Intracranial neoplasmin Ibadan, Nigeria

Objective: To determine the pattern of histopathological variants of intracranial neoplasms, relative distribution of the variants in the age groups and also to determine the gender differences that exist in these tumours.Design: Case control study. Setting: Department of Pathology, University College Hospital, Ibadan, Nigeria.Patients: Two hundred and ten histologically confirmed cases of intracranial neoplasms seen during eleven-year period (1980 to 1990) were analysed. Interventions: Slides of tumours stained with haematoxylin and eosin, reticulin and phosphotungstic acid haematoxylin.Results: Two hundred and ten intracronial neoplasms comprising 172 primary and 48 secondary neoplasms were seen. One hundred and thirty five neoplasms occurred in adults and 75 in children. There was no gender difference, the ratio being 1:1. Gliomas accounted for the largest group of tumours followed by metastases to the brain. Of the gliomas, astrocytoma was the commonest. Craniopharyngiomas were found to becommon in children. Germ cell tumours were found to be uncommon.Conclusion: Gliomas are the commonest group of intracranial neoplasms in both adults and children. This is followed by metastatic tumours. Tumours of the sella turcica are predominantly found in children. Involvement of the brain in disseminated Burkitt’s lymphomas is predominantly found in Africans as the Burkitt’s tumour is uncommonin non Africans

Cervical spine cord injury in pregnancy. Conservative management of 3 consecutive cases in Ibadan, Nigeria

Study design A prospective study of 3 patients with incomplete cervical spinal cord injury in the 3rd trimester of pregnancy. Objectives To determine the effect of spinal cord injury and treatment with Gardner-Wells\' Tong traction on pregnancy, labour and parturition; and ascertain the effectiveness and safety of this conservative form of management in pregnancy. Setting The patients were admitted and managed between September 2002 and May 2004, in the University College Hospital Ibadan, Nigeria - the major referral Centre in neurological diseases for about a quarter to a third of Nigeria\'s population. Methods From the point of admission into our Emergency Unit, data on each patient was documented prospectively until discharge to the out-patient clinic where each of them was followed up at appointed intervals. These data were then analyzed and compared with reports in literature. Results All the patients had good outcome from the conservative management as measured by complete neurological recovery, uneventful pregnancy and normal parturition. They however, seem to be disposed to pre-term labour, without being aware of the labour pains. Conclusion Spinal cord injury in pregnancy could be successfully manage with Gardner-Wells\' Tong traction without deleterious effects on pregnancy and parturition, but appears to induce pre-term labour, associated with regional analgesia for labour pains. Etude prospecitve de 3 patientes présentant un traumatisme du rachis cervical au cours du 3ème trimestre de la grossesse. Déterminer les effets du traumatisme rachi-médullaire au cours d\'un traitement par traction cervicale de Gardner-Well dutant le travail et l\'accouchement. Les patientes ont été admises entre septembre 2002 et mai 2004 au centre hospitalier et universitaire d\'Ibadan, Nigeria, centre réferent neurochirurgical pour environ le tiers voire la moitié de la population du Nigéria. Les données cliniques et paracliniques ont été recueillies de l\'admission jusqu\'à la sortie et au cours des consultations de contrôle puis analysées par rapport aux observations de la littérature. Tous les patients ont eu une évolution favorable avec le traitement conservateur que nous avons adopté, avec une récupération neurologique complète, une absence d\'événement indésirable lors du travail, de l\'accouchent et des suites de couches. Keywords: Cervical spinal cord. Gardner-Wells\' Tongs traction. Third trimester gestationAfrican Journal of Neurological Sciences Vol. 25 (2) 2006: pp. 6-1

Conservative Management Of Third Trimester Cervical Spinal Cord Injury Using Gardner-Wells\' Tongs Traction

Spinal cord injury, though an important cause of morbidity appears to be uncommon in pregnant women or perhaps, has not been accurately documented among them. Superimposed on the many impairments resulting from spinal cord injury is the presence of the foetus in the womb, which in itself normally brings about intense physiological alterations in the patient. Despite the complexities, neither the pregnancy nor the spinal cord injury needs jeopardize the optimal care of the other as long as the standard protocols are followed. In the past 10 years, the University college Hospital, Ibadan, Nigeria treated approximately 900 spinal cord injury patients, and only 3 of these were pregnant-an incidence of 0.30 per 90 patients per year, or 0.33%. We report here, the conservative management of one of these pregnant patients using the Gardner-Wells\' tongs traction, resulting in normal parturition and full neurological recovery. Key Words: Spinal cord injury, Third trimester pregnancy, Gardner-Wells\' tongs traction Nigerian Journal of Clinical Practice Vol 8(1) 2005: 46-5

Anesthetic and surgical predictors of treatment outcome in re-do craniotomy

Introduction: Craniotomy is a neurosurgical operation done to remove brain tumor, repair vascular lesion, and relieve intracranial pressure. Complications can arise which may necessitate re-do craniotomy. The study is planned to find out the relationship between variables such as age, American Society of Anaesthesiologist (ASA), Glasgow coma score (GCS), frequency of re-do craniotomy, and surgical outcome of re-do craniotomy. Materials and Methods: This is a retrospective study of all the patients who had re-do craniotomy over a 4-year period. The data that were collected included age, sex, ASA classification, indication for re-do craniotomy, GCS, frequency of re-do craniotomy, postoperative complications, and outcome. Results: Twenty-five patients had indication for re-do craniotomy within the study period. Forty percent were male and 60% were female, and their mean age was 38.56 ± 17.38 years. The indications for re-do craniotomy were removal of residual tumor, evacuation of clot, and cerebrospinal fluid leakage. Seventy-six percent had good outcome, while 24% had poor outcome. Outcome was good for patients who had re-do craniotomy done once, while poor outcome was for patients with second and third craniotomies. Ninety percent of patients with ASA 2 had good outcome, while 9.1% had poor outcome; but 64.3% had good outcome with ASA 3, while 37.7% had poor outcome with a P-value of 0.18. Seventy-five percent had poor outcome in patients with GCS of less than 9, while 25% had good outcome; but 14.3% had poor outcome in patients with GCS above 9, while 85.7% had good outcome with a P-value of 0.031. Conclusions: Increasing frequency of re-do craniotomy and lower GCS were major factors affecting outcome in re-do craniotomy in our center. The outcome of these patients is valuable in the management of other patients with re-do craniotomy in future

Severe Neurological Involvement In Tuberous Sclerosis: A Report Of Two Cases And A Review Of The African Literature

Tuberous sclerosis (TS) is a genetic disorder characterised by the triad of cutaneous lesions, epilepsy and mental retardation. TS is known to have a wide clinical spectrum, with some affected individuals having only the cutaneous manifestations, normal IQ and no seizures, while others are severely affected having intractable seizures and profound mental retardation. A report of two Nigerian children with TS managed at the University College Hospital, Ibadan, Nigeria is presented. Both had severe neurological manifestations of the disease and a sub clinical affectation was found in a first degree relative in one of them. African Journal of Neurological Sciences Vol. 26 (2) 2007: pp. 102-10