Archives of CraniOrofacial Sciences

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Volume 6, Number 1, Vol. 6 2018
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REVIEW ARTICLE

Mohd Sheeba K, Deepa Sahu, Suryapratap Singh

Home-Based Palliative Care in Neurotrauma

[Year:2018] [Month:Vol. 6] [Volume:6] [Number:1] [Pages:4] [Pages No:1 - 4]

Keywords: Head injury, Neurotrauma, Mental Health, Anxiety, Depression, caregiver

   DOI: 10.5005/ACOFS-11029-06101  |  Open Access |  How to cite  | 

Abstract

Families usually offer home care for those with head injuries in India, since there aren't many professional longterm care institutions. In this situation, the caregivers mental health becomes a serious issue. Regretfully, society and healthcare providers frequently ignore this factor. As such, caregivers are susceptible to mental health illnesses like anxiety, depression, and other mental health problems. Head injury victims recuperation and rehabilitation are negatively impacted by this circumstance. The authors of this study have reviewed relevant literature to determine the scope and frequency of this problem among family caregivers of patients with neurotrauma. To properly manage these issues, the authors have identified several possible actions that the community and the neurosurgeon treating the patient can take. Their objective is to educate the neurosurgeon and other medical professionals about this issue and its various ramifications.

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Original Article

Arun Kumar, Lokendra Singh, Surya P Singh

An Institutional Experience with Surgical Evacuation for Chronic Subdural Hematomas with Burr-Hole Drainage

[Year:2018] [Month:Vol. 6] [Volume:6] [Number:1] [Pages:5] [Pages No:5 - 9]

Keywords: Chronic subdural hematoma (CSDH), burr hole, infection, headache, pneumocephalus

   DOI: 10.5005/ACOFS-11029-06102  |  Open Access |  How to cite  | 

Abstract

BACKGROUND: Surgery for chronic SDH (CSDH), one of the most common clinical entities in neurosurgery with the best prognosis, is the gold standard of therapy for elderly patients with a history of moderate trauma. RESEARCH GOALS: This study aimed to evaluate the clinical presentation, radiologic findings, therapy, and consequences of individuals with CSDH following surgical burr-hole evacuation. MATERIALS AND PROCEDURES: This prospective study was conducted on 24 patients who underwent cranial burr hole surgery for chronic subdural hematomas. RESULT: Five (20.8%) of the 24 patients in this study were female, and 19 (79.19%) were male. The most common age range for CSDH detection was 51-70 years old. The most frequent presenting symptoms of the patients were headache (14 {58.33%}) and giddiness (17 {70.8%}), which were followed by hemiparesis, or one-sided weakness. Of the patients, 22 (91.6%) exhibited a midline displacement greater than 5 mm. Recurrence of CSDH was the most common result in our study, occurring in 3 instances (12.5%). Recurrence was 8.3% (1 case out of 12) after two burr holes and 16.6% (2 cases out of 12) after a single burr hole. Mild uncomplicated pneumocephalus was present in 66.66% of the cases. We discovered a wound infection in 1 case (4.1%), which was treated with antibiotics. We did not have complications such as severe bleeding, CSF (cerebrospinal fluid) leakage, or tension pneumocephalus (TP). CONCLUSION: Two burr holes at the highest point of the hematoma are sufficient to fully drain the unilateral CSDH. Significant midline movement, single or multiple burr holes, and the age of the patient with comorbidities all affect the recurrence rate. Surgery is not required to treat postoperative mild pneumocephalus that appears on follow-up radiological imaging. For hazardous conditions such infection, post-operative pneumocephalus CSF leak, and recurrence of CSDH, emergency care is required.

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REVIEW ARTICLE

Rohit Namdev, Manish Swarnkar, Dhirendra Wagh, SP Singh

Burr Hole Surgery: Types, Technique and Review of Literature

[Year:2018] [Month:Vol. 6] [Volume:6] [Number:1] [Pages:3] [Pages No:10 - 12]

   DOI: 10.5005/ACOFS-11029-06103  |  Open Access |  How to cite  | 

Abstract

This article provides a basic overview of burr hole surgery and its applications, such as emergency burr hole evacuation for extra-axial cerebral haemorrhage or for different types of craniotomies. To perform fronto-orbito-zygomatic craniotomy, fronto-temporal, supra-orbital, or fronto-temporal-parietal decompressive craniectomies, among other procedures, a key bur-hole at the fronto-zygomatic-temporal region is usually utilized. However, the term “key hole,” or “key burr hole,” is frequently used to describe any burr hole in this region (fronto-zygomatic-temporal region anterior to pterional region).(1,2)

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