Nonoperative treatment of acute traumatic spinal injuries: A prospective study

Background: Traumatic spinal injury is a major cause of morbidity and mortality worldwide. There is no agreed method of care. Neurological recovery in complete injury has been dismal.Aims and Objectives: The aim of this study is to determine the neurological recovery at discharge in traumatic spinal injury patients managed nonoperatively in our center.Materials and Methods: This was a prospective descriptive study carried out on traumatic spinal injury patients managed by neurosurgical unit in our center from August 2010 to July 2013. The unit started in July 2010 with virtually no available facilities for surgical care for these patients. All patients were managed nonoperatively. The unit recorded data of the patients in accident and emergency, intensive care unit, and wards using structured proforma. Data were analyzed using Epi Info 7 software.Results: There were 76 patients studied of which 57 were males and 25 were females. Fifty three were caused by road traffic accident. Nineteen were complete injury. Patients with incomplete injuries did well at discharge. Completeness of injury significantly affected the outcome.Conclusion: The neurological recovery in incomplete spinal injuries in our study was good, but poor in complete injury. Conservative treatment should be adopted in developing countries in patients with poor resources and in centers where facilities are not available for adequate imaging and surgical care. Trauma system is imperative in our country.Key words: Nonoperative, spinal injuries, traumatic, treatmen

Traumatic Brain Injury Patients: Direct Versus Inter-facility Transfer Time to Neurosurgical Center and the Effects on Outcome

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Superficial Temporal Artery Pseudoaneurysm: A Report of Two Ruptured Cases and Review of Literature

Superficial temporal artery (STA) pseudoaneurysms are rare cause of scalp swellings and majority are due to trauma. Diagnosis is mainly clinical and the treatment of choice is surgery. Haemorrhage is a rare complication of untreated cases. We report two bleeding superficial temporal artery pseudoaneurysms managed in our centre. They presented with actively bleeding scalp swellings, one in the parietal region and the other in the temple. Diagnosis of superficial temporal artery pseudoaneurysm was made clinically in both cases. Xylocaine with Adrenaline infiltration around the afferent and efferent vessels stopped the bleeding. The patients had coagulation of afferent and efferent vessels and excision of the  pseudoaneurysms with good outcome. We also reviewed literature on pseudoaneurysms of the superficial temporal artery.Key words: Bleeding, Pseudoaneurysm, Superficial temporal artery, Surgery

Teachers’ Attitude and Competence Towards the use Of ICT Resources: A Case Study Of University Of Agriculture Lecturers, Abeokuta Ogun State, Nigeria

The study is on teachers’ attitude and competency towards the use of ICT resources in their lectures.The population of the study were lecturers at the federal university of agriculture, Abeokuta. Questionnaire and observation were instruments used to gather data from the respondents. The findings revealed that majority of the lecturers have positive attitude and competency towards the use of ICT resources in their lectures, and the use of ICT in instruction enhance academic performance of students. The study concludes by recommending that university administration should provide more training in the area of ICT to its staff and improve on regular and uninterrupted power supply to the campus

Effects of computerised tomography scan features on outcome of traumatic brain injuries

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Aetiology and treatment outcome of severe traumatic brain injuries in neurosurgical center with inadequate facilities

Background: Severe traumatic brain injury (TBI) is a major challenge to the patient, the relatives, the care givers, and the society in general. The primary and secondary injuries, and the high metabolism are formidable stages of the injury, each capable of taking the life of the patient. The objectives were to determine the etiology and outcome in severe traumatic brain injuries patients.Methods: This was a prospective study on patients with severe traumatic brain injury patients managed in our center from August 2010 to December 2014. Patients were resuscitated in accident and emergency unit using Advanced Trauma Life Support protocols. Those with Glasgow Coma scale scores ≤8 were included in the study.Data were collected with structured proforma which was component of our prospective data bank that was approved by our ethics committee, and were analyzed with Environmental Performance Index info 7 softwareResults: One hundred and ten patients were studied. Males were 86. The mean age Was 31.43 years. Ninety six were involved in road traffic accident. Seventy seven patients had favorable outcome.Conclusion: The commonest etiology was road traffic accident.Seventy seven patients had favorable outcome.Keywords: etiology, outcome, severe traumatic brain injur

Chronic subdural haematoma:Clinical presentation, surgical treatment and outcome at the Lagos University Teaching Hospital

Background Chronic subdural haematoma (CSDH) is a relatively common problem in neurosurgical practice worldwide with favourable prognosis when treated adequately. The incidence is about five per 100,000 per year in general population. Incidence is higher in the elderly, about 58 per  100,000 per year. Diagnosis of CSDH is still frequently missed or delayed in our environment with many patients often admitted and managed for various medical conditions before finally being referred for brain computerized tomographic scan.Objective To determine the surgical outcome of patients treated for chronic subdural Haematoma in our environment.Methods A surgical audit of 73 patients consecutively treated for CSDH at our institution between May 2005 and September 2010 to determine their demographic characteristics, clinical presentations and management outcome.Results Majority of the patients were between 61 - 70 years. Sixty four percent of the patients had history of trauma; Only 2 patients were on anticoagulant therapy prior to presentation. The diagnosis was delayed or initially missed in 50% of the patients. Burrhole evacuation under general anaesthesia was the commonest operative procedure (96%). Five patients developed post operative complications; outcome was favourable in the majority (91.3%) of patients with a recurrence rate of 12.5% and mortality rate of 6.3%. Conclusion Despite frequent delay in diagnosis and  institution of treatment, surgical outcome is favourable in the majority of patients with CSDH many of whom are elderly

Craniopharyngioma causing visual loss in an adult

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Spinal Neural Tube Defects in Lagos University Teaching Hospital, Nigeria

Background: The incidence of neural tube defects is known to vary among regions. Very little has been reported about the incidence in Sub-Saharan Africa except for the general impression that the prevalent rates are low.Objective: To determine the profile of patients presenting with neural tube defects in Lagos , NigeriaMethods: We studied all patients with congenital midline back swellings presenting to one of two neurosurgical services in the state over a 5-year period to establish the incidence of spina bifida and develop demographic data. Data collected included the age at presentation, maternal age, education and parity, presence of co-existing anomalies and the social status of the parents.Results: One hundred and eight patients with congenital midline swellings of the back were studied. Meningomyelocele accounted for 96% of the cases seen. Half the patients presented within the first two weeks of life and although fifty percent of mothers had ultrasound scans done during pregnancy none of the patients were diagnosed prenatally. Seventy-three percent of mothers of affected children were from a low socio-economic class. The commonest co-existing congenital anomaly was lower limb deformity (Talipes equino-varus).Conclusion: Spina bifida is the commonest indication for neurosurgical clinic referral with the exception of trauma in our environment. The prevalence is higher among women in the lower socio-economic groups. Improved perinatal care is required to ensure that children with such birth defects get prompt medical attention and thereby preventworsening of an already complex problem.Keywords: Neural tube defects, Spina Bifida, Myelomeningocele

Congenital inclusion cysts of the subgaleal space

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