Factors Affecting the Outcome in Traumatic Subarachnoid Hemorrhage

Objective: To define risk factors affecting the outcome in traumatic subarachnoid hemorrhage.Material and Methods: Forty-four patients with traumatic subarachnoid hemorrhage were evaluated retrospectively. They were divided into three groups according to their age: elderly (≥65 years), adult (16- 64 years), and children (<16 years). The clinical picture on admission was evaluated using the Glasgow Coma Scale. The patients were also divided into three groups according to their coma grading on admission: mild injury (Glasgow Coma Scale score 13-15), moderate injury (8-12), and severe injury (3-7). The amount of subarachnoid blood shown in computerized tomography was evaluated according to the Fisher index, and additional tomography findings were recorded. At last follow-up, presence of headache and neurological deficits as well as return to work or school were investigated, and the last clinical picture was evaluated with the Glasgow Outcome Scale.Results: There were 11 children, 23 adults and 10 elderly patients. Twelve patients died between 1-49 days after trauma; the others were followed for a mean of 14.6 months (from 10 to 30 months). In the children group, Glasgow Coma Scale score was significantly higher (p=0.004), subarachnoid blood amount was significantly lesser, and Glasgow Outcome Scale score was significantly better compared to the other groups. For all groups, higher trauma severity on admission was associated with higher Fisher index (p=0.016). Most important factors affecting clinical results were severity of head injury on admission (p=0.0001), Fisher index (p=0.003), and presence of additional findings on computerized tomography (p=0.0001).Conclusion: Traumatic subarachnoid hemorrhage usually has a good clinical outcome in children; however, in elderly patients, the outcome is worse, and there are usually additional intracranial traumatic lesions. Most important factors affecting outcome are blood amount on first computerized tomography, head trauma severity, and presence of additional intracranial traumatic lesions

Posterior fossa dermoid cysts causing cerebellar abscesses

Dermoid cysts are uncommon tumors, and posterior fossa dermoid cysts may rarely cause abscess formation or formation of daughter abscesses within the cerebellum. At present, there are only 16 cases with posterior fossa dermoid cysts causing cerebellar abscesses reported in the literature. Two cases, 22 and 14 months old, with posterior fossa dermoid cysts and dermal sinus causing multiple cerebellar abscesses are reported. In the first one, there was also marked hydrocephalus. Retrospective examination of the patients revealed pinpoint-sized dimples in their suboccipital regions. Both patients were treated with antibiotics and underwent posterior fossa surgery. In the patient with marked hydrocephalus, ventriculoperitoneal shunting was performed after treatment of the infection. Both patients were neurologically normal, and there were no complaints, except a light learning difficulty in the patient with ventriculoperitoneal shunting, 133 and 34 months after surgery, respectively. Early detection of congenital dermal abnormalities along the craniospinal axis by routine examination of newborns is highly important before development of serious complications. Because surgery is the only effective treatment modality for these lesions, radical excision should be performed in all cases to avoid tumor recurrence. However, subtotal excision may be performed in selected cases, because the cyst capsule may adhere firmly to vital structures. Copyright (C) 2007 S. Karger AG, Basel

Platelet function parameters in management of hepatic hydatid disease: A case-controlled study

Aim: To evaluate platelet function in patients with a history of surgical treatment for hepatic hydatid disease (HD). Methods: This retrospective case-controlled study was performed in a state hospital in Turkey from January 2009 to November 2013. The patients were divided into two groups: those evaluated in the preoperative period (Group 1) and those evaluated in the postoperative period (Group 2). The patient groups were compared with a control group (Group 3). All three groups were evaluated using laboratory records from day 1 of the preoperative period and day 30 of the postoperative period. The haematocrit level (HTC), platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and percentage of eosinophils (EOS) were compared among the groups. Results: Fifty-three patients who had undergone surgical treatment of hepatic HD and 55 healthy controls were included in the study. The mean follow-up time for all patients was 45 (14-70) months. The patients comprised 33 (62%) females and 20 (38%) males. The control group comprised 37 (67%) females and 18 (33%) males. The median age of the patients was 48 (19-78) years, while that of the control group was 42 (16-64) years. No significant differences in the HTC, PLT, or EOS were present among the groups. The MPV and PDW indicated that platelet function was significantly different between Group 1 and Groups 2 and 3. Additionally, nine patients had undergone previous surgical treatment for HD. In a separate long-term follow-up, these patients exhibited no statistically significant differences in MPV or PDW between the preoperative and postoperative periods. Conclusions: MPV and PDW can be used in the initial follow-up of patients with hepatic HD, but have limited use in long-term follow-up. © 2015, Int J Clin Exp Med. All rights reserved

Outcome of the Respiratory Syncytial Virus related acute lower respiratory tract infection among hospitalized newborns: A prospective multicenter study

© 2015 Taylor & Francis.Aim: To determine the incidence and outcomes of respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (ALRI) including morbidity, nosocomial infection and mortality among newborn infants who were admitted to the neonatal intensive care units (NICUs).Methods: A multicenter, prospective study was conducted in newborns who were hospitalized with community acquired or nosocomial RSV infection in 44 NICUs throughout Turkey. Newborns with ALRI were screened for RSV infection by Respi-Strip®-test. Main outcome measures were the incidence of RSV-associated admissions in the NICUs and morbidity, mortality and epidemics results related to these admissions.Findings: The incidence of RSV infection was 1.24% (n: 250) and RSV infection constituted 19.6% of all ALRI hospitalizations, 226 newborns (90.4%) had community-acquired whereas 24 (9.6%) patients had nosocomial RSV infection in the NICUs. Of the 250 newborns, 171 (68.4%) were full-term infants, 183 (73.2%) had a BW >2500 g. RSV-related mortality rate was 1.2%. Four NICUs reported seven outbreaks on different months, which could be eliminated by palivizumab prophylaxis in one NICU.Conclusion: RSV-associated ALRI both in preterm and term infants accounts an important percent of hospitalizations in the season, and may threat other high-risk patients in the NICU