Differential independent impact of the intraoperative use of navigation and angled endoscopes on the surgical outcome of endonasal endoscopy for pituitary tumors: a prospective study

Author(s):  
Ninad R. Patil ◽  
Sivashanmugam Dhandapani ◽  
Sushant K. Sahoo ◽  
Rajesh Chhabra ◽  
Apinderpreet Singh ◽  
...  
2015 ◽  
Vol 6 (4) ◽  
pp. 134-138
Author(s):  
Vishwanath Sidram ◽  
PC Chandra Kumar ◽  
Bellara Raghavendra

ABSTRACT Background Depressed skull fracture is a very serious type of trauma occurring in 11% of severe head injuries, and there is a consistent association between the presence of cranial fracture and higher incidence of intracranial lesions, neurological deficit, and poor outcome. Depressed cranial fractures have to be treated aggressively because of their association with infection and late epilepsy. Objectives To study the clinical profile and surgical outcome of patients with depressed cranial fractures. Materials and methods A case series study of 44 patients with depressed fracture was conducted in a tertiary care hospital setting at the Department of Neurosurgery, Vijayanagara Institute of Medical Sciences, Bellary, Karnataka, during the period from June 2013 to January 2015. Among the selected patients, the clinical profile, radiological profile, and surgical interventions were undertaken and the outcomes were noted. Appropriate descriptive statistics were used to analyze the findings and to draw inferences. Results There were 30 males and 14 females. The mean age of the patients was 26.95 ± 14.87 years (6–65 years). The common cause of depressed fracture was road traffic accident (45%) and assault (40.9%); 63% of them had compound type and half of the fractures were located in the frontal region. Common associated injuries were extradural hematoma (50%) followed by dural tear (27.3%). Common complications were wound infection (9.1%) and cerebrospinal fluid leak (9.1%). Conclusion The management of depressed fractures should be individualized depending on factors like the degree of depression, communication with the exterior, neurological deficit and presence of associated injuries. How to cite this article Sidram V, Kumar PCC, Raghavendra B. A Prospective Study of Spectrum of Depressed Fractures


2016 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
WaseemRaja Dar ◽  
AbdulQayoom Khan ◽  
Naseer Awan ◽  
Mufti Mehmood ◽  
Muzamil Latief ◽  
...  

Author(s):  
Agnes Andersson ◽  
Tobias Hallén ◽  
Daniel S. Olsson ◽  
Dan Farahmand ◽  
Ann-Charlotte Olofsson ◽  
...  

Abstract Objective Headache is a common symptom among patients with pituitary tumors, as it is in the general population. The aim of the study was to investigate headache as a symptom in patients with pituitary tumors before and 6 months after endoscopic transsphenoidal surgery (TSS). Design This is a prospective observational cohort study. Setting This study was conducted at university tertiary referral hospital. Participants A total of 110 adult patients underwent endoscopic TSS for pituitary tumors. Main Outcome Measures The Migraine Disability Assessment (MIDAS) questionnaire was used before and 6 months after surgery for the assessment of headache. Clinical variables with potential influence on headache were analyzed. Results Sixty-eight (62%) patients experienced headaches at least once during the 3 months before surgery. Thirty (27%) patients reported disabling headache before surgery, with younger age being an independent associated factor (p < 0.001). In patients with disabling headache before surgery, the median (interquartile range) MIDAS score improved from 78 (27–168) to 16 (2–145; p = 0.049), headache frequency decreased from 45 (20–81) to 14 (4–35) days (p = 0.009), and headache intensity decreased from 6 (5–8) to 5 (4–7) (p = 0.011) after surgery. In total, 16 of the 30 (53%) patients reported a clinically relevant improvement and five (17%) a clinically relevant worsening. Four (5%) patients developed new disabling headache. No predictor for postoperative improvement of headache was identified. Conclusion In this prospective study, the results show that disabling headache improves following endoscopic TSS in a subset of patients with pituitary tumors. However, no predictive factors for improvement could be identified.


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