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1دورية أكاديمية
المؤلفون: Assad Javed, Muhammad, Ahmad Khan, Niaz, us-Saba, Ain-, Sana, Huda
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 25 No. 2 (2021): April-June; 194-198 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Hydrocephalus, Ventriculoperitoneal shunt, Scrotal Migration
الوصف: Ventriculoperitoneal shunting (VPS) is a common procedure involved in the management of hydrocephalus. VP shunt has many inherent complications including obstruction, infection, breakage, and migration of the shunt. The incidence of scrotal shunt migration is around 14% VPS migration into the scrotum manifests as reducible trans-illuminant scrotal swelling, which is more like hydrocele. Mostly migration occurs into the right hemi-scrotum within the first 6 months of performing a ventriculoperitoneal shunt. Bilateral herniotomy with repositioning of the distal shunt catheter is thetreatmentof choice.
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2دورية أكاديمية
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 24 No. 4 (2020): October-December; 343-349 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Normal Pressure Hydrocephalus, VP Shunt
الوصف: Objective:To determine the outcome of the ventriculoperitoneal shunt in normal pressure hydrocephalus. Material and Methods:This study was conducted at Jinnah Postgraduate Medical Centre, a tertiary care hospital in Karachi. Patients with idiopathic normal pressure hydrocephalus (NPH) were included. Gender distribution, presentation of symptoms and post-operative outcome based on the Stein Langfitt Scale were assessed. CSF was sent for microbiological and biochemical analyses. All patients were evaluated preoperatively and compared postoperatively during 6 months duration for improvement and any associated complication. Results:In this study, we had 47 patients, 38 were male and 9 were female. 22 patients presented with dementia, 18 with urinary incontinence, 17 with gait disturbance 17, while 21 had headache based on Stein and Langfitt Scale. The 78.8% patients had an excellent outcome, 17% had a good outcome and 4.2% had poor results. Conclusion:Ventriculoperitoneal (VP) shunt had promising results selected on history and examination of normal pressure hydrocephalus and improved radiological in Evan’s ratio CT brain scan. Keywords:Normal Pressure Hydrocephalus (NPH), VP Shunt, Stein and Langfitt Scale.
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3دورية أكاديمية
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 25 No. 1 (2021): January – March; 2-8 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: KEYWORDS: Craniotomy, ventriculoperitoneal shunt, brain tumor, hydrocephalus
الوصف: OBJECTIVE: To determine frequency of hydrocephalus in brain tumor perioperative and and need of perment VP shunt . METHOD & MATERIAL: This was descriptive study, the ethical approval was taken from the hospital, study duration from 24-June-2014 to 30-september-2020 at JPMC, Karachi. Inclusion criteria were patient with brain tumor associated with hydrocephalus or postoperatively developed hydrocephalus within 3months of surgery and exclusion criteria were they had shunted previously due to some other reason, history of operation of brain tumor previously, history of trauma. RESULTS: We operated 156 cases of brain tumor concomitant with hydrocephalus, these included pre-operative and post-surgery development of hydrocephalus, out of that 65 (41.6%) were adult and 91 (58.33%) were children, who had hydrocephalus due to brain tumor. 90 (57.6%) were male and 66(42.3%) were female. The mean age for an adult was 34.2±8years and 8.1±4years was for a pediatric population of the patient. Patients who had preoperative hydrocephalus were 34 (21.7%) adults and 55(35.25%) pediatric and post-operative development of hydrocephalus was 28 (17.9%) in adults and 41 (26.28%) pediatric patients, CONCLUSION: The common brain tumor associate with hydrocephalus in children was craniopharyngioma and in adults it was CP angle tumor. Among 6026 cases of brain surgeries 2.6% required vp shunt dependency. Considering common cause of hydrocephalus in brain tumors, perioperative decision-making plays a pivotal role in the management of tumour-associated hydrocephalus.
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4دورية أكاديمية
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 24 No. 3 (2020): July-September; 237 – 242 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Endoscopic third ventriculostomy, Obstructive hydrocephalus, CSF leak, Complications
الوصف: Objective:To determine the frequency, pattern and outcome of early complications after endoscopic third ventriculostomy (ETV) in Obstructive hydrocephalus. Material and Methods:The study included 160 patients from Neurosurgery department, Lady Reading Hospital Peshawar and private clinics over a period of twelve months. After performing ETV under general anesthesia by a single expert neurosurgeon, the patients were followed up for seven days post operatively for the CSF leak, wound infection, meningitis, seizures, bleeding and in hospital death. Results:Eighty five percent of the patients had no untoward complications, while 15% showed complications including CSF leak (5%), wound infection (3%), meningitis (2%), seizures (2%), bleeding (2%) and in hospital death (1%). Conclusion:Due to the less invasive nature, endoscopic third ventriculostomy is favored for treating obstructive hydrocephalus in select patient population as it is safe and have better outcomes.
