International Journal of Neurology and Neurosurgery

Background: Trauma and trauma related deaths due to head injury are a major health concerns. Yet reliable statistics are difficult to discover from routinely collected data. This study helps to measure the epidemiology, mortality and morbidity of traumatic head injury patients in a tertiary care hospital in Pune. Methods: Retrospective data of one year (1st January 2021 to 31st December 2021) was collected from Medical records department. Demographic data, severity and mode of injury, interventions done, duration of stay, morbidity and mortality were recorded. Results: Of the total 984 cases recorded, 805 were males and females were 179. Majority (More than 50%) were below 40 years of age. The most common cause of trauma was RTA (83.3%). Of all the trauma patients 100 (10.16%) were found to be under influence of alcohol. On admission 80 patients (8.13%) had poor GCS (0-3), while 812 (82.53%) on admission had good GCS (8 and above). 180 patients underwent neurosurgical intervention. Average length of hospital stay of majority patients (518) was 4 to 7 days. Total mortality was 125 (12%). Conclusions: The above study gives statistics regarding the epidemiology, morbidity and mortality of patients of traumatic head injuries in a tertiary care hospital which can be used for future references in designing management policies to prevent traumatic head injuries.

Context: Lagenaria siceraria (Molina) Standley (LS), commonly known as ‘bottle gourd’ (English), possesses several medicinal properties; little is known about its action as nerve tonic. Objective: The purpose of the study was to evaluate the neuropharmacological activities of methanolic extract of Lagenaria siceraria (Molina) Standley fruits (MLSF) using several experimental (animal behavioral) models. Materials and Methods: Adult Wistar albino rats were subjected to behavior despair and elevated plus maze (EPM) tests. Thiopental induced sedation and rotarod tests were conducted on Swiss albino mice. Results and Discussion: The effects of MLSF on anxiety, depression, thiopental induced sleeping time, and rotarod performance were evaluated. The anxiolytic activity of MLSF (100, 200 and 400 mg/kg) per os (p.o.) was characterized by increased time spent and number of entries in open arms in the EPM paradigm as compared to control group (p < 0.001). The MLSF (50,100, and 200mg/kg, p.o.) showed dose dependent significant reduction in duration of immobility (p < 0.01) in behavior despair test. The MLSF at the doses 50 and 100 mg/kg, i.p. was found to produce a significant reduction in motor coordination (p<0.001) and prolongation of thiopental induced sleeping time (p<0.001). The phytochemical screening revealed the presence of flavonoids, saponins and sterols in fruits. Conclusion: The results of the study for the first time show that the plant possesses anxiolytic, anti-depressant and sedative like activities confirming the traditional claims. Future research should focus on the isolation and identification of the phytoconstituents responsible for activities of LS.

Background: This article is to assess the role of transcranial Doppler (TCD) in predicting neurological outcome in traumatic brain injury (TBI) and we review its practical aspects in management of TBI. Material and Methods: This was a prospective study conducted on 50 patients with traumatic brain injury in the Neurosurgery department of a tertiary care hospital in Rajasthan. Transcranial colour Doppler was done in all the patients to assess the cerebral perfusion. Doppler parameters like Peak systolic velocity, End diastolic velocity, Mean flow velocity and Pulsatility index in bilateral proximal middle cerebral arteries were obtained in all the cases. Patients are categorized into normal, hypoperfusion and vasospasm groups depending on the values. Prognosis was assessed by the neurological deficit and mortality. Results: Among thirty six patients (51%) who had normal measurement on TCD, 72% patients had good outcome, 18% patients had poor neurological status and 10%patients died. Out of these eleven patients (23%) who had vasospasm, three died, six had severe neurological disability and two patients were discharged in good neurological status. Eighteen patients (26%) had hypoperfusion, of whom, 7 patients had neurological impairment and 5 patients progressed to brain death. Conclusion: TCD is a valuable imaging tool in prognostication of patients with TBI information by providing information about the cerebral blood flow. It is an emerging modality in predicting neurological outcome in patients with TBI.

Diastematomyeliais a congenital malformation in which a part of the spinal cord is split, usually at the level of the upper lumbar vertebra in the sagittal direction. It results from an abnormal adhesion between ectoderm and endoderm. Females are affected much more commonly than males (3:1). There is complete or incomplete sagittal division of the spinal cord into two hemi cords due to the presence of an osseous, cartilaginous or fibrous septum in the central portion of the spinal canal. The course of the disease is progressive as the patients may be asymptomatic to begin with and gradually progress to sensory motor disorder and loss of bowel and bladder control. With modern imaging techniques, various spinal dysraphism can be diagnosed earlier which can aid in improving quality of life of the individual. Treatment depends upon the symptoms. Regular neurological examinations may helps in early detection of progression of the disease and resection is done if required. We are presenting here a case of diastematomyelia, its imaging study and management.