Chronic Subdural Hematoma: Predicting Postoperative Recurrence Using a Correlation of Computerized Tomographic Volume with Intraoperative Volume.

Background: Chronic subdural hematoma (CSDH) recurrence is the most common complication following surgery.

Objective: To predict postoperative recurrence of CSDH using a correlation of the calculated preoperative brain computerized tomographic (CT) volume with the intraoperative volume.

Materials And Methods: A prospective study was conducted over 14 months in a tertiary hospital in southwestern Nigeria.

Female monozygotic twins with sacral myelomeningocele.

Background: Concurrent myelomeningocele in twins is a rare clinical presentation, only reported twice in Nigeria.

Case Description: We present a set of identical female twins from Nigeria. Both twins were females that presented at 3 years with low back swelling since birth, associated with bisphincteric dysfunction but normal motor and sensory functions in the lower extremities.

Clinical and microbiological profile of otomycosis in Lagos, Nigeria.

Introduction: Otomycosis is a global disease, common in the world's tropical and subtropical regions. The diagnosis is clinical, but mycological examination is required for its confirmation. There is a paucity of published data on otomycosis particularly the aetiologic agents in Nigeria.

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.

Contemporary Management of Intracranial Subdural Empyema: An Institutional Experience.

Background: Intracranial subdural empyema (SDE) is a seemingly uncommon life-threatening ailment with varying presentations and outcomes. A variety of risk factors have been associated with predisposition to intracranial SDEs; however, they may be cryptogenic. There is an increased predilection for intracranial SDE in children and teenagers with paranasal sinusitis or middle ear infections.

Vascular injuries: Aetiology, presentation and management outcomes at a tertiary hospital in Lagos, Nigeria.

Unlabelled: Vascular injuries lead to haemorrhagic shock and distal limb ischaemia, especially with an arterial injury. This life-threatening state mandates urgent evaluation and intervention to save life and limbs. The treatment aims to restore blood flow and replace lost blood within the golden hours, stabilising cardiovascular haemodynamics and averting irreversible ischaemic damage.

Pediatric brain abscess - etiology, management challenges and outcome in Lagos Nigeria.

Background: Brain abscess in children is a neurosurgical emergency with potentially catastrophic outcome despite the advances made in neuroimaging techniques and antibiotic therapy. Symptoms are nonspecific and may vary with the child's age, location, size, numbers and stage of abscess, and the primary source of infection. Treatment is usually with broad-spectrum antibiotics in combination and surgical evacuation in most cases or antibiotics alone in selected cases with clear-cut indications.

Early Outcome of Endoscopic Third Ventriculostomy With Choroid Plexus Cauterization Versus Ventriculoperitoneal Shunt as Primary Treatment of Hydrocephalus in Children With Myelomeningocele: A Prospective Cohort Study.

Background: Myelomeningocele is associated with hydrocephalus in 35% to 90% of cases. Hydrocephalus is usually treated with insertion of ventriculoperitoneal shunt; however, there is growing evidence that endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) is an alternative.

Objective: To compare the success rate and morbidity of ETV with CPC and ventriculoperitoneal shunt (VPS) as the primary treatment of hydrocephalus in patients with myelomeningocele.

Perspectives of buruli ulcer patients toward informed consent - An insight from Nigeria.

Introduction: Informed consent is a basic ethical requirement in situations involving sharing of patients' data. It supports and upholds the ethical principle of respect for persons and individual autonomy. For Buruli ulcer (BU) patients, associated stigma renders them vulnerable, hence the need for emphasis on additional protection by ensuring obtaining informed consent before third party use of their data.

Infantile supratentorial subdural empyema managed by percutaneous aspiration: an outcome study in a Nigerian city.

Subdural empyema (SDE), a common neurosurgical emergency in the developing countries, accounts for 15%-20% of localised paediatric intracranial infections. In regions where modern diagnostic tools are scarce and inaccessible, detection of SDE may be delayed with subsequent poor outcome. Percutaneous subdural aspiration in patients with open anterior fontanel may be the only surgical option in resource-poor regions of the world.

Surgical decompression for traumatic spinal cord injury in a tertiary center.

Background: There are controversies regarding the importance and timing of spinal cord decompression following trauma. Documented evidence shows that early decompression in the setting of acute spinal cord injury (SCI) improves neurologic outcomes. Our objective was to evaluate the outcome of posttraumatic spinal cord decompression with or without spinal stabilization in our region.

Surgical site infection in posterior spine surgery.

Background: Surgical site infections (SSIs) in spine surgery remain a significant cause of morbidity and prolonged hospitalization. Factors affecting SSI includes patient's comorbidities, duration of surgery, type and indication for surgery among others. We intend to document our experience in our center and highlight possible factors influencing SSI in posterior spine surgery.

Reconstruction of complex craniofacial defects by free flaps: Two case reports.

Complex craniofacial defects often create a reconstructive challenge in our region. We highlight two cases that demonstrate this problem and highlight the role of microvascular free flaps in covering these defects. The evolution of head and neck reconstruction as well as the peculiarities of these types of reconstruction in our environment are discussed.

Antithrombin III: Plasma Activity and Reference Range Among Nigerian Blood Donors.

