Lumbar Pedicle Dimensions Using CT Scan in Adults of South-Eastern Nigeria as Related to Transpedicular Fixation.

Background: Transpedicular fixation depends on accuracy of the entry points, angle of insertion and pedicular isthmus width for adequate screw insertion. Preoperative measurements of pedicle dimensions reduce the chances of failure during insertion. These pedicle dimensions (transverse diameter, longitudinal diameter, and maximum length of purchase [MLP]) vary with sex and race.

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.

Rare vermian pilocytic astrocytoma with recurrent spontaneous hemorrhage in the elderly: A case report and review of literature.

Background: Pilocytic astrocytoma (PA) is a benign glial tumor predominately seen in pediatrics and early adolescence with associated overall good outcomes. Very few cases of elderly PA have been reported in the literature, and they are known to display unique anatomic, histologic, and genetic peculiarities distinct from pediatric disease. We report a rare case of vermian PA in an octogenarian with recurrent spontaneous intratumoral hemorrhage as a presenting symptom.

Pain outcome of non-instrumented lumbar decompressive surgery for degenerative lumbar spine disease using patient-reported pain outcome instruments.

Objectives: A clinical disorder known as degenerative lumbar spine disease (DLSD) is characterized by persistent low back pain (LBP) coupled with radiculopathy and other signs of neurologic impairment. Using patient-reported pain outcome assessment tools, this study evaluated the pain outcome of non-instrumented lumbar decompressive surgery for DLSD.

Materials And Methods: A prospective longitudinal research was conducted.

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.

Unexpected recovery from complete deafness to normal hearing post surgical excision of a cerebellopontine angle meningioma: A case report.

Background: Cerebellopontine angle (CPA) meningioma presents a significant management challenge due to its intricate relationship with the brainstem neurovascular bundles. The emphasis in the past has been on facial nerve preservation, but the current management standard is hearing preservation in patients with serviceable hearing; however, hearing restoration after complete loss is rare. We report an elderly man who had restoration of hearing in the right ear after complete loss following tumor resection through the retrosigmoid route.

Will improved neuroradiology facilities debunk the reported rarity of intracranial aneurysms in Sub-Saharan Africa?

Background: Intracranial aneurysms (IAN) are rare in the Sub-Saharan Africa unlike other parts of the world. The debate is whether the low frequency might be apparent because of the scarcity of advanced neuroimaging services, or real. This study investigated if improved imaging facilities would debunk the rarity of IAN in our subregion.

MRI-based morphometric analysis of corpus callosum dimensions of adults in Southeast Nigeria.

The Corpus callosum (CC) is the largest commissural fibre tract, ensuring swift information transfer and integration in both cerebral hemispheres. Variations in morphometry exist. There is a paucity of data on CC dimensions in our subregion, and no standardized reference is available.

Prevention of Surgical Site Infection Following Open Spine Surgery: The Efficacy of Intraoperative Wound Irrigation with Normal Saline Containing Gentamicin Versus Dilute Povidone-Iodine.

Background: Intraoperative wound irrigation (IOWI) is an important step in preventing surgical site infection (SSI). This study compared the effectiveness of saline with gentamicin versus povidine-iodine (PI) as IOWI solutions in preventing SSI in open spine surgery.

Methods: It is a prospective comparative study.

Balo's concentric sclerosis a rare variant of multiple sclerosis in a Nigerian adult male: A case report.

Background: Balo's concentric sclerosis (BCS) is a rare variant of multiple sclerosis (MS) that usually runs a benign course. Typically, brain magnetic resonance imaging (MRI) shows concentric lamella of areas of demyelination alternating with normal zones of myelin preservation. Clinically, it may be mistaken for other intracranial space-occupying lesions, especially in our subregion, where neuroimaging facilities are scarce or not affordable.

Surgical strategy for symptomatic pineal cyst: is endoscopit third ventriculostomy necessary in addition to cyst fenestration?

Symptomatic large pineal cyst (PC) remains a rare entity. The stable natural course of asymptomatic PCs is well established. However, large cysts may cause pressure-related symptoms necessitating surgical intervention.

Rare sphenoid ridge intracranial mature teratoma in an adult female.

Intracranially located teratomas usually involve midline brain structures. However, they rarely occur in adults. A 26-year-old woman presented with a growing intracranial mass lesion in the left sphenoid ridge without neurological deficits.

Primary myxoid temporal bone tumor: A rare neurosurgical manifestation of Carney complex?

Background: Carney complex (CNC) is a rare autosomal dominant syndrome, manifesting mainly with cardiac, cutaneous, and mucosal myxomas. Osteochondromyxoma is known as an extremely rare bone lesion of CNC which usually appears early in life; however, there were no reports of primary bone myxoma of the skull in the patients with CNC. We present the first case of primary myxoid skull tumor in the patient with CNC.

