Postgraduate Neurosurgical Education in the Current COVID‑19 Climate: An Auspicious Time for a Paradigm Shift in Africa

Neurosurgical education is undergoing serious challenges in the present climate of the COVID-19 pandemic, especially in Africa and other developing countries where the Halstedian style of medical education and training remains persistent due to a lack of infrastructural innovations and resources. Therefore, to ensure the continuity of training and services with guaranteed safety of the neurosurgical staff and patients, there is a need for a pedagogical change of the training and educational model with the incorporation of neurosurgical simulation laboratory training and online/virtual neurosurgical education. Keywords: Africa, education, neurosurger

Paediatric Cervical Spine Tuberculosis: A Diagnostic Dilemma!

Tuberculosis (TB) is still a problem in Paediatrics practice. Diagnosis of extra-pulmonary tuberculosis in children has remained difficult despite the gains made by newer TB diagnostic investigations. We report a twelve-year-old female, with a history of neck pain, fever, headache and weakness of all the limbs. The results of TB diagnostic investigations were all negative and the child was treated for meningitis with no clinical response. However, she responded only to a therapeutic trial of anti-TB drugs with improvement of motor function of all the limbs. The child had completed 12 months anti-TB chemotherapy for extra-pulmonary tuberculosis with full recovery of all the neurological deficits. Currently she is on follow up. A high index of suspicion is needed for diagnosis and care of rare/emerging extra-pulmonary tuberculosis in childhood

Management of brain abscess: Changing trend and experience in Enugu, Nigeria

Background: Intracranial abscess remains a significant health-care problem. Its causes, diagnosis, treatment, and outcome are changing. Aim: This paper reviewed the demography, examined new trends, and compared outcomes with different treatment options. Methodology: Retrospective analysis of intracranial abscesses managed at Memfys Hospital, Enugu (2004–2014) and University of Nigeria Teaching Hospital (2009–2014). Patients were followed up for at least 6 months. All patients had neuroimaging before intervention. Microscopy and culture were performed for the specimens. Intravenous antibiotics were given for 2 weeks before conversion to oral. Results: Seventy-nine parenchymal abscesses (eight cases per year) were managed. Peak age was the second decade of life. Previous head injury (21.5%) and meningitis (16.5%) were the most common predisposing factors. The frontal lobe was most common anatomical location (32%). Only 24% had positive culture result. Three cases were fungal infections. Seventy percent of patients managed with burr hole drainage and 37.5% of craniotomy made complete recovery. Overall, 58% of patients made complete recovery, whereas 19.0% died. Nine percent of cases died before definitive intervention. Among the 24% of patients that presented in coma, 47% died within 6 months. Most important factor influencing mortality was admission level of consciousness. Abscess recurred in 6% of cases. Conclusion: Intraparenchymal abscesses in Enugu were mostly solitary lesions resulting from poorly managed head injury and meningitis. Predisposition from otitis media and systemic diseases has reduced. The proportion of fungal organisms is increasing. A significant proportion of the patients present in coma. Burr hole and aspiration of abscess is less invasive and has very good outcome

Cerebellar liponeurocytoma: a novel report from Nigeria in a 6-year-old girl, and review of literature

Liponeurocytoma is a newly defined clinical entity predominantly seen in the cerebellum as a slow-growing tumor. In this report, we present the case of a 6-year-old Nigerian girl with a liponeurocytoma, and review of literature