Bhavuk Kapoor

Background: Endovascular treatment has proven to be effective in the management of intracranial aneurysm, and can achieve permanent occlusion in up to 85% of cases, reducing the bleeding or rebleeding rate. A paradigm shift from microsurgical clipping to endovascular intervention has been observed since the publication of the International Subarachnoid Aneurysm Trial. Aneurysm recurrence after coil embolization remains both a major shortcoming of endovascular treatment and a daunting challenge for neurosurgeons without optimal management strategies. Materials and Methods: We present a case report of a patient with history of previously endovascularly coiled and presenting with aneurysmal bleed. Conclusions: Microsurgical clipping is an effective intervention for managing reruptured previously coiled intracranial aneurysm.   Keywords: Endovascular coiling, Recurrent aneurysm, Clipping, Aneurysmal bleed, ICH

Background: Traumatic brain injury (TBI) constitutes a major health and socioeconomic problem throughout the world TBI is called the ‘silent epidemic’ because problems resulting from TBI are often not immediately visible and TBI patients are not very vociferous. Epidemiological studies of TBI are essential to the targeted prevention and effective treatment of brain-injured patients. Epidemiology analysis of surgically managed traumatic brain injury patients was done. Results: Mean age was 35.9 years. Males were more commonly (80%) involved than females (20%). In 57.5% of cases, falls were responsible for TBI and in 42.5% of cases, Road traffic accidents were responsible. Edh was the most common type of TBI in (50%). Chronic SDH occurred in 25% of cases. Acute SDH and Contusions were both seen in 13.75% of cases. Depressed fractures occurred in 6.25% of cases and ICH occurred in 1.25% of cases. Craniotomy was the most common (42%) surgical procedure performed, followed by burrhole drainage (22.5%). Decompressive craniectomy was done in 18.75% of cases and elevation of depressed fracture was performed in 6.25% of cases. Conclusions: Traumatic brain injury (TBI) constitutes a major health and socioeconomic problem throughout the world. People of all ages are affected by it. Males are more commonly involved as compared to females. Timely hospitalisation and surgical management whenever indicated improves the survival.   Keywords: Traumatic Brain Injury, Epidemiology, Surgery in Traumatic Brain injury, Demography

Background: One of the major public health issues worldwide is traumatic brain injury. EDH is most commonly located in the temporoparietal region. Proper and timely management of these patients improves the outcome. To interpret theincidence, etiology and location of EDH in surgically managed patients. Settings and Design: Surgically operated EDH patients were epidemiologically analysed as per the age, gender, mechanism of injury, GCS at admission, site of hematoma and associated intracranial injuries. Materials and Methods: Epidemiological analysis of thirty operated EDH patients was done. Statistical analysis: Statistical evaluation was done   . Results: EDH was more common (76.67%) among males than females (23.33%). Mostly patients (50%) were in the age group of 21-41 years. Road traffic accident was the most common (50%) mode of trauma leading to EDH occurrence. Temporoparietal EDH was the most common (36.66%) location on CT scan. Most common (70%) associated intracranial injury observed was the skull fractures. Conclusion: EDH is a serious complication of head injury. Early diagnosis and proper management is required. EDH is more common in men. Careful interpretation of CT scan head is important to get information about the location EDH and other associated injuries before proceeding for surgical evacuation.   Keywords: Extradural haematoma, Incidence, Etiology, EDH location

Background: Chronic SDH is a condition which usually affects the elderly population. Trauma is the most common cause of chronic subdural haematoma. Surgical Treatment of chronic subdural haematoma includes burr holes with or without drainage. In patients with membrane formation, craniotomy is considered. Aims: To know the incidence of chronic subdural haematoma in different age groups, the risk factors for its occurrence and its surgical management. Settings and Design: The incidence of chronic SDH in different age groups and the different surgical procedures done for its management were noted. Materials and Methods: Fifty patients of chronic SDH who underwent surgical intervention were analysed. Statistical analysis: Statistical evaluation was done Results: Mean age was 62.06 years. 54% of patients were in the age group of >62 years. Mostly (56%) chronic subdural haematoma was on the right side. Right side chronic subdural haematoma patients had mean age of 60.8 years, left side chronic subdural haematoma patients had mean age of 56.7 years and bilateral chronic subdural haematoma patients had mean age of 75.6 years. Trauma (46%) was most commonly associated with chronic SDH formation. Burr hole evacuation was the preferred surgical treatment modality (92%). Conclusion: Chronic SDH usually occurs in elderly population. Bilateral Chronic SDH is commonly seen in elderly patients. Traumatic brain injury is the commonest predisposing factor for its occurrence. In some elderly patients even a trivial injury may lead to the occurrence of chronic SDH. Keywords: Chronic subdural haematoma, Burr hole drainage, Age related incidence, Bilateral chronic SDH.

