Outcome of transforaminal epidural steroid injection for lumbar radiculopathy: initial three-year experience at Upendra Devkota Memorial-National Institute of Neurological and Allied Sciences, Nepal.

Background: The prevalence of low back pain with radiculopathy in general population varies from 9.9% to 25%, which can be due to bony narrowing of the lateral recess or due to prolapsed intervertebral disc. Transforaminal epidural injection of a mixture of long-acting anaesthetic (bupivacaine) and particulate steroids (depomedrol) has been a treatment modality in patients not responding to initial physiotherapy and neuropathic pain medications.

Does Diffuse Axonal Injury MRI Grade Really Correlate with Functional Outcome?

Objective: Diffuse axonal injury (DAI) is a common form of primary head injury. This study was done to see the association of DAI grades with extended Glasgow Outcome Scale (GOSE).

Methods: We retrospectively reviewed the charts and radiology reports of a cohort of patients discharged with the diagnosis of diffuse axonal injury.

Renal impairment in stroke patients: A comparison between the haemorrhagic and ischemic variants.

Renal impairment is regularly seen in hospitalized stroke patients, affecting the outcome of patients, as well as causing difficulties in their management. A prospective cohort study was conducted to assess the trend of renal function in hospitalized ischemic and haemorrhagic stroke patients. The incidence of renal impairment in these subgroups, the contributing factors and the need for renal replacement in renal impaired patients was evaluated.

Outcomes of endoscopic suturectomy with postoperative helmet therapy in bilateral coronal craniosynostosis.

OBJECTIVE Historically, bilateral frontoorbital advancement (FOA) has been the keystone for treatment of turribrachycephaly caused by bilateral coronal synostosis. Early endoscopic suturectomy has become a popular technique for treatment of single-suture synostosis, with acceptable results and minimal perioperative morbidity. Boston Children's Hospital has adopted this method of treating early-presenting cases of bilateral coronal synostosis.

Unsung hero: Donald Darrow Matson's legacy in pediatric neurosurgery.

Donald Darrow Matson made seminal contributions to the field of pediatric neurosurgery. Born in 1913 in Fort Hamilton, New York, Matson was the youngest of four sons of an army colonel. He graduated from Cornell University and, years later, from Harvard Medical School.

Surgery for intractable epilepsy due to unilateral brain disease: a retrospective study comparing hemispherectomy techniques.

Background: Hemispherectomy is a surgical procedure used to treat medically intractable epilepsy in children with severe unilateral cortical disease secondary to acquired brain or congenital lesions. The major surgical approaches for hemispherectomy are anatomic hemispherectomy, traditional functional hemispherectomy, and peri-insular hemispherotomy. We describe the epilepsy outcome, including the need for reoperation, after hemispherectomy in patients with brain malformations or acquired brain lesions who underwent hemispherectomy for refractory epilepsy.

Ruptured temporal lobe arachnoid cyst presenting with severe back pain.

Arachnoid cyst is a common congenital anomaly in the pediatric population. The cysts are often asymptomatic, but they can cause headache and other symptoms. Occasionally a cyst may rupture after head trauma producing a subdural hematoma.

Virtual reality simulation: basic concepts and use in endoscopic neurosurgery training.

Introduction: Virtual reality simulation is a promising alternative to training surgical residents outside the operating room. It is also a useful aide to anatomic study, residency training, surgical rehearsal, credentialing, and recertification.

Discussion: Surgical simulation is based on a virtual reality with varying degrees of immersion and realism.

Franc D. Ingraham and the genesis of pediatric neurosurgery.

In 1929, Franc D. Ingraham, Harvey Cushing's protégé, established the first pediatric neurosurgical unit in the world at Boston Children's Hospital and dedicated his career to the neurosurgical care of children. He trained with both Cushing and Dandy and spent 1 year working in Oxford with Sherrington, who considered Ingraham to be the finest operative surgeon ever to work in his laboratory.

Intrasacral meningocele in the pediatric population.

Object: Intrasacral meningoceles are rare cystic lesions that can cause focal compression within the bony sacral canal. Their mechanisms are poorly understood, but most intrasacral meningoceles appear to be intrasacral extradural cysts caused by arachnoid herniating through a small dural defect in the caudal end of the thecal sac. As opposed to perineural cysts, they are not associated with an exiting nerve root.

Moyamoya disease with mesial temporal sclerosis.

The combination of moyamoya syndrome and symptomatic mesial temporal sclerosis (MTS) has not previously been reported. The authors present the case of a 5-year-old boy with symptomatic MTS who developed progressive moyamoya syndrome. This combination of progressive moyamoya and a structural seizure focus presented a unique clinical problem, with the natural history of MTS predicting a high likelihood of needing resection in the future, which could be challenging following any type of moyamoya-related revascularization surgery.

Hyponatremia in patients with traumatic brain injury: etiology, incidence, and severity correlation.

Background: Hyponatremia is common in patients with traumatic brain injury (TBI). This study aims at ascertaining the incidence of hyponatremia in TBI with its etiologic diagnosis, biochemical confirmation, and severity correlation with initial Glasgow Coma Scale (GCS) score and computed tomography (CT) abnormality.

Methods: All patients more than 20 years old with severe and moderate TBI and the mild ones with CT abnormality were included.

Predictors of unfavourable seizure outcome in patients with epilepsy in Nepal.

Background: Despite optimal medical therapy, a sizeable number of patients continue to have persistent seizures. We evaluated the association of pretreatment and treatment variables with unfavorable seizure outcome.

Methods: Patients with follow-up over 12 years in the Nepal Epilepsy Association were evaluated.