Trigeminal Nerve Compression (TGNC) Technique for the Treatment of Trigeminal Neuralgia; Study of 80 Cases in 10 Years

Objective: To evaluate the outcome of compression technique of trigeminal nerve at the intracisternal part of 5th nerve for trigeminal neuralgia. Methodology: This cross sectional study was conducted in Hayatabad medical complex, Lady ready hospital and Abasin hospital Peshawer from Jun 2004 to December 2014. After taking consent from the ethical committee all post operative cases of trigeminal neuralgia of compression technique with either gender were included while post operative cases of it due mass lesion in the brain were excluded. Patient’s particulars documentation were done in pre designed proforma. Post operatively patients were followed till to 1½ years. Results were analyzed by SPSS version 20 and presented in the form of graphs, charts and tables. Results: Total 80 patients were included in this study in which males were 60 (75%) while females were 20 (25%) cases having males to females ratio of 2;1. All the patients were in the age range of 35 to 65 years with the mean range of 45.76 ± 9.6 SD. V2, V3 pain distribution was on the top having 33 (41.25%) cases followed by V2 in 19 (23.75%). post operative outcome till to 1½ years out of 80 Patients 77 (96.2%) were completely pain free while 3 (3.8%) patients developed recurrence in the same branch of trigeminal nerve and 1(1.25%) case of CSF rhinorrhea, otorrhea and facial nerve paresis along with deafness for each of the three. Conclusion: Compression technique for trigeminal neuralgia is safe, simple and cost effective. Abbreviations: TGNC: Trigeminal Nerve Compression. CBC: Complete Blood Count

Incidence of Infection and Causative Organisms in Patients with Ventriculoperitoneal Shunting for Hydrocephalus

Objective: To determine about the incidence of infection and causative organisms in patients with Ventriculoperitoneal shunting for hydrocephalus. Materials and Methods: This retrospective observational study was carried out in the Department of Neurosurgery Lady Reading Hospital Peshawar, from Jan 2012 to Dec 2013 (one year). The medical record of all cases operated in last one year was checked from record room. Documentation was done according to Performa designed indicating age, sex, clinical features and type of microorganism. All patients of either sex and age with Previous Ventriculoperitoneal shunt surgery and Signs and symptoms suggestive of shunt infection were included in the study. While patients of previous Ventriculoperitoneal shunt with no signs and symptoms were excluded from the study. All the data were analyzed by SPSS 20 and results were represented in the form of graphs / tables. Results: Total 82 patients were included in the study in which males were 50 (60.97%) and females were 32 (39.02%). All the patients were in the age range of 6 months to 75 years having mean age of 37.75 years ± 5 SD. 58 (70.73%) were in pediatric age group and 24 (29.26%) were adults. Regarding etiology congenital acquiductal stenosis was the leading cause in children’s having 22/58 (37.93%) and CNS tumors were the most common cause in adults having 10/24 (41.66%). Fever and vomiting were the most common mode of presentation with 66 (80%) cases. overall incidence of shunt infection was 12 (14.63%) in which the most common microorganism was coagulase negative staphylococci having 6/12 (50%) cases. Conclusion: Shunt infection most commonly occur in children’s and coagulase negative staphylococci is the most common causative organism. Abbreviations: CSF: Cerebrospinal Fluid