Neurology India
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Evaluation of the degree of severity of injury, coma duration, and prediction of outcome are integral parts of present-day management of severe traumatic brain injury (TBI). ⋯ 1 H-MRS may be a novel method of assessing brain function, estimating coma duration, and predicting outcome in patients with severe TBI.
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Transformational epidural steroid (TFES) is commonly used to treat lumbosacral radicular pain. However, very few studies have systematically evaluated the quality of analgesia following such procedures with respect to time. ⋯ Quality of pain relief produced by TFES was significant. Long-term quality of pain relief was better in patients with pain duration less than 6 months. Even though, the study was designed to inject the drug once, many of the patients required second injection. A further study with multiple injections at prefixed time interval might probably result in a better overall outcome.
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Neurosurgical patients, in particular patients with severe head injury require frequent computed tomogram (CT) of the head, usually at short notice. A mobile CT may prove to be invaluable for these patients. This report reviews the initial experience with a mobile CT at tertiary trauma center. ⋯ During the study period, the main CT scanner broke down four times (for variable time periods) and the mobile CT scanner could manage the load of severe head injured patients in the casualty without any problems. The mobile CT machine itself broke down 36 times and the mean response time was 12.5 h (range 1-144 h) during each breakdown point. This experience suggests that mobile CT is extremely useful in the management of patients with severe traumatic brain injury and can be recommended for any high-volume neurosurgery department in the country.
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Severe Guillain-Barré syndrome (GBS) is associated with significant morbidity and also mortality. Identification of modifiable risk factors may help in reducing the morbidity and mortality. ⋯ Early identification of modifiable risk factors, such as pulmonary involvement, autonomic dysfunction, hypokalemia, sepsis, bleeding, and nutritional complications, may reduce the mortality and morbidity associated with GBS.