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Head injury is a leading cause of death in young age group. Extradural hematoma, a complication of head injury, is often fatal if not treated in time. The surgical outcome of EDH is dependent upon many variables including preoperative GCS, time between injury and surgery, associated intracranial injuries, anisocoria and hematoma volume. In order to reduce the mortality near to nil, it is essential to determine the magnitude of effect of affecting factors on surgical outcome which will also help us in preoperative counseling and prioritizing the operative candidates. This study was conducted determine the factors affecting surgical outcome of traumatic intracranial extradural hematoma in Punjab Institute of Neurosciences/ Lahore general hospital, Lahore. It was a Cross sectional study conducted for 3 years from 28th May 2012 to 28th May 2015. The study was conducted on the patients admitted through emergency and diagnosed as Extradural hematoma. These patients underwent surgical evacuation of EDH on emergent basis and outcome was measured by Glasgow Outcome Scale (GOS) after 48 hours of surgery. Using GOS, good surgical outcome was observed in 80.9% (157 out of 194) patients. Preoperative GCS, anisocoria, hematoma volume, associated intracranial injuries and time between injury and surgery were the factors affecting the outcome signifi cantly (p value=0.000) while age and sex of the patient had no signifi cant effect. In Conclusion, good surgical outcome is associated with patients with solitary Extra Dural Hematoma of volume less than 60ml, preoperative GCS more than 8, absence of anisocoria and undergoing surgical evacuation within 6 hours of injury. [ABSTRACT FROM AUTHOR]

Objective: To associate the findings of CT scan with the Glasgow coma scale (GCS) of cases presenting with head trauma in the Emergency Department. Study Design: Cross-sectional study. Place and Duration of Study: Emergency Department, Combined Military Hospital, Rawalpindi Pakistan, from Jul to Dec 2021. Methodology: Ninty head injury cases of either gender, aged 12-60 years were included using non-probability consecutive sampling. The severity of the head injury was determined via GCS. CT scan findings were noted. Results: The mean age was 22.21±11.10 years. The highest frequency of patients was noted in the age group of (13-29 years). The most common cause of head injury in men was road traffic accidents n=39/58(67.24%). As per GCS scoring, 63.3% of patients had mild brain injury. A strong association was observed between GCS and CT scan findings in cases with brain oedema (p=0.002), skull fracture (0.018) and no findings on CT scan (p-value≤0.001). No association between findings on CT scan and GCS scoring was noted in cases with epidural, subdural hematoma, cerebral contusions, intracranial and subarachnoid haemorrhage. Conclusions: There is a lack of association between brain injury based on GCS scoring and CT scan findings. Using GCS scoring only for assessing the degree of brain injury is insufficient. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency, etiological profile and mortality in neonates with seizure disorders. Study Design and setting: prospective study at National Institute of Child Health (NICH) Karachi from January 15th 2011 to 16th September 2011. Material and Method: A total of 115 neonates (1 -28 days) with various types of seizures were enrolled after explaining purpose and procedure of the study, consent was taken from parents. Their detailed history, physical examination and appropriate investigations were recorded on a predesigned proforma. Data was analyzed using descriptive statistics. Results: Out of a total 3240 admissions, 115 neonates (3.54%) presented with seizures. Birth asphyxia was the leading cause and found in 45(39.13%) of neonatal seizure disorders (NSDs). Hypoglycemia and hypocalcaemia was found in 35(30.43%) of the cases while 18 (15.65%) had infections like meningitis and sepsis. The common type of seizures observed were subtle (44.35%) followed by focal (27.83%), clonic (20.87%) and myoclonic types (6.95%).The overall mortality was 26 %. Brain malformations, Intracranial hemorrhage, kernicterus, birth asphyxia and infections were responsible for the mortality in 66.67%, 42.85%, 40%, 37.77% and 27.77% of cases respectively. There was no death attributed to metabolic causes. Conclusion: In this study frequency of neonatal seizure disorders observed was 3.54%. Birth asphyxia, metabolic causes and infections has been observed to be the common cause of seizures in neonates. Brain malformation, intracranial hemorrhage, kernicterus, birth asphyxia and infections were significant contributors to mortality. Metabolic group had a favourable outcome. [ABSTRACT FROM AUTHOR]