British journal of neurosurgery
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Background: Traumatic brain injury (TBI) is the most common cause of death and disability in young adults in industrialised countries. Post-TBI hypopituitarism (PTHP) is thought to occur in one-third of patients, however the natural history and predictive factors are not fully understood and as such guidelines for surveillance vary. The aim of this study was to assess the variations in current surveillance practices across the Neurosurgery Centres within the United Kingdom. ⋯ There was wide variation in the criteria used to determine which patients were screened. Conclusions: Our survey suggests that few Neurosurgeons routinely screen for PTHP and those that do use a wide variation of clinical parameters to guide surveillance practice. A UK-wide prospective cohort study may help identify patients at risk of developing PTHP.
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Background: The clinical symptoms and signs of Cauda equina syndrome (CES) are non specific and poorly predictive of cauda equina compression on MRI. We aimed to establish whether a history of lumbar spine surgery predicts cauda equina compression on MRI in those presenting with suspected CES. Methods: A retrospective electronic record review was undertaken of 276 patients referred with clinically suspected CES who underwent a lumbosacral spine MRI. ⋯ Twenty six (9%) patients presented more than once with suspected CES. Patients with a history of lumbar surgery were more likely to re-present with suspected CES (χ2 - p = .002). Conclusions: Prior lumbar surgery was associated with a higher frequency of re-presentation with clinically suspected CES but a lower frequency of radiological cauda equina compression.