic accidents. 4% of patients presented to the hospital within 12 hours of injury, 16.2% between 12 to 24 hours, and 5.4% between 24 to 48 hours. 29% had seizures and upgoing plantar. 18% had hemiparesis or hemiplegia. Light reflex was absent in 40.5% of patients. The GCS kept improving postoperatively. GCS at admission was averaging 8 which improved to 10, 12, and 13 after surgery. The presenting mean GCS at 1st-week, 2nd-week, 6th-week, and mean GOS at 30th PAD. Counter coup injury improved to 15/15 right in 1st week. Mean GOS was 5 at 30th PAD. The most improvement was seen in the frontoparietal, temporoparietal, and fronto-temporo-parietal locations. The mean GOS at 30th PAD was 4. \u0000Conclusion: The outcome following cerebral contusion depends upon the initial presenting GCS and GOS. Therefore, the better the presenting GCS and GOS better is the prognosis of the patient.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78375921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Micro-Endoscopic Discectomy versus Open Discectomy: A Struggle for Better Clinical Outcomes 显微内镜椎间盘切除术与开放式椎间盘切除术:争取更好的临床结果

Pakistan Journal Of Neurological Surgery Pub Date : 2022-09-30 DOI: 10.36552/pjns.v26i3.784

A. Anwer, Ijaz Hussain Wadd, Abdul Ghafoor, Javaria Siddiq, Malik Muhammad Yasin, Jamshaid Farooq

{"title":"Micro-Endoscopic Discectomy versus Open Discectomy: A Struggle for Better Clinical Outcomes","authors":"A. Anwer, Ijaz Hussain Wadd, Abdul Ghafoor, Javaria Siddiq, Malik Muhammad Yasin, Jamshaid Farooq","doi":"10.36552/pjns.v26i3.784","DOIUrl":"https://doi.org/10.36552/pjns.v26i3.784","url":null,"abstract":"Objective: The objective of the current study was to compare the clinical outcomes of a micro-endoscopic discectomy with an open discectomy. \u0000Materials & Methods: This Quasi-experimental study was conducted in the Department of Neurosurgery, Alrazi Healthcare, Lahore, and Ammar Medical Complex, Lahore. The sample consisted of 40 patients with lower back pain with radiation to the lower limbs. A lumbar disc single-segment hernia was diagnosed based on magnetic resonance imaging (MRI) findings. Independent sample t-test was used to explore the difference in outcomes and level of pain between group A and group B. Chi-square test was used to compare the recovery rate of patients in both groups. \u0000Results: A significant difference between the two groups in terms of surgery duration (t = 15.977, P = .000), blood loss during surgery (t = -10.256, P = .000), length of incision (t = -58.355, P = .000), and hospital stay after surgery (t = -4.687, P = .000) was found. The overall recovery rate for the micro-endoscopic Discectomy group was 95% whereas, in the open discectomy group, it was 90%. \u0000Conclusion: Micro-endoscopic discectomy is superior to open discectomy in terms of lesser surgical trauma, lesser blood loss, lesser hospital stay, earlier return to work, and higher pain resolution.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"89 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79179012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lipoma at Conus Medullaris without Spinal Dysraphism causing Neurological Deficit: A Rare Occurrence 髓圆锥脂肪瘤无脊柱异常导致神经功能缺损:罕见的发生

Pakistan Journal Of Neurological Surgery Pub Date : 2022-09-30 DOI: 10.36552/pjns.v26i3.668

Shahzaib Tasdique, Z. Sarwar, Obaid ur Rehman, Samra Majeed, Waqas Mehdi, Azam Niaz

引用次数: 0

Cerebellopontine Angle (CPA) Tumors Presenting with Trigeminal Neuralgia (TN): A Study from LRH, Peshawar 以三叉神经痛(TN)为表现的桥小脑角(CPA)肿瘤:白沙瓦LRH地区的研究

Pakistan Journal Of Neurological Surgery Pub Date : 2022-09-30 DOI: 10.36552/pjns.v26i3.772

