Pattern of reporting and practices for the management of traumatic brain injury: An overview of published literature from India.

BACKGROUND: Published literature regarding the demographics and mechanism of injury for traumatic brain injury (TBI) in India has not been analyzed in an organized sample. OBJECTIVES: The objective of this systematic review was to organize the published literature from India related to TBI and analyze it in a very specific sample to identify the specific patterns of injury and associated mortality. MATERIALS AND METHODS: A search strategy with specific inclusion criteria was performed in PubMed, Cochrane, Web of Science, and the World Health Organisation (WHO) Global Health Library. The process included an additional search within the indexed literature and the website-based population survey reports. RESULTS: Our review identified 72 studies from 300 potentially relevant articles based on the broad criteria that defined the demographics of the patients suffering from TBI and the details of trauma sustained, including the mechanism of injury as well as its diagnosis, management, and outcome. Changes in demographic patterns, the patterns of the body regions involved, the associated injuries, the clinical presentation, the follow-up status of patients suffering from TBI, who may or may not have shown clinical improvement, the overall outcome, as well as the mortality and disability status reported in the literature were analyzed. A high incidence of TBI in the productive population is of serious concern. Extremes of ages are more vulnerable to severe injury and a poor outcome. CONCLUSION: Quantitative analysis of injuries and outcomes of TBI victims shows a bigger health impact in the economically active population and in patients in the extremes of age groups.

Evaluation of Radiological and Neurological Outcomes after Anterior Cervical Corpectomy with Fusion using Expandable Cage Alone and Expandable Cage with Anterior Cervical Plating.

Objective After anterior cervical corpectomy expandable cage were used with or without using anterior cervical plate for structural support are being preferred over autologous bone graft and other types of cages. Nowadays, the preferable type of cages and application of anterior cervical plate remain a debatable topic with studies giving divergent results. The purpose of this study is to evaluate the outcomes of expandable cages used alone or expandable cage used with anterior cervical plate following anterior cervical corpectomy. Materials and Methods This study was conducted on 100 patients from January 2019 to December 2021 and all patients were undergone anterior cervical corpectomy and fusion and divided in two groups with expandable cage only (Group A) and expandable cage with anterior cervical plate (Group B). Various long-term benefits and radiological outcomes were studied in both groups. Statistical Analysis and Results In this study, 100 patients were included and all patients underwent corpectomy followed by insertion of expandable cage alone or with anterior cervical plate. There was an improvement in C2-C7 Cobb's angle in group B was significantly higher than group A ( p < 0.05) and decrease in Nurick's scale score in group B was significantly higher than group A ( p < 0.05). The outcomes were measured with fusion rate (94%), subsidence rate (15%) and change in C2-C7 Cobb's angle was 4 degrees in this study. Conclusion Expandable cage with or without anterior cervical plate was used after anterior cervical corpectomy for various cervical pathological conditions. In this study, we conclude the long-term benefits and radiological outcomes of two groups as expandable cage was used alone or with additional application of anterior cervical plate. In this study, the results were more in favor of additional application of anterior cervical plate as compared with expandable cage alone and more studies were required in future for more established long-term benefits and drawbacks.

Prehospital Care in Traumatic Brain Injury: Factors Affecting Patient's Outcome.

BACKGROUND: Traumatic brain injury (TBI) is the leading cause of deaths worldwide. The morbidity and mortality due to TBI are related to both primary as well as secondary insults. The patients who survive from the primary insults, some may still have long-term disabilities. Most of these outcomes are related to the high incidence of prehospital secondary brain insults. Knowledge of these variables and timely management of the disease at the prehospital level can significantly improve the outcome and decrease the mortality. AIMS: The present study is aimed to evaluate the current status of prehospital care, prehospital factors, epidemiological characteristics, and outcome of TBI patients at a Level 1 trauma center. MATERIAL AND METHODS: It is a prospective observational study of 830 cases of TBI, done from November 15, 2015, to March 15, 2016, in the Department of Neurosurgery, Institute of Traumatology, SMS Medical College, Jaipur, Rajasthan, India. RESULTS: Analysis of data revealed that the incidence of TBI in males is four times higher than females. Most patients are in the age group of 21-30 years (30.24%) followed by 31-40 years (18.55%). Road traffic injury (69.52%) is the most common mode of injury in the age group of 21-30 years followed by injury due to fall (22.77%) which mostly affects the age group of 0-10 years (72.64%) and 61-70 years (38.6%). Analysis of different factors revealed that age is significantly correlated with the outcome having P = 0.016. Glasgow Coma Scale, saturation of peripheral oxygen, systolic blood pressure at admission are also significantly correlated with the outcome having P < 0.001, P < 0.001, and P < 0.001, respectively. CONCLUSION: It is evident from the study that the factors which affect the outcome of a TBI are influenced by prehospital care, and thus prehospital management of the TBIs can definitely improve the outcomes.

Spontaneous closure of posttraumatic high-flow carotid-cavernous fistula following cerebral angiography.

Traumatic carotid-cavernous fistula (TCCF) is a direct communication between cavernous portion of the internal carotid artery (ICA) and cavernous sinus due to tear in ICA. Most of the cases are treated by endovascular embolization. Spontaneous resolution of high-flow TCCFs is extremely rare. We report a case of posttraumatic, direct, high-flow carotid cavernous fistula (Barrow type A) that resolved spontaneously after cerebral angiography.

Gliosarcoma: A rare variant of glioblastoma multiforme in paediatric patient: Case report and review of literature.

Gliosarcoma is rare central nervous system tumour and a variant of glioblastoma multiforme with bimorphic histological pattern of glial and sarcomatous differentiation. It occurs in elderly between 5(th) and 6(th) decades of life and extremely rare in children. It is highly aggressive tumour and managed like glioblastoma multiforme. A 12-year-old female child presented with complaints of headache and vomiting from 15 d and blurring of vision from 3 d. Magnetic resonance imaging of brain shows heterogeneous mass in right parieto-occipital cortex. A right parieto-occipito-temporal craniotomy with complete excision of mass revealed a primary glioblastoma on histopathological investigation. Treatment consists of maximum surgical excision followed by adjuvant radiotherapy. The etiopathogenesis, treatment modalities and prognosis is discussed. The available literature is also reviewed.