Background: Chronic SDH usually affects the elderly population. The common symptoms in chronic SDH patients are headache, altered sensorium, memory loss, weakness and lethargy. Timely surgical intervention is advisable wherever indicated. Aims: To interpret the patient demographics, causes, presentations and surgical management in chronic subdural haematoma patients. Settings and Design: Patients were analysed as per their demographic characteristics, clinical features and surgical management done. Materials and Methods: Fifty patients of chronic SDH were analysed. Statistical analysis: Statistical evaluation was done Results: Most of the patients were in the 7th and 8th decade of life. Patients in our study were mostly of the urban areas (60%) than rural areas (40%). 66% of patients were males and 34% of patients were females. Trauma (52%) was most common cause for Chronic SDH formation. Headache was the most common (89%) presenting symptom in our study. Altered sensorium was the next common presentation. Most of the patients (76%) had GCS score of 13-15 at presentation. Burr hole evacuation was the preferred surgical treatment modality (90%). Conclusion: Chronic SDH is a common neurosurgical entity mostly seen in elderly. Patients from urban areas have higher occurrence of Chronic SDH due to better diagnostic and health facilities. Headache is the one of the most common presenting symptom and trauma being one of the most common causes for its occurrence. Whenever in doubt especially in elderly CT scan head can be considered to rule out its occurrence. Burr hole evacuation is the preferred surgical treatment modality in most of the cases. Timely surgical intervention is advisable wherever indicated. Keywords: Chronic subdural haematoma, Causes, Patients demography, Clinical presentation.

Background: Benign breast diseases are a common problem. This study was done to evaluate the different types of benign breast diseases in females based on their epidemiological characteristics, clinical, radiological and pathological findings. Aims: To evaluate the different types of benign breast diseases in females based on their epidemiological characteristics, clinical, radiological and pathological findings. Settings and Design: The epidemiological characteristics of patients of benign breast diseases were observed. Methods: A study of 35 female patients of benign breast disease was done and their characteristic findings were recorded. Statistical analysis: Statistical calculations were performed. Results: The age group of 30-39 years had the highest incidence of the cases (34.28%). Lump in the breast was the most common (51.42%) presenting symptom. Most commonly involved quadrant was upper outer quadrant (60%). Fibroadenoma (51.42%) the most common lesion in our study and presented mostly as lump in the breast in the upper outer quadrant and occurred in the age group of 20-29 years mostly. Conclusions: Benign breast diseases are fairly common in the younger age group. Fibroadenoma is the most common benign breast condition. Proper assessment and investigations are necessary for its diagnosis. The patient needs assurance regarding the benign nature of their disease by appropriate clinical, radiological and pathological diagnosis to allay their anxiety. Keywords: Benign breast disease, Fibroadenoma, Fibrocystic disease, Duct ectasia, Breast Abscess.

Background: Lumbar degenerative spine conditions cause mobility dysfunction and can result in alterations in physical functioning and variable levels of pain. The best measurement of treatment quality in these diseases should be the patient’s opinion of the results using patient-reported outcome instruments. Aims: To do comparative evaluation of pain intensity in lumbar degenerative spine patients in preoperative and postoperative period. Settings and Design: Pain intensity of all selected patients was measured at admission and postoperatively using Numeric pain rating scale (NPRS). Materials and Methods: Effect of surgery on pain relief in 60 patients of degenerative lumbar spine disease was studied. Statistical Analysis used: Paired ‘t’ test was performed to find out the differences in the variables between pre-operative and post-operative stages among the study population. Results: Preoperative NPRS values (mean=7.88) improved at discharge (mean=4.8) and throughout the follow up period at 1month (mean=3.46), at 6 months (mean=2) and 1 year (mean=1.11). Conclusions: All the patients showed improvement in their NPRS scores throughout the follow up period. The use of NPRS outcome instrument gives us a platform to predict a positive and accurate outcome after surgery in the long term. Keywords: Degenerative lumbar spine disease, Pain relief, Numeric pain rating scale, Outcome measure.