Corrected QT (QTc) interval prolongation has been described after subarachnoid hemorrhage and head injury in adults. Abnormal QTc prolongation is associated with a higher risk of ventricular arrhythmias. The aim of this study was to analyze QTc interval and QTc dispersion in children with severe head trauma.Forty-three patients with severe head trauma and 49 children with no or only mild head injury as controls were enrolled in the study. QT interval from standard 12-lead electrocardiogram immediately after admission was calculated. QT interval was corrected by heart rate according to Bazett formula, and then QTc dispersion was calculated. At the same time, levels of serum electrolytes were measured.Although no significant difference in terms of age, sex, and R-R interval was found, QTc interval and QTc dispersion values were significantly increased in the patients with severe head trauma compared with those with no or only mild head injury (QTc, 447 +/- 31 vs. 409 +/- 27 milliseconds; QTc dispersion, 77 +/- 22 vs. 52 +/- 16 milliseconds, respectively). When the patients with severe head trauma were categorized as those with or without intracranial hemorrhage, both QTc interval and QTc dispersion were significantly greater in those with intracranial hemorrhage. These electrocardiographic parameters were inversely associated with Glasgow Coma Scale score, serum calcium levels, and, at a lesser degree, potassium levels.Children with severe head trauma, especially those with intracranial hemorrhage have longer QTc interval and greater QTc dispersion.
Aim: The scope of this study is to investigate the correlation between the clinical and radiological findings of high level lomber disc hernia (L1-2, L2-3, L3-4) and surgical outcome. Material and Method: 23 high level lomber disc hernia out of 262 lomber disc cases operated between January1996 and November 2001 at the department of Neurosurgery , Faculty of Medicine, Inonu University (Malatya Turkey) were retrospectively reviewed. Results: 39.1% of the cases were male and 60.9% were female. The mean age was 49.6. The mean interval between the initial complaint and the admittance was 3.7 months. The incidence of high level lumbar disc hernia was 8.8% and were mostly seen on L3-L4 level (78.3%). CT and myelography were performed in 13% of the cases and MRI and CT on the rest (87%). Only one case having the initial operation in our clinic required a second surgery with the diagnosis of recurrent disc hernia. Conclusion: None of the patients after surgery declared preoperative pain. Postoperative early evaluation using Prolo scale revealeed 56% good and 44% fair results. Reevaluation on the postoperative sixth month disclosed 87% good and 13% fair results. All of the patients benefited from surgery. Key words: Magnetic Resonance Imaging, Lumbar, Disc, High Level Disc Hernia
Between 1986 and 1994, 270 patients with an acute extradural hematoma (EDH) were treated in the Department of Neurosurgery, Izmir State Hospital in Izmir, Turkey. Eighty patients with a supratentorial EDH of less than 30 mL in volume were treated conservatively. The 69 male and 11 female patients ranged in age from 5 to 68 years. Five of the patients subsequently underwent surgery because of the deterioration in the level of consciousness and enlargement of EDH. One patient died after the operation. EDHs were localized in the temporal region in all five patients who subsequently required the surgical intervention. It has been emphasized that the findings on a computed tomographic (CT) scan performed very early may be misleading in patients with an EDH in progress. We concluded that the temporal location of EDHs with heterogeneous density in patients whose CT scan was performed less than 6 hours after trauma had a higher risk of hematoma growth and thus should be treated surgically. Periodic CT scans should be performed at brief intervals during the early phase of hospitalization.
Intraradicular lumbar disc herniation is very rare. The exact mechanism of the dural tear by a herniated disc is not known. Diagnosis of intraradicular lumbar disc herniation is difficult, so that it is rarely suspected preoperatively. This pathological entity may be a factor in the failure of lumbar disc surgery. We present the seventeenth and eighteenth cases of intraradicular lumbar disc herniation. We emphasise its importance and review the literature on intraradicular disc herniation.
Fiisun DEMİRÇIViŞevket TEKTAŞ cas es •Nith brain abscesses•who have been treated ai: mu department betweerı 1986 and 1991 were analyzed retrospecüvely.Twenty-seven abscesses were pn~sent in 20 cases.Abscesses we.re sol.H:aı:y in 15 cases and multiple in five cases.All patients underwent su:rgery and having drainage except l:wo abs~ cesses.Both of these ahscesses were smail and deeply localized and so conservative h•eat~ D:t
Contralateral acute complications such as acute epi/subdural hematomas can be encountered after evacuation of a chronic subdural hematoma, though they are rare. We found only one case of chronic subdural hematoma following the surgery for contralateral chronic subdural hematoma, have been published in English language literature. A 73-year-old male admitted to our hospital with a right-sided subdural hematoma. The subdural hematoma was evacuated through a burr-hole. A left-sided subdural higroma appeared after operation and turned into classical subdural hematoma in the course of time. After evacuation of contralateral chronic subdural hematoma, the patient recovered completely. All stages of the development of contralateral chronic subdural hematomas were shown by serial computed tomograms. It was suggested that traumatic chronic subdural hematomas develop from mostly subdural higromas. If contralateral subdural higroma is seen after surgical evacuation of a chronic subdural hematoma, the possibility of development of contralateral chronic subdural hematoma must be kept on mind.
