Burr hole and craniotomy in the treatment of subdural hematoma: A comparative study.

Aim: This article aims to study the clinical outcomes in patients with chronic subdural hematoma (CSDH) who underwent burr hole drainage or craniotomy. Patients and Methods: The length of hospitalization, Glasgow outcome scales (GOS) of patients undergoing burr-hole drainage or craniotomy, were evaluated and compared statistically. In this study, we also evaluated the relationship by receiver operating characteristic (ROC) analysis. Results: The sex and age distribution and specific clinical parameters of the patients were investigated. In this study, we provide the evidence of the GOS and length of hospitalization findings of the patients and the superiority of burr hole drainage over craniotomy. Conclusions: Chronic subdural hematoma responds better to burr hole drainage with shorter hospitalization and improved Glasgow score.

Brain MRI and MR Spectroscopy Findings in Children with Nutritional Vitamin B12 Deficiency.

INTRODUCTION: Our aim in this study was to analyze the findings of brain magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) of children with vitamin B12 deficiency. METHODS: This study included 14 cases. The findings of brain MRI and MRS in all cases were investigated. Four patients had been followed up and mean follow-up time 71.8 (59-85) day. RESULTS: Eight patients of the cases (57 %) had at least one abnormal MRI finding. The most commonly found MRI findings were thinning of the corpus callosum and brain atrophy, respectively. The mean ratio of NAA/Cr and Cho/Cr were measured in MRS, with values of 1.31 ± 0.17 and 1.04 ± 0.27, respectively. In two of three patients with abnormal MRI studies at presentation, subsequent MRI showed improvement while one patient remained unchanged. An increase in the ratios of metabolites were found in one case with control MRS. There was no lactate peak. CONCLUSION: Brain MRI was abnormal in more than half of the cases of children with vitamin B12 deficiency. Our radiologic findings similar with literature. There was no identifiable lactate peak. B12 deficiency could be the cause of the thinning of the corpus callosum and brain atrophy in the children that were given a brain MRI.

Importance of arterial distensibility in patients with vasovagal syncope.

OBJECTIVE: Vasovagal syncope (VS) has a significant place in the etiology of syncope; tilt table (TT) test is used for identification of patients with vasovagal syncope (VS); however, the repeatability of the TT test is low. Upon repeated administration of TT test to patients with a positive result, the test may reveal a negative result. This feature of the test renders it inadequate particularly in evaluating therapeutical efficacy in patients receiving treatment. The left ventricular (LV) volume changes are important in the pathology of VS; in addition, LV volume changes are directly affected by the changes in the arterial system and therefore, the present study investigated arterial distensibility (AD) in this patient population. PATIENTS AND METHODS: A total of 142 VS patients with a positive TT test result (A group) and 93 healthy individuals (B group) were enrolled in the study. The patients received tilt training treatment for 6 months. VS patients were further classified into two: syncope (+) or syncope (-) subgroup according to having at least one or more syncope episode during the 6 months of training program. All patients and controls underwent Doppler echocardiography and AD measurement which were repeated at the end of 6th month in syncope (+) and (-) subgroups. RESULTS: The mean AD value of patients in group A was significantly lower than that of participants in group B (0.39 ± 0.1 vs. 0.42 ± 0.1, p = 0.025). In Group A, AD was significantly correlated with left ventricular diastolic filling time (DFT), isovolumetric relaxation time and right ventricular DFT (r = 0.38, p < 0.05; r = -0.42, p < 0.05; r = 0.35, p < 0.05, respectively). Syncope (+) subgroup had lower mean AD value compared to syncope (-) subgroup (0.38 ± 0.1 vs. 0.44 ± 0.1, p < 0.001). CONCLUSIONS: AD may have valuable contribution to understanding the pathophysiology underlying VS and AD may be used in evaluating therapeutical efficacy for vasovagal syncope.