International Journal of Neurology and Neurosurgery

A very rare case of penetrating iron rod injury to brain at work place. We report a rare case of perforating iron rod injury to brain, rarity due to its entry point and how it manage to enter in to the brain parenchyma and damaging motor cortex, and managed in time to save his life and give him good recovery. A 21 year old male working in building construction, and had fall from height on a 12mm iron rod and sustained iron rod injury, after 10 min he become unconscious and brought to casualty after 3 hours of injury. Due to his poor GCS(Glasgow coma scale) patient intubated and evaluated found to having penetrating head injury with right temporal and parietal intraparanchymal hematoma with significant mass effect, and emergency decompressive Craniectomy with hematoma evacuation with bone flap kept in abdominal parietal wall. After six months he underwent cranioplasty and hemi paresis improving.

Keywords: Penetrating head injury; Soft palate; Iron rod; Workplace.

Ossification of ligamentumflavum (OLF), though rare, is being increasingly recognized as a cause of thoracic myelopathy. Earlier, OLF has been reported almost exclusively in East Asian countries, particularly in Japan and Korea. Studies of OLF from other regions, such as India, Middle East &Caribbean are increasingly being reported. In view of the low incidence of this disorder and rarity of large clinical reports, the treatment guidelines and surgical prognosis in patients with this disease remain unclear. Hence, the study was conducted. Objectives: We retrospectively& prospectively studied the risk factors, clinical manifestations, radiological aspects, surgical treatment, and prognostic factors in 31 patients ofthoracic ossification of ligamentumflavum (OLF). Methods and results: A total of 31 patients who underwent surgical treatment for thoracicmyelopathy secondary to OLF between 2014 and 2018 were studied retrospectively&prospectively.Preoperative and postoperative neurological data were reviewed and the correlationbetween the variables of patient characteristics, preoperative duration of symptoms,preoperative neurological status, and the functional outcome were analyzed. The maleto female ratio was 1.9:1. In total, 23 patients (74.2%) were in the 5th & 6th decadeof life. The lower thoracicregion (D9–D11) was most commonly affected (48.4%).All patientsunderwent wide decompressive laminectomy with medial one-third facetectomyandOLF was resected. The average follow-up was 2 years. Conclusion: In all, 21 patients (67.7%) had good outcome, 6 patients (19.4%) had fair outcome, 2 patients(6.5%) improved but still required help for their routine work &2 patients (6.5%)were bed-ridden at last follow-up.Mostcommoncomplications observed were dural tear &csf leak (6.4%).

Keywords: Ligamentumflavum; Thoracicspine; Ossification; Laminectomy.

Background: Young population is the most productive age group in a community and contributes major share to the economy. The impact,stroke can leave is disproportionately large.Public health efforts addressing stroke in young is very scarce.Further research is needed in this field to decrease the burden of the disease in our society.The aim of our study was to find out the risk factors and to study the clinical and etiological profile of stroke in young. Materials and Methods: This is a hospital-based prospective cross sectional study in patients in the age group 18-45 years,attending the Neurology Outpatient Department,casualty and Department of Internal Medicine of a tertiary care centre, in central Tamil Nadu, with history suggestive of stroke and in whom brain imaging showed evidence of stroke. The study was done for a period of 1 year. Results:Among the 160 young persons with stroke , most affected were males(68.75%),ischemic stroke was seen in 50.625%, followed by intracerebral hemorrhage (ICH) in 35.0%, cortical venous thrombosis(CVT) in 7.5%,subarachnoid hemorrhage(SAH) in 6.875%. Hemiparesis was the most common presenting symptom.Alcohol consumption was the most prevalent risk factor for development of stroke, followed by other risk factors such as smoking and hypertension. Conclusion: Stroke was predominantly seen in young male patients.Other than the traditional risk factors which are associated with stroke in young, unfavorable behavioral patterns like alcohol abuse,smoking also may promote development of stroke in young.

Keywords: Atherosclerosis; Hemiparesis; Hemorrhage; Ischemia; Subarachnoid.

Neural tube defects are most frequent, costly & deadly of all congenital anomalies. Open neural tube defect has exposed neural tissue and is continuously or intermittently leaking cerebrospinal fluid, extensive changes are almost always present in the CNS. Closed neural tube defect has no visible neural tissue and no leaking CSF. Causes include genetic and environmental factors. They may occur in isolation or as a part of a syndrome or chromosomal disorder. It has been estimated that 60-70% of neural tube defects have genetic component. The occurrence or recurrence of neural tube defects can be prevented with administration of folic acid before and in early pregnancy. The aim of present study is to assess different types of spinal cord malformation and their outcome of surgery of the patients admitted to our institute. Methods: This prospective study reports 10 cases of neural tube defects at different levels of spinal cord. Occipital, dorsal and lumbo-sacral regions that are admitted to our hospital for surgical repair between October 2018 to September 2019. Results- A total of 10 cases have been operated after confirming the diagnosis with MRI, out of which 1-occipital, 1-thoracic and 8 are lumbosacral region. All the patients have improved well and are under regular follow-up.Out of which 6 were male and 4 were female. 3 were neonates, 2 were infants and 5 were children. Conclusion- All 10 cases are managed accordingly and producing no new neurological deficits post operatively. An early diagnosis, timely intervention and meticulous repair gives good results.

Keywords: Congenital; Neural tube defect; Surgical repair; Prevention.