Traumatic Brain Injury Patients: Direct Versus Inter-facility Transfer Time to Neurosurgical Center and the Effects on Outcome

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Nonoperative treatment of acute traumatic spinal injuries: A prospective study

Background: Traumatic spinal injury is a major cause of morbidity and mortality worldwide. There is no agreed method of care. Neurological recovery in complete injury has been dismal.Aims and Objectives: The aim of this study is to determine the neurological recovery at discharge in traumatic spinal injury patients managed nonoperatively in our center.Materials and Methods: This was a prospective descriptive study carried out on traumatic spinal injury patients managed by neurosurgical unit in our center from August 2010 to July 2013. The unit started in July 2010 with virtually no available facilities for surgical care for these patients. All patients were managed nonoperatively. The unit recorded data of the patients in accident and emergency, intensive care unit, and wards using structured proforma. Data were analyzed using Epi Info 7 software.Results: There were 76 patients studied of which 57 were males and 25 were females. Fifty three were caused by road traffic accident. Nineteen were complete injury. Patients with incomplete injuries did well at discharge. Completeness of injury significantly affected the outcome.Conclusion: The neurological recovery in incomplete spinal injuries in our study was good, but poor in complete injury. Conservative treatment should be adopted in developing countries in patients with poor resources and in centers where facilities are not available for adequate imaging and surgical care. Trauma system is imperative in our country.Key words: Nonoperative, spinal injuries, traumatic, treatmen

Superficial Temporal Artery Pseudoaneurysm: A Report of Two Ruptured Cases and Review of Literature

Superficial temporal artery (STA) pseudoaneurysms are rare cause of scalp swellings and majority are due to trauma. Diagnosis is mainly clinical and the treatment of choice is surgery. Haemorrhage is a rare complication of untreated cases. We report two bleeding superficial temporal artery pseudoaneurysms managed in our centre. They presented with actively bleeding scalp swellings, one in the parietal region and the other in the temple. Diagnosis of superficial temporal artery pseudoaneurysm was made clinically in both cases. Xylocaine with Adrenaline infiltration around the afferent and efferent vessels stopped the bleeding. The patients had coagulation of afferent and efferent vessels and excision of the  pseudoaneurysms with good outcome. We also reviewed literature on pseudoaneurysms of the superficial temporal artery.Key words: Bleeding, Pseudoaneurysm, Superficial temporal artery, Surgery

Effects of computerised tomography scan features on outcome of traumatic brain injuries

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Aetiology and treatment outcome of severe traumatic brain injuries in neurosurgical center with inadequate facilities

Background: Severe traumatic brain injury (TBI) is a major challenge to the patient, the relatives, the care givers, and the society in general. The primary and secondary injuries, and the high metabolism are formidable stages of the injury, each capable of taking the life of the patient. The objectives were to determine the etiology and outcome in severe traumatic brain injuries patients.Methods: This was a prospective study on patients with severe traumatic brain injury patients managed in our center from August 2010 to December 2014. Patients were resuscitated in accident and emergency unit using Advanced Trauma Life Support protocols. Those with Glasgow Coma scale scores ≤8 were included in the study.Data were collected with structured proforma which was component of our prospective data bank that was approved by our ethics committee, and were analyzed with Environmental Performance Index info 7 softwareResults: One hundred and ten patients were studied. Males were 86. The mean age Was 31.43 years. Ninety six were involved in road traffic accident. Seventy seven patients had favorable outcome.Conclusion: The commonest etiology was road traffic accident.Seventy seven patients had favorable outcome.Keywords: etiology, outcome, severe traumatic brain injur