Women in Nigerian Neurosurgery: A Cross-Sectional Survey.

Background: Although women have made remarkable strides in several medical specialties in Sub-Saharan Africa, their presence and contribution to the development of neurosurgery remain limited. We sought to study the gender differences within Nigerian neurosurgery, identify challenges resulting from these differences, and recommend how African female neurosurgeons can maximize their effects in neurosurgery.

Methods: A structured online survey captured data on neurosurgical infrastructural capacity, workforce, and training from neurosurgical consultants and residents in neurosurgical centers in Nigeria.

Assessing the Neurosurgical Capacity in Nigeria Using the Modified Neuro-PIPES Tool.

Background: Like many low- and-middle-income countries in Africa, documented assessment of the neurosurgical workforce, equipment, infrastructure, and scope of service delivery in Nigeria is lacking. This study aimed to assess the capacity for the delivery of neurosurgical services in Nigeria.

Methods: An 83-question survey was disseminated to neurosurgeons and residents in Nigeria.

A Geospatial Analysis of the Availability, Distribution, and Accessibility of Neurosurgical Facilities, Workforce, and Infrastructure in Nigeria; and Projection Towards 2050.

Objective: There has been a modest but progressive increase in the neurosurgical workforce, training, and service delivery in Nigeria in the last 2 decades. However, these resources are unevenly distributed. This study aimed to quantitatively assess the availability and distribution of neurosurgical resources in Nigeria while projecting the needed workforce capacity up to 2050.

Neurocysticercosis in a Nigerian woman -missed diagnosis of a neglected disease and surgical management.

Neurocysticercosis is a rarely diagnosed but significant clinical problem from infestation with taenia solium. It occurs as a result of ingestion of infested pork and the mode of transmission is usually feco-oral. It is commonly associated with non-specific neurologic manifestations expected of intracranial space-occupying lesions with its most common neurological presentation being seizures.

Surgical management of Aneurysmal Subarachnoid Haemorrhage in a resource-constrained region: A Nigerian regional experience.

Background: Aneurysmal Subarachnoid Haemorrhage (aSAH) is a vascular injury with significantly high mortality, especially when poorly managed. This study seeks to outline the experiences in setting up a neurovascular service in Lagos, Nigeria.

Methods: A series of 45 patients were operated after aSAH over a period of 10 years.

The Role of International Collaborations in Sustainable Neurosurgical Development in Nigeria.

Objective: Despite 6 decades of existence, neurosurgery is still in the developing stages in Nigeria. In this era of collaborative health system capacity-building in low- and middle-income countries, this article reviews past efforts and future prospects for collaborative neurosurgical development in Nigeria.

Methods: A bibliometric review of the Nigerian neurosurgical literature and data from a structured survey of Nigerian neurosurgeons and residents provided details of current local and international collaborations for neurosurgical research, service delivery, training, and capacity building.

The Status of Specialist Neurosurgical Training in Nigeria: A Survey of Practitioners, Trainers, and Trainees.

Objective: Despite the well-known neurosurgical workforce deficit in Sub-Saharan Africa, there remains a low number of neurosurgical training programs in Nigeria. This study sought to reassess the current status of specialist neurosurgical training in the country.

Methods: An electronic survey was distributed to all consultant neurosurgeons and neurosurgery residents in Nigeria.

Sellar brain tumour co-existing with a left posterior communicating aneurysm causing ptosis: lessons learnt (case report).

Posterior communicating aneurysm (PCOM) commonly presents with ptosis of the eye. This is so also with space occupying lesion compressing the oculomotor nerve. It is quite uncommon for a patient to have both lesions at the same anatomical space concurrently causing ptosis.

Proposal of a Novel Anatomic Guide to the Sphenoid Sinus.

Background: Landmarks for transsphenoidal surgery have been described to facilitate resection for pituitary lesions. However, carrying out sphenoidotomy for access to the sellar floor could still be challenging, especially for young surgeons during the steep learning curve.

Objective: We describe the LUTH (Lagos University Teaching Hospital) line as a simple anatomic guide to avoid missing the trajectory to the sella during anterior sphenoidotomy in microscopic transsphenoidal pituitary surgery.

Strategies for Treatment of Multiple Brain Aneurysms Without Intraoperative Adjuncts.

Background: Although fairly rare, multiple brain aneurysms are well known to occur in certain conditions such as arteriovenous malformations, coarctation of the aorta, renal artery stenosis, adult type 3 polycystic kidney disease, as well as connective tissue disorders (such as Ehlers-Danlos syndrome, Marfan syndrome, and fibromuscular dysplasia). Increased incidence of complications of surgery in such situations is expected to be more likely than in surgery for a single aneurysm, particularly in the absence of intraoperative guidance with adjuncts.

Methods: We report a case of an anterior communicating artery aneurysm, a right middle cerebral artery aneurysm, and a right pericallosal aneurysm in a 70-year-old man.

Review of pharmacological treatment of depression in patients with primary brain tumour and proposal of modification in management strategy.

This brief paper describes the challenges with treatment of depression in brain tumour patients particularly in the absence of any currently accepted guidelines for treating this perculiar subset of patients. The proposal offered here is to move to pharmacologic treatment with other modalities in a methodical pattern only after surgical intervention. This is because simply treating with medications based on physician / patient choice as currently recommended may not achieve optimal results in majority of cases in view of the multiple aetiological factors that interplay.

