Post concussion syndrome after mild traumatic brain injury in a single neurosurgical center in East Coast, Malaysia - A preliminary report

Introduction: Mild traumatic brain injury is the most common form of traumatic brain injury. Individuals sustaining mild head injuries often complain of a cluster of symptoms termed post concussion syndrome. Post concussion syndrome can be profoundly disabling. Thus the aim of this study is to determine the prevalence of post concussion syndrome in an adult population with mild traumatic brain injury in a single neurosurgical center in East Coast, Malaysia. Methods: Cross Sectional study, in a single neurosurgical center in Kuantan, Pahang. The study period is from January 2016 – December 2016. Universal sampling method was used, all patients with mild traumatic brain injury presenting to HTAA, meeting the inclusion and exclusion criteria is included in this study. Patients are then subjected to the checklist for diagnosis of post concussion syndrome as per ICD 10 classification at 2 weeks interval. Results: Between February 2016 – June 2016, a total of 136 patients with mild traumatic injury have been recruited to this study. The leading cause of mild traumatic brain injury is road traffic accidents, 86 patients (63.2%), and the mean age of this patient with mild traumatic brain injury is 28.8. Out of this number, 11 patients (8.1%) have been diagnosed with post concussion syndrome. Conclusions: The majority of individuals who sustain mild traumatic brain injuries are young adults, and the most common cause is road traffic accidents. Less than 10% of recruited patients suffered from post concussion syndrome

Symptomatic cerebral ependymal cyst: a case report

Cerebral ependymal cyst is a rare benign neuroepithelial cyst. We report a case of cerebral ependymal cyst in a 62-year-old lady who presented with status epilepticus. She gave history of progressive right occipital headache over a year. Magnetic Resonance Imaging of the brain showed a large occipital cyst. She underwent a right craniotomy, deroofing of the cyst and insertion of Ommaya catheter. The clinicopathological aspects of the cyst are discussed

Conus Medullary Syndrome secondary to Spinal Schwannoma : A report of 3 cases

Spinal Schwannoma originates from the Schwann cells, hence it is called Schwannoma. The tumor localization is in various parts of the spinal cord, but prevails in cervical and thoracic. In the literature 70 to 80% of spinal schwannomas are reported to be intradural in location, and 15% with both intradural and extradural components. All 3 cases were female in their 4th-5th decade, presented with either low back pain, radiculopathy, weakness of both lower limbs associated with urinary incontinence. MRI revealed a well defined mass adjacent to conus medullary area located intradural, extramedullary. All three patients underwent microscopic assisted excision of the tumour. All patients had Good Early Outcome. Spinal schwannoma causing Conus Medullary Syndrome is rare. Back pain and radicular pain were most common early presenting symptoms while urinary symptoms occur later. Schwannomas typically arise from a single nerve root originating from the schwann cells. To obtain total resection, the affected nerve root is commonly sacrificed in order to prevent recurrence. Intradural Extramedullary Schwannoma, even presented at a later stage with significant neurological deficit, has a Good Outcome post operatively owing to its Benign nature, Extramedullary location, and a Meticulous Microscopic assisted Complete Surgical Excision

A local study on the incidence and risk factors of post-traumatic seizures among patients with traumatic brain injury

Post-traumatic seizures are a well-known and serious complication of traumatic brain injury. The incidence and risk factors vary among study populations. Very little data has been published concerning this in the population of Malaysia. The aim of this study was to ascertain the incidence and risk factors for the development of post-traumatic seizures among patients with traumatic brain injury in this part of the country. This was a prospective observational study, carried out in Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan under the Department of Neurosciences. A total of 157 patients from any age group who were diagnosed with traumatic brain injury were enrolled from June 2007 to December 2007, then followed up for 12 months, until death or their first post-traumatic seizure. Patients were further divided into highrisk and low-risk groups and randomized to receive either phenytoin for 1 week or 1 year ( for the high-risk group ) and either phenytoin for 1 year or no phenytoin ( for the lowrisk group). Survival analysis using Kaplan-Meier curves and Cox proportional hazards regression were used. 26 out of 157 ( 16.6%) patients developed post-traumatic seizures. 11 of the 26 ( 42.3%) developed early post-traumatic seizures ( within 7 days ) of the trauma whereas the remaining 15 ( 57.7%) developed seizures between 8 days to 12 months after trauma. The mean time to develop late post-traumatic seizures was 9.4±3.2 months. The risk factors for developing early and late post-traumatic seizures were different. For early post-traumatic seizures, the risk factors were young age (p=0.021, 95% CI =0.806, 0.982) and intubated patients ( p=0.029, 95% Cl=1.194, 25.913 ). For late post-traumatic seizures, the significant risk factor was severe head injury with a Glasgow Coma Scale of 3-8 (p=0.036, 95% Cl=l.065, 6.464). Log-rank tests for phenytoin treatment in both high-risk and low-risk groups were insignificant (log-rank statistic of 0.31 with a p-value of 0.5784 for the high-risk group; log-rank statistic was 0.23 with a p-value of 0.6283 for the low-risk group). Incidence of post-traumatic seizures in the local population was 16.6%. Risk factors for early post-traumatic seizures were young age and intubated patients; whereas for late post-traumatic seizures, only severity of head injury was found to be signifi9ant. Phenytoin was not beneficial as prophylaxis against post-traumatic seizures

Choroid plexus carcinoma: A case report and literature review

Choroid plexus carcinoma is a rare tumor representing less than 1% of all brain tumors. In adult, the incidence is extremely rare making the diagnosis difficult. Majority of choroid plexus tumor is found in the ventricle. However, ectopic sites such as intracranial extraventricular or spine have been reported. We report a case of choroid plexus carcinoma in a 39-year-old man. The clinical presentation, pathology and management are discussed