Farooq Azam, Hamayun Tahir, Adnan Khaliq

{"title":"Cerebellopontine Angle (CPA) Tumors Presenting with Trigeminal Neuralgia (TN): A Study from LRH, Peshawar","authors":"Farooq Azam, Hamayun Tahir, Adnan Khaliq","doi":"10.36552/pjns.v26i3.772","DOIUrl":"https://doi.org/10.36552/pjns.v26i3.772","url":null,"abstract":"Background/Objective: The cerebellopontine angle (CPA) is the most prevalent site for brain tumors, accounting for 10% of all cases. CPA tumors can have a direct or indirect pathogenic impact on the auditory nerve and brain stem. The study aimed to quantify the prevalence of cerebellopontine angle tumors in patients with trigeminal neuralgia. \u0000Material and Methods: A cross sections study was conducted and 100 patients were included from the Neurosurgery department of LRH, Peshawar. Magnetic resonance images (MRI) were used to look for CPA tumors. The data on CPA tumors were stratified for age and gender. Suboccipital retromastoid craniectomy was performed. \u0000Results: The mean age of the patients was 43 years. 38 patients were male and 62 were female. CPA tumors were seen in three percent of trigeminal neuralgia patients. There existed a significant difference (p < 0.00001) between the presence and absence of CPA tumors. A maximum number of patients (n = 37) were not having CPA tumors from the age group of 51-60 years. An insignificant association was reported for CPA distribution concerning age and gender. \u0000Conclusion: According to our findings, 3% of trigeminal neuralgia patients had cerebellopontine angle tumors. We urge more investigation and screening of trigeminal neuralgia patients for CPA tumors based on the findings of this study.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81325758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Autologous Bone Graft vs PEEK Cage in Patients with Cervical Spondylotic Myelopathy 骨髓型颈椎病患者自体骨移植与PEEK Cage的比较

Pakistan Journal Of Neurological Surgery Pub Date : 2022-09-30 DOI: 10.36552/pjns.v26i3.786

Ijaz Hussain Wadd, Ammar Anwer, Liaqat Mehmood Awan, Arsalan Haider, Asif Shabbir, Zayed Qamar

{"title":"Autologous Bone Graft vs PEEK Cage in Patients with Cervical Spondylotic Myelopathy","authors":"Ijaz Hussain Wadd, Ammar Anwer, Liaqat Mehmood Awan, Arsalan Haider, Asif Shabbir, Zayed Qamar","doi":"10.36552/pjns.v26i3.786","DOIUrl":"https://doi.org/10.36552/pjns.v26i3.786","url":null,"abstract":"Background: Cervical spine stenosis is one of the most common degenerative changes of cervical spondylotic myelopathy (CSM) and results in severe dysfunction of the cervical spinal cord. The conventional treatment of such degenerative cervical spine conditions is anterior cervical discectomy and fusion (ACDF). Strut graft remains the gold standard in ACDF with excellent patient recovery but has many shortcomings. Polyetheretherketone (PEEK) cages have recently become popular as a replacement for strut grafts in patients undergoing ACDF. \u0000Objective: This study was carried out to compare the clinical and radiographic outcomes of autologous bone grafts versus PEEK cages in patients undergoing ACDF surgery. \u0000Materials and Methods: It was a randomized controlled trial conducted at the Neurosurgery Department Punjab Institute of Neurosciences for three years. Patients who consented to be a part of this study and fulfilled our predefined inclusion criteria were recruited and randomized into 2 groups. One group underwent ACDF with auto bone graft whereas the other group underwent ACDF with PEEK cage. \u0000Results: A total of 198 subjects were included in this study. The mean age was calculated as 47.60 ± 9.17 years in the PEEK cage group and 46.74 ± 8.87 years in the Autologous bone graft group. Males accounted for 59.6% of the study population. The fusion rate was found to be higher in the PEEK cage group with a p-value of 0.002. \u0000Conclusion: PEEK cages are superior to strut grafts as they have lesser morbidity after ACDF surgery in patients with CSM. \u0000 ","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88532783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of One vs. Two Burr Hole Craniostomy in Chronic Subdural Hematoma Recurrence 一孔与双孔开颅术治疗慢性硬膜下血肿复发的比较

Pakistan Journal Of Neurological Surgery Pub Date : 2022-09-30 DOI: 10.36552/pjns.v26i3.770