Cyst fenestration and Ommaya reservoir placement in endoscopic transcortical transventricular approach for recurrent suprasellar cystic craniopharyngioma without ventriculomegaly.

The efficacy of the endoscopic transcortical transventricular approach (ETTA) for craniopharyngioma in the third ventricle with hydrocephalus has been reported focusing on its reduced invasiveness. On the other hand, suprasellar craniopharyngioma without ventriculomegaly is generally surgically managed by craniotomy or the endoscopic endonasal approach (EEA). Here, we report an elderly patient who received cyst fenestration and Ommaya reservoir placement in ETTA for recurrent suprasellar cystic craniopharyngioma without ventriculomegaly.

Changing Trends and Challenges of Spine Surgery in a Developing Country.

Background: Spine conditions are common and the surgery is evolving even in developed economies. This study aims to review the changing trends and challenges of spine surgery, particularly from a low-income country.

Methods: This is a retrospective study of patients who were surgically treated for spine conditions in Enugu, Nigeria.

Factors influencing the outcome of spontaneous intracerebral haematoma in a Neurosurgical Hospital in South-East Nigeria.

Introduction: Spontaneous intracerebral haemorrhage (SICH) is a major cause of stroke worldwide. SICH management is still challenging, especially in developing countries. This study highlights certain factors affecting outcome of SICH managed in a Nigerian Neurosurgical centre, on a background of the modernisation of the patient care facilities.

Normal Atlanto-Occipital Interval in Adults of Southeast Nigeria: An Evaluation of the Effect of Age, Sex, and Race.

Background: Imaging of the craniocervical junction (CCJ) after trauma is crucial for injury detection and description. Of all the anatomic measurements of the CCJ, the normal value of atlanto-occipital interval (AOI) is not yet well established in adults. The aim of our study is to determine the normal values of the AOI in Nigerians aged between 21 and 60 years using multidetector computed tomography (MDCT) scan and to determine racial, age, and sex differences.

Superficial Siderosis Associated with Craniopharyngioma.

Background: Superficial siderosis (SS) associated with craniopharyngioma is an extremely rare occurrence. To our knowledge, only 3 cases have been reported in literature. Two of the cases occurred following resection of the tumor.

Paediatric brain tumours managed in Enugu, Southeast Nigeria: Review of one centre experience.

Background: Nothing has been published about paediatric brain tumours (PBTs) in Southeast Nigeria. This pioneer study analyses the tumour characteristics and management outcome of PBTs in Enugu, Southeast Nigeria.

Methodology: Retrospective longitudinal study utilising information from medical, radiology and histopathology records of all paediatric tumour cases managed at Memfys Hospital for Neurosurgery, Enugu, a major referral centre, from 2006 to 2017.

Diploic mature teratoma originating from the orbital roof: An extremely rare case report.

Background: Orbital mature teratoma is a rare congenital tumor.

Case Description: A 37-year-old woman presented with ophthalmalgia predated by years of progressive incongruous right eye position, diplopia, and restricted extraocular movement. Neuroimages revealed a right orbital mass originating from the orbital roof.

Modified Laminoplasty for Degenerative Cervical Spondylosis: The Technique of Floating Laminoplasty.

Background: Laminoplasty is an established alternative to laminectomy for posterior cervical decompression in spondylotic myelopathy. However, standard laminoplasty requires internal fixation, which is often not obtainable in developing countries. We present our experience with a technique of noninstrumented (floating) laminoplasty developed to avoid the need to anchor the laminoplasty to the anterior elements.

Surgically Treated Primary Spinal Cord Neoplasms in Southeastern Nigeria.

Background: Primary spinal cord tumors are not as frequently encountered as their cranial counterparts. They could present in such an indolent manner that requires a reasonable index of suspicion for their diagnosis to be considered.

Objective: The objective of this study is to analyze the incidence and pattern of primary spinal cord and appendage neoplasms in patients surgically treated in our institution over a decade of practice.

Histologically Confirmed Intracranial Tumors Managed at Enugu, Nigeria.

Background: There is controversy about the global distribution of intracranial tumors (ICTs). The previous reports from Africa suggested low frequency and different pattern of distribution of brain tumors from what obtains in other continents. The limitations at that time, including paucity of diagnostic facilities and personnel, have improved.

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.

Space Available for the Cervical Spinal Cord of Asymptomatic Adult Nigerians.

Objective: The space available for the spinal cord (SAC) is a measure of spinal cord functional reserve and may vary in different societies. The objective of this study is to measure normal SAC at each subaxial cervical disc level of asymptomatic adult Nigerians and to compare obtained values with published studies worldwide.

Methods: This is a prospective, cross-sectional study using magnetic resonance imaging facility at Memfys Hospital Enugu, from 2012 to 2013.