Post concussion syndrome after mild traumatic brain injury in a single neurosurgical center in East Coast, Malaysia - A preliminary report

Introduction: Mild traumatic brain injury is the most common form of traumatic brain injury. Individuals sustaining mild head injuries often complain of a cluster of symptoms termed post concussion syndrome. Post concussion syndrome can be profoundly disabling. Thus the aim of this study is to determine the prevalence of post concussion syndrome in an adult population with mild traumatic brain injury in a single neurosurgical center in East Coast, Malaysia. Methods: Cross Sectional study, in a single neurosurgical center in Kuantan, Pahang. The study period is from January 2016 – December 2016. Universal sampling method was used, all patients with mild traumatic brain injury presenting to HTAA, meeting the inclusion and exclusion criteria is included in this study. Patients are then subjected to the checklist for diagnosis of post concussion syndrome as per ICD 10 classification at 2 weeks interval. Results: Between February 2016 – June 2016, a total of 136 patients with mild traumatic injury have been recruited to this study. The leading cause of mild traumatic brain injury is road traffic accidents, 86 patients (63.2%), and the mean age of this patient with mild traumatic brain injury is 28.8. Out of this number, 11 patients (8.1%) have been diagnosed with post concussion syndrome. Conclusions: The majority of individuals who sustain mild traumatic brain injuries are young adults, and the most common cause is road traffic accidents. Less than 10% of recruited patients suffered from post concussion syndrome.</jats:p

Post concussion syndrome after mild traumatic brain injury in a single neurosurgical center in East Coast, Malaysia - A preliminary report

Introduction: Mild traumatic brain injury is the most common form of traumatic brain injury. Individuals sustaining mild head injuries often complain of a cluster of symptoms termed post concussion syndrome. Post concussion syndrome can be profoundly disabling. Thus the aim of this study is to determine the prevalence of post concussion syndrome in an adult population with mild traumatic brain injury in a single neurosurgical center in East Coast, Malaysia. Methods: Cross Sectional study, in a single neurosurgical center in Kuantan, Pahang. The study period is from January 2016 – December 2016. Universal sampling method was used, all patients with mild traumatic brain injury presenting to HTAA, meeting the inclusion and exclusion criteria is included in this study. Patients are then subjected to the checklist for diagnosis of post concussion syndrome as per ICD 10 classification at 2 weeks interval. Results: Between February 2016 – June 2016, a total of 136 patients with mild traumatic injury have been recruited to this study. The leading cause of mild traumatic brain injury is road traffic accidents, 86 patients (63.2%), and the mean age of this patient with mild traumatic brain injury is 28.8. Out of this number, 11 patients (8.1%) have been diagnosed with post concussion syndrome. Conclusions: The majority of individuals who sustain mild traumatic brain injuries are young adults, and the most common cause is road traffic accidents. Less than 10% of recruited patients suffered from post concussion syndrome

Risk Factors and Phenytoin Prophylaxis for Early Post-Traumatic Seizures among Patients with Traumatic Brain Injury

Background: Post-traumatic seizure is a well-known and serious complication of traumatic brain injury (TBI). The incidence and risk factors vary among study populations. Very little data have been published concerning this in the Malaysian population. The aim of this study was to ascertain the risk factors for the development of early post-traumatic seizures among patients with TBI. Methods: This was a prospective observational study, carried out in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, under the Department of Neurosciences. A total of 157 patients, from all age groups, who were diagnosed with TBI were enrolled from June 2007 to December 2007. They were followed-up for 12 months until death or their first post-traumatic seizure. Survival analysis with Kaplan–Meier curves and Cox proportional hazards regression was performed. Results: A total of 11 (7.0%) of the patients developed early post-traumatic seizures. The risk factors for early post-traumatic seizures were young age (P = 0.021, 95% CI 0.806 to 0.982) and intubated patients (P = 0.029, 95% CI 1.194 to 25.913). The incidence of early post-traumatic seizures in the local population was 7.0%. Conclusion: The incidence of early post-traumatic seizures in the local population of Kelantan and Terengganu is comparable to the incidences reported elsewhere. Younger as well as intubated patients were at a higher risk of developing this condition. It may be necessary to give antiepileptic prophylaxis because any seizure could adversely affect morbidity and mortality. However, the study showed that antiepileptic drug was not beneficial in preventing late post-traumatic seizures, but may have a role in preventing early seizures

A Case Report of Atypical Teratoid/Rhabdoid Tumour in a 9-Year-Old Girl

Primary central nervous system atypical rhabdoid/teratoid tumour (ATRT) is a rare and highly malignant tumour that tends to occur in infancy and early childhood. The majority of tumours (approximately two-third) arise in the posterior fossa. The optimal treatment for ATRT remains unclear. Options of treatment include surgery, radiotherapy, and chemotherapy. Each of their role is still not clearly defined until now. The prognosis of the disease is generally unfavourable. This is a case report of ATRT in an atypical site in a 9-year-old girl

A Case Report of Atypical Teratoid/Rhabdoid Tumour in a 9-Year-Old Girl

Primary central nervous system atypical rhabdoid/teratoid tumour (ATRT) is a rare and highly malignant tumour that tends to occur in infancy and early childhood. The majority of tumours (approximately two-third) arise in the posterior fossa. The optimal treatment for ATRT remains unclear. Options of treatment include surgery, radiotherapy, and chemotherapy. Each of their role is still not clearly defined until now. The prognosis of the disease is generally unfavourable. This is a case report of ATRT in an atypical site in a 9-year-old girl