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5دورية أكاديمية
المؤلفون: ALI, MUMTAZ, ULLAH, AKRAM, KHAN, SAJID, BASHIR, ZUBAIR, HUSSAIN, RAMZAN
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 23 No. 4 (2019): October-December; 288 – 293 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: ETV (Endoscopic Third Ventriculostomy), communicating hydrocephalus, Posterior fossa tumors, Aqueductal stenosis
الوصف: Objective: To examine the outcome of Endoscopic Third Ventriculostomy in 80 consecutive patients operated in Irfan General Hospital and Prime Teaching Hospital Peshawar.Materials and Methods: Prospective observational study was conducted in the neurosurgery department of Prime Teaching Hospital and Irfan General Hospital Peshawar. 80 patients (48 male and 32 female) were followed for 3 months. The inclusion criteria all patients with Third ventricular hydrocephalus were included in this study and the exclusion criteria unwilling patients and those who opted for VP shunting rather than ETV. Data was analyzed using SPSS version 22.Results: ETV was performed in 80 patients. With highest success rate inAqueductal stenosis and posterior fossa tumors 88% and 87% respectively. ETV had a lowest success score of 50% in patients with Hydrocephalus TBM. Common post-operative complications were seizures and CSF leakage.Conclusion: ETV is less invasive and effective treatment for non-communicating hydrocephalus.ETV is most effective in treating aqueductal stenosis and posterior fossa tumors. The overall success rate of ETV is 74%. Based on these findings, it is recommended that ETV should be attempted as first line treatment for patients with triventricular hydrocephalus due to various pathologies.
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6دورية أكاديمية
المؤلفون: RAHMAN, SAFIA, KHAN, ZAHID, SHARAFAT, SEEMA, NAWAZ, SHAHID, AZAM, FAROOQ, ALI, MUMTAZ
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 23 No. 2 (2019): April-June; 137–140 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Hydrocephalus, Cerebrospinal Fluid, Infected Cerebrospinal Fluids, Infants, Shunt Infection, Ventriculoperitoneal Shunt
الوصف: Objective: To know the frequency of ventriculoperitoneal shunt infection in infants on the basis of cerebrospinal fluid analysis.Material and Methods: A cross-sectional study conducted at the LRH Neurosurgery unit, pathology department of KTH Peshawar and department of neurosurgery Gomal Medical College. D.I. Khan, from July 2016 to June 2018. All consecutive patients with suspected ventriculoperitoneal shunt infection were included in the study. The age of the patients was up to one year, irrespective of their gender. Infants with closed fontanelle and previous revision surgery for ventriculoperitoneal shunt were excluded from the study.Results: Total 204 patients. The age of the patients were under one year (infants). Infected cerebrospinal fluids were observed in 19.1% (39/204) infants. Female infants were slightly more common (51.3%) than male. Majority (64.1%) of the patients was having age less than 6 months.Conclusion: We conclude from our study that 19.1% of infants with cerebrospinal fluid shunts have infected CSF on laboratory analysis. Most of the infected shunts occur in female infants and in the first half of their age.
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7دورية أكاديمية
المؤلفون: HAYAT, FAKHAR, AYUB, SHAHID, ALI, MUMTAZ, Siddiq, Muhammad, Khanzada, Khalid
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 15 No. 2 (2011): July-December; 90-94 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Head injury, Post traumatic hydrocephalus, External ventricular drain, VP shunt
الوصف: Objective: To evaluate different factors affecting post traumatic hydrocephalus.Material and Methods: This retrospective study was conducted in the department of Neurosurgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar from July 2009 to June 2011. Record of all head injury patients was reviewed. Out of 5438 admitted patients with head injury, those who developed post traumatic hydrocephalus were included in the study.Results: A total of 68 patients with post traumatic hydrocephalus were diagnosed over the last two years. Out of these 47 (69%) were male and 21 (31%) female. Mostly they were of young age group between 08 years to 41 years. Mean age of presentation being 20 years. A large group 56 (82%) out of 68 patients were in state of moderate to severe head injury, diagnosed within matter of hours or days, as acute post traumatic hydrocephalus. Those who developed after two weeks, fall in group chronic post traumatic hydrocephalus. Out of these, 55 (81%) patients underwent some sort of CSF diversion procedure like external ventricular drain (EVD) or Ventriculo Peritoneal (VP) Shunt. Subarachnoid hemorrhage, intraventricular hemorrhage, intracranial hematoma, posterior fossa bleed, meningitis and craniotomy were recognized associative factors for development of PTH. There was improvement in about 59% after surgery. And the long term prognosis, expressed in GOS, was good in 44% of the cases.Conclusion: Post traumatic hydrocephalus is a dangerous complication and needs critical consideration and early diagnosis in severe head injury cases.
