Surgical Outcome of Spontaneous Intracebellar Haemorrhage

Introduction: The management of spontaneous intracerebellar hemorrhage has always been a challenge for neurosurgeons and neurophysicians. So far, neither medical nor surgical intervention has been shown consis-tently to improve the outcome. In this study, we described our experience of surgery for the treatment of sponta-neous cerebellar haemorrhage.Objective: To determine the frequency of good outcome of surgical evacuation of intracerebellar hematoma.Materials and Methods: This was a descriptive prospective study conducted at the department of Neurosurgery PGMI / Lahore General Hospital Lahore. Duration of study was 1 year from 6th August 2010 to 6th August 2011. This study included 75 patients with spontaneous intracerebellar haemorrhage that underwent surgical treatment. Patients were followed for 30 days to see the frequency of good outcome.Results: The mean age of the patients was 60.60, SD 9.43 years (range 43 – 77). There were 15 (20%) patients of age range of 40 – 50 years, 19 (25.3%) patients of age range of 51 – 60 years, 33 (44%) patients of age range of 61 – 70 years, and 08 (10.7%) patients in the age range of 71 – 80 years). There were 51 (68%) male patients and 24 (32 %) female patient in the study. There were 33 (44%) patients who showed good outcome after surgical treatment of spontaneous intracerebellar haemorrhage.Conclusions: Surgery for spontaneous intracerebellar hemorrhage holds good outcome and should be conside-red for intracerebellar hemorrhage

Surgical Outcome of Anterior Decompression, Grafting and Fixation in Dorsolumbar Caries Spine

To evaluate the surgical outcome of anterior decompression, grafting and fixation in tuberculosis of the dorsal and lumbar spine.Study Design: Retrospective study.Place and Duration of Study: Department of Neurosurgery Unit – I, Lahore General Hospital, Lahore, From Jan 2008 to March 2012.Materials and Methods: Patients with caries spine having compression over the thecal sac with neurological deficit and kyphosis were included in the study. Patients below 17 years and above 56 year of age; patients with bed sores and unfit patients for anesthesia were excluded from the study. Complete blood picture with ESR, X-ray Chest, X-ray of the relevant spinal level and MRI were done. All patients were treated with corpectomy, debri-dement, drainage of abscess and grafting followed by fixation with poly-axial screws and rods. All patients were assessed by ASIA Impairment Scale before and after surgery and with Bridwell grading after surgery.Results: Among 79 patients, 47(59.49%) Male and 32(40.51%) Female patients, mean age was 37.2 ± 3 years. The commonest involved level was the dorsolumbar junction 53.16% (N = 42). Backache, sensory motor deficit and deformity were main presenting complains. Anterior decompression and grafting followed by fixation with poly axial screw and rods were done in all patients who fulfill the inclusion criteria. Lower limb power improved to ambulatory level in 60% of patients with complete paraplegia and recovery was excellent in patients with partial weakness; only n = 2 patients (2.53%) deteriorated to a lower grade. There was no postoperative mor-tality and one patient had long ICU stay due to lung injury. All patients have pain at the intercostal area and graft donor site that were treated with analgesia.Conclusion: According to our study, corpectomy followed by grafting and fixation is safe and effective pro-cedure. Even those patients presenting with complete paraplegia showed improvement in motor power to ambu-latory level and those who had partial deficit showed excellent improvement