Print ISSN: 0027-1446

Online ISSN: 2309-6217

Main Subjects : Neurosurgery


Factors Influencing Outcome and Mortality of Brain Abscess in Mosul City

Ali Hikmat Azeez; Ali Al-shalchy; Omar Khalid Agha

Annals of the College of Medicine, Mosul, 2021, Volume 43, Issue 2, Pages 198-206
DOI: 10.33899/mmed.2021.130630.1097

Background: Brain abscess by definition is a crucial pus collection inside the brain, resulted from the infection by a variety of bacteria, fungi, and parasite. It can be single or multiple. The size, position, and number of lesions, as well as the organism's pathogenicity, host reactions, and the severity of cerebral edema, all influence the presentation.
Objective: To assess how well a brain abscess was managed and to evaluate the patients with favorable and unfavorable Glasgow outcome scale (GOS). 
Patients and methods: From January 2014 to January 2021, the study was achieved and conducted in the Neurosurgical Department of Ibn-Sina Teaching Hospital on Mosul's left coast. The neurosurgery unit managed a case series investigation of 70 patients who had a brain abscess. Age, sex, duration of illness, initial neurosurgical status, and abscess features are among the clinical data.
A comparison was performed between patient with Favorable Glasgow outcome scale (GOS), moderate disability or those with good recovery and those with Unfavorable GOS, death or persist vegetate status outcome at discharge.
Results: The study involved 48 male and 22 female patients (male / female ratios 2.2:1). The series consist of 52 patients who experienced favorable outcome and 18 resulted from an unfavorable outcome. The mean of age for those patients was 20 years. The difference between males and females regarding favorable and unfavorable outcomes is insignificant. P-value was significant in cyanotic congenital heart diseases as cause of brain abscess were particularly prevalent among the children (adult VS children = 1:9). The most common site for single abscesses was the frontal lobe (25 patients), and majority of patients treated with burr hole drainage, which had the best results.
Conclusion: Although there were technological improvement of imaging and antibiotics treatment, the mortality of brain abscesses is still relatively high, especially among those with decreased level of consciousness on admission.  

Surgical Outcome and Prognosis of Spinal Missile injuries

Ali Hikmat Azeez; Nashwan Yaseen Sallama; Saad A. Yahya Alsaqa

Annals of the College of Medicine, Mosul, 2021, Volume 43, Issue 1, Pages 55-59
DOI: 10.33899/mmed.2021.129309.1070

Background: The spinal cord is so sensitive to injury. Once it is damaged; it shall lose its ability to repair itself .Unfortunately spinal cord injuries (SCI)are common in Iraq . It could be either complete or incomplete SCI. In the complete injury there is a total loss of sensation and motor function in the level below the site of the injury, while in the incomplete one there is some remaining neurological functions below the level of the injury.
Objectives: The aim of this study is to compare the surgical and conservative management of complete and incomplete spinal cord Injuries due to missile in Mosul city.

Patients and methods: A case series study of (60) patients with missile cord injury of the spine who were managed in the Neurosurgical Department at Ibn-Sina Teaching Hospital in Mosul from August 2011 – August 2013. The mean patient age was 30 years. Thirty three (55%) patients were surgically treated. The mean time of follow up was 9 months ranged from 6-18 months. All patients had complete radiological assessment, CT scan and one patient with through and through bullet injury magnetic resonance imaging( MRI) was done after initial resuscitation.

Results: All patients with complete spinal cord injury did not improved after non-surgical management, after surgical removal of bullet and it's pressure effect from the spinal cord just one case with conus medullaris injury gets improvement. Those with incomplete injuries show good improvement after surgical management.
Conclusion: Conus medullaris and cervical injuries show a better outcome in surgical treatment than those out surgical intervention in incomplete spinal cord injuries. There were no difference between the outcomes of surgical and non- surgical management of complete neurological injuries of the spinal cord.