scholarly journals Temporal Delays Along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients at a Tertiary Care Hospital in Kampala, Uganda

Neurosurgery ◽  
2018 ◽  
Vol 84 (1) ◽  
pp. 95-103 ◽  
Author(s):  
Silvia D Vaca ◽  
Benjamin J Kuo ◽  
Joao Ricardo Nickenig Vissoci ◽  
Catherine A Staton ◽  
Linda W Xu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Continuum

scholarly journals Outcome of Cranioplasty Done within and Beyond 2 Months after Decompressive Craniectomy for Traumatic Brain Injury

2021 ◽  
Vol 10 (10) ◽  
pp. 711-714
Author(s):  
Khongbantabam Vyas ◽  
Khaidem Mani Singh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Categorical Variables ◽  
P Value ◽  
Consecutive Series ◽  
Complication Rates ◽  
Care Hospital

BACKGROUND Cranioplasty although a simple elective neurosurgical procedure is burdened by considerable morbidity. The timing of doing cranioplasty and a good outcome remains a topic of much debate. We wanted to compare the outcome of doing cranioplasty within (early) and beyond (late) 2 months after decompressive craniectomy for traumatic brain injury. METHODS The study was carried out in a tertiary care hospital. A 5-year retrospective study of patient records was analysed. Consecutive series of traumatic brain injury patients who underwent cranioplasty after decompressive craniectomy from a tertiary care hospital operated by a single neurosurgeon, were studied. Data was analysed using SPSS version 21, IBM. Associations of categorical variables were compared using chisquare test and of continuous variables by using unpaired 2-tailed Student t-test. RESULTS Altogether 90 patients were identified who had undergone cranioplasty after decompressive craniectomy for traumatic brain injury and were grouped into early (within 2 months; 44 patients) and late (beyond 2 months; 46 patients). Cranioplasty operative time was significantly shorter in the early (59.39 mins) than the late (77.28 mins) with a P value of 0.001. Infection rates were significantly higher in the early (4.55 %) than late (0 %), with P value 0.144. Other complication rates were postoperative haematoma (0 % early, 2.17 % late, P = 0.325), hydrocephalus (0 % early, 6.52 % late, P = 0.085), sunken brain (0 % early, 4.35 % late, P = 0.162), and bone graft resorption (0 % early, 2.17 % late, P = 0.325). These differences were not statistically significant though. CONCLUSIONS Early cranioplasty performed within 2 months of decompressive craniectomy has better outcome in the form of reduced hospital stay, decreased cost, and fewer complications. KEY WORDS Traumatic Brain Injury, Decompressive Craniectomy, Outcome, Cranioplasty

scholarly journals Incidence of progressive hemorrhagic injury in patients presenting with traumatic brain injury at a large tertiary care hospital in Karachi, Pakistan. A Case Series.

2020 ◽  
Vol 27 (01) ◽  
pp. 94-99
Author(s):  
Qazi Muhammad Zeeshan ◽  
Ramesh Kumar ◽  
Asim Rehmani ◽  
Muhammad Imran ◽  
Atiq Ahmed Khan ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Subarachnoid Hemorrhage ◽  
Brain Injury ◽  
Ct Scan ◽  
Epidural Hematoma ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Progressive Hemorrhagic Injury

Objectives: Our study aims to determine the frequency of progressive hemorrhagic injury as observed on the CT scan from the initial scan performed at the time of presentation to a subsequent one in the 12 hours after the initial scan. Study Design: The type of study is a prospective observational case series. Setting: At Tertiary Care Hospital in Karachi, Pakistan. Period: 3 months from June 2018 to August 2018. Materials & Methods: All patients over 18 years of age who presented to the Accident and Emergency Department of the hospital with traumatic brain injury and had a CT scan performed within four hours of the injury were included in the study. A predesigned proforma was used to note down patient findings. CT scan findings were classified as subdural hematoma (SDH), intraparenchymal contusion (IPC) extradural hematoma (EDH) and subarachnoid hemorrhage (SAH). A repeat CT scan was performed twelve hours after the initial CT scan. Data were analyzed using IBM SPSS version 20.0, mean and frequencies were calculated for continuous variables while frequencies and percentages were calculated for categorical variables. Results: Of the n= 110 patients in our study 79 were males and 31 were female, the mean age of the patients was 34.25 years. The Glasgow Coma Scale scores at the time of arrival were between thirteen and fifteen for n= 33 (30%) of the patients, between nine and twelve for n= 54 (49.09%) of the patients, less than and equal to eight for n= 23 (20.90%) of the patients. Subarachnoid hemorrhage was present in n= 32 (29.09%) patients, intraparenchymal hematoma was present in n= 42 (38.18%) of the patients, while subdural hematoma and epidural hematoma was present in n= 14 (12.72%) and n= 22 (20%) of the patients respectively. Progressive hemorrhagic injury was found in n= 66 (60%) of the patients, while in n= 11 (10%) of the patients there was resolution of the lesion and n= 33 (33%) of the patients showed no observable changes in the repeat CT scan. Finally, our results indicate that of the 110 patients in our study PHI was seen in n= 17 (53.12%) patients with SAH, n= 18 (81.81%) patients of EDH, n= 5 (35.71%) patients of SDH and n= 26 (61.90%) patients of IPC respectively. Conclusion: According to the results of our study PHI is observed in 60% of the patients with a traumatic brain injury observed within the initial 12 hours after injury, and epidural hematoma and intraparenchymal contusions had the highest incidences of PHI among all the different types of traumatic brain injuries.

scholarly journals ROLE OF COMPUTED TOMOGRAPHY IN PATIENT WITH MINOR HEAD INJURY IN TERTIARY CARE HOSPITAL

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Sanjay Narayangiri Gosavi ◽  
Sambhav Lodha ◽  
Apoorva Poonia
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Ct Scan ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Minor Head Injury ◽  
Ct Scans ◽  
Care Hospital

Aim: Approximately 2 million people sustain traumatic brain injury (TBI) annually in India. A CT scan of the head is the initial choice of radiological investigation to evaluate patients with suspected head injury. The need for neurosurgical intervention is based on the clinical status of the patient and the radiological finding on head CT. Material and Methods: This was a prospective observational study done over a period of 6 months. A total of 201 patients were included in the study. Patients of traumatic brain injury above 15 years of age who were subjected to two or more CT scans of the brain. Patients were followed for a maximum of up to 5 scans. The decision of repeat scan was taken by the treating neurosurgeon. Patients who were taken up for surgery based upon the findings of the first CT scan. Patients who were discharged or who expired after the first CT scan. Results: A total of 201 consequent head injury patients with 2 or more CT scans were studied. 192 were male. The mean age was 38.6 years (Range: 16e80). Road traffic accidents was the most common cause of trauma (134, 67%) followed by fall from height (47, 24%) and assault (17, 10%). Progression of lesion was seen more frequently in mixed lesions (21.8%), followed by SDH (12.5%) and EDH (6.2%). Conclusions: Repeat CT scans were found to be of value in detecting new lesions or enlargement of existing lesions resulting in change of management in a significant proportion of patients. Keywords: Computed Tomography, Minor Head Injury, Tertiary Care Hospital, Traumatic Brain Injury (TBI), Lesions.

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