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8دورية أكاديمية
المؤلفون: Ishfaq, Muhammad, SAMI ULLAH, REHMAN, HAMEED-UR-
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 21 No. 2 (2017): April-June; 95-100 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Hydrocephalus, Tuberculus meningitis, Pediatric
الوصف: Objective: Objectivity of study is to determine the frequency of hydrophalus in pediatric tuberculus meningitis patients. Materials and Methods: This prospective observational study was done in pediatrics department Lady Reading Hospital Peshawer from 1st January 2013 to 31st June 2015 with 2½ years duration. All patients of tuberculus meningitis who survived with both gender and age ranging from 1 to 10 years were included. Pediatric patients admitted with other diseases, age greater than 10 years and those who expired due to tuberculus meningitis were excluded. Patient’s demographic features, vaccination status, clinical features of tuberculus meningitis and Frequency of hydrocephalus post meningitis were doccumented according to the proforma. Follow up duration was 6 months, SPSS version 189 used for data analysis, Results represented in the form of tables. Results: 38 patients fulfilled inclusion criteria. Females 22 (57.90%) were common than males 16 (42.10%). Patients age was in the range of 1 to 10 years with the mean age 5 years ± 5 SD. Fever 35 (92.10%), headache 37 (97.36%), vomiting 31 (81.57%) and failure to thrive 32 (84.21%) were dominant in clinical presentation. 29 (76.31%) patients vaccination status was satisfied. 14 (36.84%) patients developed hydrocephalus in 6 months follow-up. Conclusion: Hydrophalus is common in post tuberculus meningitic patients. It mostly affect non vaccinated patients.
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9دورية أكاديمية
المؤلفون: Ghani, Fazal, Ali, Mumtaz, Azam, Farooq, Ishaq, Muhammad, Zaib, Jahan, Shamsudin, Dr
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 20 No. 1 (2016): January-March; 53-57 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: MMC, Wound dehiscence, Complications, Spinal dysraphism, Hydrocephalus, V/P shunting
الوصف: Objective: To know about complications in Myelomeningocele (MMC) surgery.Material and Methods: Fifty five children underwent surgical repair of MMCs and represent our experience about complication in surgery for MMC. Retrospective observational study carried out in Neurosurgery ward, Lady reading hospital Peshawar, from 2013 to 2015. Patients suffering from MMC were admitted. The clinical, radiological and laboratory finding of patients were documented on a designed proforma. Moreover ventri-culoperitonial shunting (V/P) was performed for children who had or developed hydrocephalus. Eliptical incision in vertical plane was given in 45 cases and horizontal incision in 6 cases. Plastic surgery unit consulted for very large MMC in rest of 4 cases and transposition of gluteus maximus musculocutaneous unit performed. All patients with MMC of both gender and age range from 1 month to 10 years who were willing and fit for surgery were included in this study and all those who were not willing and fit for surgery were excluded. The study was approved by Institute of Research in Ethics and Biomedicine (IREB).This study will help to make recommen-dations.Results: Patients in this study were in the age range of 1 month to 10 years. Mean age was 1.8 years. Thirty seven patients (67%) were Paraparetic (MRC grade from 1 to 4) and 18 patients (32.72%) were completely paraplegic. Seventeen patients (30.9%) had ruptured MMC at presentation and underwent surgery in emergency. Fifteen patients (27.27%) had V/P shunting before surgery for MMC and 11 patients (20%) developed hydro-cephalus after excision and repair of MMC and V/P shunting carried out. Seven patients (12.72%) developed wound dehiscence and CSF leak and subjected to redo surgery. Three patients (5.45%) had wound infection followed by meningitis and two patients (3.63%) died after surgery.Conclusion: From this study we concluded that wound dehiscence and CSF leak are the most common complication after surgery for MMC and can be prevented by tensionless closure of the ...
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10دورية أكاديمية
المؤلفون: NADEEM, MALIK MUHAMMAD, HASSAN, MISBAH-UL-, BASHIR, SHABNAM
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 17 No. 1 (2013): January-June; 35-39 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Paediatric Neurosurgery, ETV, ETVSS, Obstructive Hydrocephalus
الوصف: Object: In February 2011 Abhaya V. Kulkarni et al. reported endoscopic third ventriculostomy success score in order to predict the outcome of obstructive hydrocephalus. After ETV the object of the present study was to evaluate this predictive value in our own setup, prospectively.Materials and Methods: From April 2011-November 2012, 110 endoscopic third ventriculostomy procedures were performed for obstructive hydrocephalus of different etiologies at the department of pediatric neurosurgery, the Children’s Hospital Lahore. All of these cases were more than 6 months old and the data was analyzed by the senior author.Results: A total number of 110 patients were operated between April 2011 – November 2012. The patients’ ages ranged from 6 months – 13 years. No child below 6 months was included in this study. Children were stratified into 4 age groups: 6 months – 1 year (Group – 1), 1 year – 2 years (Group – 2), 2 years – 10 years (Group – 3) and more than 10 years (Group – 4). The score was calculated for each patient before surgery according to ETVSS and at the end of 6months the success or failure of the ETV was determined by clinical, radiological measures. Out of 110 patients, only 80 were available at the completion of 6months period after surgery. The ETV was successful in 56 patients (70%). Patients below 1 year achieved lowest success. Of the ten patients with a high probability of ETV success, eight (80%) were successfully treated.Conclusion: The results show that EVT success can be predicted very well by ETVSS and it should help in establishing surgical selection criteria in order to obtain high success rate. It can also help in preparing the patients and their families to the expected outcome.
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