1.Cognitive impairments in mild traumatic brain injury apolipoprotein E: A preliminary study in a Level I trauma center
Vigneswaran Veeramuthu ; Devaraj Pancharatnam MSurg ; Anada Raj Poovindran ; Nur Atikah Musthapha ; Wong Kum Thong ; Mazlina Mazlah ; Vicknes Waran ; Dharmendra Ganesan
Neurology Asia 2014;19(1):69-77
The complex pathophysiology of traumatic brain injury, its cascading effects and a varied outcome
suggest that factors such as genetics may permeate and modulate the neurocognitive outcomes
in patients with mild traumatic brain injury (mTBI). This study was conducted to determine the
relationship between genetic polymorphism of apolipoprotein E, and neurocognitive and functional
outcomes in mTBI. Twenty-one patients with mTBI were recruited prospectively. The severity of the
injury was established with the Glasgow Coma Score (GCS). Other assessments included the CT Scan
of the head on admission, Disability Rating Scale, Chessington Occupational Therapy Neurological
Assessment (COTNAB) and Glasgow Outcome Scale (GOS). The Spearmen correlation analysis
of ApoE allele status and the cognitive and functional assessments saw some association with the
Sensory Motor Ability - Coordination (-0.526, p<0.05), Communication Ability (-0.651, p<0.05),
and the Employability (Return to Work) at 1st month (0.455, p<0.05). Notably, the deficits of specific
attributes of visuospatial and sensory motor function were seen with greater impairment consistently
observed in patients with ApoE e4 allele. In conclusion, the preliminary findings support the possible
relationship that exists between ApoE e4 and neurocognitive impairment in mTBI, despite good
functional recovery in 6 months post injury.
2.Multicompartmental congenital intracranial immature teratoma
Dharmendra Ganesan ; Sheau Fung Sia ; Vairavan Narayanan ; Gnana Kumar ; Lucy Lum ; Lucy Chan ; KS Mun ; Vicknes Waran
Neurology Asia 2013;18(1):117-121
Congenital intracranial tumors are rare and account for 0.5 to 1.5% of all childhood tumours. We report
a case of a 3 week old baby presenting with multi compartmental congenital intracranial immature
teratoma, fi rst of its kind in the literature. The child had gross total excision in two stages with aid of
neuronavigation. The short term outcome was good. The four years of follow-up with serial imaging
showed no tumour recurrence with a stable hydrocephalus after shunting. However, there is global
developmental delay with full time dependence of care giver