Background: Diagnosis of antithrombin III (ATIII) deficiency as a common cause of thrombophilia is primarily based on the determination of antithrombin levels in plasma using a functional activity assay or an immunological assay, but local reference interval is lacking.

Aims: The aim of the present study was to determine pattern of antithrombin activity and local reference intervals for ATIII among Nigerians.

Subjects And Methods: A cross-sectional study was carried out among healthy blood donors at the Lagos University Teaching Hospital in Nigeria between the age range 18 and 65 years.

Improvised external ventricular drain in neurosurgery: A Nigerian tertiary hospital experience.

Background: The most common type of hydrocephalus in developing countries is post infective hydrocephalus. Infected cerebrospinal fluid (CSF) however cannot be shunted for the reason that it will block the chamber of the ventriculo-peritoneal (VP) shunt due to its high protein content. In centers where standard external ventricular drain (EVD) sets are not available, improvised feeding tube can be used.

Early decompressive craniectomy for traumatic brain injury in resource poor centres:a tertiary institution experience.

Unlabelled: Decompressive craniectomy (DC) is the surgical management of increasing intracranial pressure (ICP) following a severe traumatic brain injury (TBI) as well as severe cerebrovascular insult. Established protocols for the use of DC include monitoring ICP and going through non-surgical methods to reduce ICP before DC which is the last resort. ICP monitors and facilities to render patients hypothermic and for inducing barbiturate coma are not readily available in resource depleted facilities, hence the need for a timely DC.

Efficacy of endoscopic third ventriculostomy in the management of hydrocephalus in children under 2 years of age: experience from a tertiary institution in Nigeria.

Background: The management of hydrocephalus in developing countries is challenging. Hydrocephalus is a common childhood disorder in developing countries in particular and its management is quite challenging. Ventriculoperitoneal (VP) shunt is associated with high failure rates and complications.

Early outcome of combined endoscopic third ventriculostomy and choroid plexus cauterization in childhood hydrocephalus.

Object: Although shunts have been the mainstay in treating hydrocephalus over the past 5 decades, the use of endoscopic techniques in addressing this disorder in children offers both the neurosurgeon and the patient a unique opportunity to avoid shunting and its attendant complications. The combination of endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) remains uncommon in most centers despite its potential promise. The authors sought to investigate the efficacy of combining ETV and CPC (ETV+CPC) in treating childhood hydrocephalus in Nigeria.

Infantile subdural empyema: The role of brain sonography and percutaneous subdural tapping in a resource-challenged region.

Background: This study explored the outcome of children with patent anterior fontanelles who were treated with trans-fontanelle ultrasound scan (TFUSS), which is more affordable and available than CT scan and MRI in the diagnosis of childhood intracranial pathologies and treatment of subdural empyema, in developing countries.

Patients And Methods: Seventeen infants with post-meningitic subdural empyema, diagnosed using trans-fontanelle ultrasound alone and treated with subdural tapping over a 31-months period, were studied.

Results: Eleven patients presented with grades II and III Bannister and William grading for level of consciousness in intracranial subdural empyema.

Socio-demographic determinants of maternal health-care service utilization among rural women in anambra state, South East Nigeria.

Background: Although, antenatal care (ANC) attendance in sub Saharan Africa is high, however this does not always translate into quality ANC care service utilization.

Aim: This study therefore is aimed at exploring pattern of maternal health (MH) services utilization and the socio-demographic factors influencing it in Anambra State, South East Nigeria.

Subjects And Methods: A total of 310 women of reproductive age with a previous history of gestation attending ANC services between September, 2007 and August, 2008 in selected Primary Health Centers in Anambra State were studied.

What do medical interns in Nigeria think of the white coat? A cross sectional study.

Background: The appeal of the white coat to both the doctors and the public is waning. In most developing countries such as Nigeria doctors' view of the white coat is not known.

Objective: To determine the proportion of interns which supported wearing of white coat by doctors.

Hydrocephalus and the eyes: a teaching hospital experience.

Background: The eye developes from prosencephalon, the primitive forebrain and hence share similar embryonic origin with brain. This gives insight into primary or secondary involvement of eyes in intra-cranial pathology.

Objective: The study was done to describe ocular findings in hydrocephalus patients and effect of intervention on the complications.

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, Nigeria

Methods: 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.

Neonatal burns in Lagos, South-Western Nigeria: Epidemiology and outcome of management.

Background: Burns in the neonate are rare and result mostly from iatrogenic sources in developed countries. The socioeconomic settings of developing countries are different from those in the developed countries. A review of the epidemiology and management of burns in the neonates in Lagos, Nigeria is presented.

Frameless stereotactic procedures in pediatric patients: safety and diagnostic efficacy.

Purpose: The aim of our retrospective study was to evaluate the feasibility, safety, and diagnostic yield of a frameless method for stereotactic neurosurgical procedures in pediatric patients.

Methods: Twenty-two frameless stereotactic neurosurgical procedures (18 biopsies, 4 catheter placements), using a modified frameless stereotactic navigational system, were performed in 21 pediatric patients in our institution from 2004 to 2009. All procedures were performed by the senior authors (AAK, SC).