Mahboob Khan, Abdul Aziz khan, Sohail Ahmad, Amir Zaman, Khalid Khan, Khalid Zardan, Muhammad Irfanudin Khan

{"title":"Comparison of One vs. Two Burr Hole Craniostomy in Chronic Subdural Hematoma Recurrence","authors":"Mahboob Khan, Abdul Aziz khan, Sohail Ahmad, Amir Zaman, Khalid Khan, Khalid Zardan, Muhammad Irfanudin Khan","doi":"10.36552/pjns.v26i3.770","DOIUrl":"https://doi.org/10.36552/pjns.v26i3.770","url":null,"abstract":"Introduction/Objective: Chronic subdural hematoma (CSDH) is most frequent neurosurgical conditions. To find the recurrence rate of chronic subdural hematoma in patients who underwent one vs. two burr craniostomy. \u0000Material And Methods: A randomized controlled trial was conducted at the Neurosurgery department, Ayub Teaching Hospital, Abbottabad. In the current study, a total of 76 (38 in each group) patients were observed. ASA-I, ASA-II, ASA III patients, symptomatic radiologically proven Chronic subdural hematoma. Patients were randomly allocated into two groups of 38 patients each. randomization with blocks. Group A was treated with intraoperative epidural methylprednisolone while Group B was treated with normal saline only. Clinical information was recorded on a pre-designed proforma. \u0000Results: Mean age was 54 years in group A, and 56 years in group B. In group A, 74% were male and 26% of patients were female. In Group B, 76% were male and 24% were female. The group A, 5% of patients had recurrence while in Group B, 13% of patients had a recurrence. There existed a significant difference between effectiveness and not-effectiveness of one/two burr hole craniostomy among patients who were less than 40 years. \u0000Conclusion: The recurrence rate of chronic subdural hematoma is higher in patients undergoing two burr hole craniostomy as compared to one burr craniostomy.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82428132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Delay in Diagnosis of Brain Tumors: A Dilemma For Neurosurgical Community Due To Spirituality and Quackery In A Developing Country 延迟诊断脑肿瘤:一个发展中国家神经外科社区由于灵性和庸医的困境

Pakistan Journal Of Neurological Surgery Pub Date : 2022-09-30 DOI: 10.36552/pjns.v26i3.796

Usman Ahmad Kamboh, Sidra Abid, Mehwish Manzoor, Mehreen Mehboob, Sana Jamal, Mohammad Ashraf et al.

{"title":"Delay in Diagnosis of Brain Tumors: A Dilemma For Neurosurgical Community Due To Spirituality and Quackery In A Developing Country","authors":"Usman Ahmad Kamboh, Sidra Abid, Mehwish Manzoor, Mehreen Mehboob, Sana Jamal, Mohammad Ashraf et al.","doi":"10.36552/pjns.v26i3.796","DOIUrl":"https://doi.org/10.36552/pjns.v26i3.796","url":null,"abstract":"Objectives: Primary and metastatic brain tumors are a significant cause of mortality and morbidity. The complex pathway to a cancer diagnosis is not human error and the achievements of better outcomes solely depend on the early diagnosis and management of symptomatic tumors. The estimated time between the first presentation to any health care professional and diagnosis is approximately 3 times longer in the UK as compared to other developed countries. \u0000Material and Methods: It was a descriptive study and included 52 patients who were admitted to the Neurosurgery department at Jinnah hospital Lahore. The required data were collected either directly from the patients or from the hospital record of discharged patients. Our study compares the time interval difference of presentation of a patient to a local care provider (Quacks, Hakeem, and spiritual healers) and Neurosurgeon as well as delay in surgical intervention even after diagnosis and radiological investigations. \u0000Results: 54% of patients presented with supratentorial lesions and out of these, parietal lobe lesions were more common (39%) while 29% of lesions were infratentorial. Around 50% of patients presented to a Local Care Provider within 20 days. However, only 42% of patients presented to a neurosurgeon after 6-9 months of the onset of symptoms. \u0000Conclusion: Public awareness is the key to timely diagnosis, proper management, and better outcomes. The availability of specialists in peripheral hospitals can bring a change in this regard.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"273 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73487208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0