Outcome of surgically treated head injury in unattended patients at Neurosurgery Department in Tertiary Care Centre - an institutional study

2017 ◽  
Vol 31 (2) ◽  
pp. 233-239
Author(s):  
Praveen Kumar Tripathi ◽  
Vardan Kulshreshtha ◽  
Gaurav Jaiswal ◽  
Tarun Kumar Gupta

Abstract This is a prospective study, carried out at our department. Many patients with history of trauma with head injury, whose identity cannot be ascertained, are admitted in our hospital. The management of these unattended patients from pre-hospital till discharge, rehabilitation or death is full of difficulties especially when surgical intervention has to be done. We conducted a prospective study by enrolling 11 consecutive unattended patients in whom neurosurgical procedures performed at our hospital. Out of 11 patients, 9 (82%) were male, most were in the age group of 21-30 years. The mean age was 30 years. Mean duration of hospital stay was 11.27 days. The cause of head injury was road traffic accident in all patients. Majority of the patients 10 (90%) had Glasgow coma scale less than 8 on admission. Two patients 2 (18%) died in hospital, 7 (63%) patients had good recovery. During the course of treatment identity of all 11 patients was established and 8 (72%) patients who survived were discharged to home. All discharged patients were followed at interval of 1 month and 3 months. Four (50%) & 5 (62%) patients showed good recovery (GOS) at 1 month & 3 month respectively

2018 ◽  
Vol 32 (2) ◽  
pp. 505-512
Author(s):  
Gaurav Jaiswal ◽  
Praveen Kumar Tripathi ◽  
Vardan Kulshreshtha ◽  
Tarun Kumar Gupta

Abstract This is a prospective study, carried out at the Department of Neurosurgery at M.B.G Hospital, R.N.T Medical College, Udaipur, Rajasthan (India). Many patients with history of trauma with head injury, whose identity cannot be ascertained, are admitted in our hospital. The management of these unattended patients from pre-hospital till discharge, rehabilitation or death is full of difficulties especially when surgical intervention has to be done. From March 16, 2015, until March 30, 2016, 118 consecutive patients unattended patients admitted in our department with history of head injury were enrolled in the study. Out of 118 patients, 107 (91%) were male, most were in the age group of 30-39 years. In majority of patients, 115 (97%) principal cause of head injury was road traffic accident. Majority of the patients 49 (41%) had Glasgow coma scale >13 on admission. Twenty three patients 23 (20%) died in hospital, 71 (60%) patients had good recovery. During the course of treatment identity of 115 patients was established and 92 (78%) patients, who survived were discharged to home. Three (3%) patients were shifted to destitute home. All discharged patients were followed at 1 month and 6 month interval. 78 (82%) & 76 (80%) patients showed good recovery (GOS) at 1 month & 6 month respectively. One patient expired at home within one month of discharge and 6 patients lost to follow up at 6 months.


2019 ◽  
Vol 8 (50) ◽  
pp. 3785-3789
Author(s):  
Lt. Col. Ravindra Dubey ◽  
Sunil Panchal ◽  
Junaid Ahmed ◽  
Manoj Agarwala

Author(s):  
Ashvamedh Singh ◽  
Kulwant Singh ◽  
Anurag Sahu ◽  
R. S. Prasad ◽  
N. Pandey ◽  
...  

Abstract Objective To estimate the level of myelin basic protein (MBP) and look for its validity in outcome prediction among mild-to-moderate head injury patients. Materials and Methods It was a prospective study done at the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University from Jan 2018 to July 2019. All patients who presented to us within 48 hours of injury with mild-to-moderate head injury with apparently normal CT brain were include in the study. The serum sample were collected on the day of admission and 48 hours later, and patients were treated with standard protocols and observed 6 months postdischarge. Results Of the 32 patients enrolled, we observed mean MBP level was higher for severity of brain damage, but not associated with age, mode of injury, and radiological diagnosis. Mean MBP levels were not statistically associated with Glasgow coma scale (GCS) score at admission but was correlated to outcome with p < 0.05, with sensitivity of 50% and specificity 72%, that is, patients with good outcome have lower mean MBP levels. Conclusion MBP as per our analysis can be used as a prognostic marker in patients with head injury. It is not the absolute value rather a trend showing rise in serum MBP levels, which carries a significant value in outcome prediction.


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