Split cord malformation associated with congenital dermoid cyst and myeloschisis - case-based literature review on possible embryonic derivation and implications.

Split cord malformation co-existing with either congenital dermoid or myeloschisis has been previously reported. Theories exist which explain the underlying embryopathy behind the occurrence of each of these anomalies in conjunction with split cord malformation. However, the occurrence of all three anomalies in the same patient, to the best of our knowledge, has not yet been reported in the literature.

Collaborative International Neurosurgery Education for Africa-The Journey So Far and the Way Forward.

Objective: Lack of standard neurosurgical training has long been a major factor limiting the availability of neurosurgical services in most parts of Africa. International collaborative efforts have however, to a large extent, resolved this challenge.

Methods: A review of previous international collaborative programs and educational initiatives in Africa along with their outcomes and accomplishments was conducted.

Developing a Guideline for Neurotrauma in Nigeria.

Background: The Nigerian Academy of Neurological Surgeons in 2019 resolved to standardize the practice of neurosurgery in Nigeria. It set up committees to standardize the various aspects of neurosurgery, such as neurotrauma, pediatrics, functional, vascular, skull base, brain tumor, and spine. The Committee on Neurotrauma convened and resolved to study most of the available protocols and guidelines in use in different parts of the world.

Intracranial abscesses in children at Ile-Ife, Nigeria: a case series and review of literature.

Purpose: Central nervous system (CNS) infections are significant causes of morbidities and mortalities in children with some being prone to the development of abscesses which can either be within the brain parenchyma or located in extracranial structures. We aimed to describe the clinical profile and outcome of children with cranial abscesses at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC).

Methods: Consecutive cases presenting at the Children Emergency Ward of OAUTHC Ile-Ife were recruited.

An audit of surgical site infection following open prostatectomy in a Nigerian Teaching Hospital.

Background: Surgical site infections (SSI) are a potential cause of morbidity and increased cost of care after operations such as open prostatectomy.

Objective: To audit the occurrence of SSI after open prostatectomy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria.

Methods: A review of all patients who underwent open prostatectomy over a ten-year period (July 2005 to June 2015).

Impact of Comorbidities on Outcome Following Revision of Recurrent Single-Level Lumbar Disc Prolapse between Revision Microdiscectomy and Posterior Lumbar Interbody Fusion: A Single-Institutional Analysis.

Objectives: Reports exist in the literature on the relationship between comorbid conditions and recurrence of lumbar disc herniation. Meanwhile, documented evidence abound on microdiscectomy and posterior lumbar interbody fusion (PLIF) as techniques of managing recurrent disc prolapse. Some surgeons would choose to perform PLIF instead of microdiscectomy for a first time re-herniation, because of the possibility of higher chances of further recurrence as well as increased likelihood of spinal instability following treatment with microdiscectomy.

Proposal of modification in management strategy for intracranial hemorrhage in low- and middle-income countries.

This brief communication describes the challenges faced by neurosurgeons in Low- or middle-income countries to treat neurosurgical emergencies from intracranial bleeds (whether traumatic or spontaneous). The authors point out that in low- or middle-income countries and Africa in particular, resources, facilities, and personnel are lacking to follow the guidelines proposed for treating these conditions in high-income countries. The proposal offered here is to move to early surgical intervention because algorithms to monitor patients under conservative management guidelines are often not possible.

Short Report on a Rare Presentation of Temporal Arachnoid Cyst and Lessons Learned.

Background: Stiff neck or nuchal rigidity is a significant clinical sign of neurologic disease. It is commonly associated with meningitis, subarachnoid hemorrhage, and posterior fossa tumors. It may also occur as a result of tonsillar impaction following pressure in the infratentorial compartment from an expanding posterior fossa mass.

Antiplasmodial Activity of the -Hexane Extract from (Jacq. ex. Fr) P. Kumm.

Objectives: Several mushrooms species have been reported to be nematophagous and antiprotozoan. This study reported the antiplasmodial and cytotoxic properties of the n-hexane extract from the edible mushroom and the isolation of a sterol from the extract.

Materials And Methods: Antiplasmodial and cytotoxicity assays were done using the plasmodium lactate dehydrogenase assay and human HeLa cervical cell lines, respectively.

Idiopathic intracranial hypertension: Proposal of a stratification strategy for monitoring risk of disease progression.

Objectives: A general consensus based on a multidisciplinary perspective involving an international panel was recently developed for management of patients with idiopathic intracranial hypertension (IIH). In this paper, the authors sought to develop further on the aspect of this consensus that concerns monitoring progression of the disease.

Patients And Methods: A systematic literature review of previous publications on monitoring disease progression in IIH and a meta-analysis to examine efficacy of method of monitoring employed in each study.

Laminectomy Versus Laminoplasty in the Surgical Management of Long-Segment Intradural Spinal Tumors: Any Difference in Neurological Outcomes?

Background: Previous comparative studies have shown that apart from lack of any significant difference in neurologic outcomes between laminoplasty and laminectomy following resection of intradural spinal tumours, spinal column issues such as postoperative deformities, malalignment, and adjacent level disease have also been clearly demonstrated to be quite similar for both techniques. However, there is no study yet that describes any difference in neurologic outcomes for long-segment intradural lesions as a rare subset of these lesions (in terms of number of spinal segments involved) following surgical management between these two techniques.

Materials And Methods: This is a retrospective review of surgical treatment with either laminectomy or laminoplasty done for patients with long-segment intradural tumors at a tertiary health-care institution in India.