Assessment of childhood intracranial pressure: a comparative study of transcranial Doppler ultrasound indices and findings at ventriculoperitoneal shunt.

Purpose: This study compares transcranial Doppler (TCD) Pulsatility Index (PI) and Resistivity Index (RI) with intra-operative CSF opening pressure measured by manometric technique during ventriculoperitoneal (V-P) shunt in children with hydrocephalus.

Methods: It was a prospective, hospital-based study performed among patients diagnosed with hydrocephalus. Patients had TCD ultrasonography before V-P shunt.

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.

Correlation of the transorbital ultrasonographic optic nerve sheath diameter with intracranial pressure measured intraoperatively in infants with hydrocephalus.

Objective: Hydrocephalus is a highly significant global public health concern. In infants, it may be associated with a potentially deleterious increase in intracranial pressure (ICP). Currently, the gold standard for accurate monitoring of ICP is an intraventricular ICP monitor, but this method is invasive and expensive.

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.

Smartphone Ocular Fundal Photography in the Diagnosis of Raised Intracranial Pressure: A Novel Adaptation to Neurosurgical Practice.

Background Consistently raised intracranial pressure (ICP) is a common final pathway to morbidity/mortality in many neurosurgical conditions. This underscores the need for early diagnosis and prompt management of raised ICP. This study aims to determine whether smartphone fundal photography features of raised ICP can accurately predict the computed tomography (CT) findings suggestive of elevated ICP in neurosurgery patients.

Correlation of palpation anterior fontanometry and cerebrospinal fluid opening pressure in early childhood hydrocephalus.

Background: The anterior fontanelle (AF) tension has been a traditional clinical method of indirect assessment of intracranial pressure (ICP). How does this time-tested bedside assessment technique compare with an objective ventricular cerebrospinal fluid (CSF) opening pressure?

Objective: To determine the correlation of palpation anterior fontanometry and CSF opening pressure in early childhood hydrocephalus.

Materials And Methods: Children diagnosed with hydrocephalus who were planned for CSF diversion using ventriculo-peritoneal (V-P) shunt were prospectively studied over 18 months.

Challenges in the management of cerebrospinal fluid ascites: a case report.

Cerebrospinal fluid (CSF) ascites is an uncommon sequela of ventriculo-peritoneal (V-P) shunt. We report a case of CSF ascites in a 7-year-old girl with craniopharyngioma and the challenges and limitations we faced in her management. Ascites completely resolved after a ventriculo-atrial (V-A) shunt surgery.

Pilot application of Lecture-Panel-Discussion Model (LPDM) in global collaborative neurosurgical education: a novel training paradigm innovated by the Swedish African Neurosurgery Collaboration.

Background: Disruptions in global surgery educational routines by the COVID-19 pandemic have elicited demands for alternative formats for rendering qualitative neurosurgical education. This study presents application of a novel model of online neurosurgical course, the Lecture-Panel-Discussion Model (LPDM).

Methods: This is a cross-sectional survey of participants who attended the Swedish African Neurosurgery Collaboration (SANC)-100A course.

Correlation of Quantitative MRI Parameters with Neurological Outcome in Acute Cervical Spinal Cord Injury.

Background: The unbearable morbidity and significant mortality associated with traumatic cervical spine injuries (T-CSIs) have been complicated by difficulties in outcome prediction.

Objectives: This study aims to determine the correlation between quantitative magnetic resonance imaging (MRI) parameters and neurological outcome among patients with acute T-CSI.

Materials And Methods: This is a prospective study in which patients with T-CSI were recruited over a 12-month period.

Pediatric brain tumor care in a Sub-Saharan setting: current poise of a precariously loaded dice.

Objective: To evaluate the current status of pediatric brain tumor (PBT) care and identify determinants and profiles of survival and school attendance.

Methods: An 8-year institution-based prospective longitudinal study. All cases investigated with neuroimaging and treated were enrolled.

Improving capacity and access to neurosurgery in sub-Saharan Africa using a twinning paradigm pioneered by the Swedish African Neurosurgical Collaboration.

Background: The unmet need for neurosurgery in sub-Saharan Africa is staggering. Resolving this requires strategies that synergize salient local resources with tailored foreign help. This study is a trial of a twinning model adopted by the Swedish African Neurosurgical Collaboration (SANC).

The Ebb and Flow of Neurosurgery in a Re-Emerging Sub-Saharan Center. Lessons from 1025 Consecutive Operated Cases and Progress Models. A Prospective Observational Cohort Study.

Background: The evolution of neurosurgery in our center comprises 2 active phases separated by a decade-long latent phase. This study evaluates our experience in the renaissance phase using 1025 cases. We identify paradigms that predict progress under existing practice conditions.

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.

Impact of Active Leisure (Noncompetitive) Contact Sports Activities on the Space Available for the Cord of the Subaxial Cervical Spine of Asymptomatic Adults.

Background: Leisure sports activities are assumed to be safe. It is however possible that participation in contact sports as leisure activity may also affect the space available for the cervical cord (SAC). The objective of this study is to compare the SAC of asymptomatic young adults involved in active leisure contact sports with matched controls that do not participate in contact sports.

The Challenges of Management of High-grade Gliomas in Nigeria.

Background: High-grade gliomas (HGG) are among the most challenging brain tumors despite many research efforts worldwide.

Aim: The aim of this study was to evaluate the local challenges that may influence outcome of HGG managed in a neurosurgical center in Nigeria.

Methodology: Retrospective analysis of prospectively recorded data of patients managed for intracranial HGG at Memfys Hospital for Neurosurgery, Enugu, Nigeria, between the year 2006 and 2015.

Civilian Penetrating Gunshot Injury to the Neurocranium in Enugu.

Introduction: Civilian penetrating gunshot injuries to the neurocranium are no longer uncommon in Nigeria. Such injuries are however poorly reported. They are associated with poor outcome and, at close range, are frequently fatal, especially when inflicted by high-velocity weapons.

Some characteristics of gliomas managed at a Neurosurgery centre in Nigeria.

Background: Gliomas are important primary brain tumours with varying prognosis.

Aim: To study the histology characteristics of brain gliomas managed in a Neurosurgical centre in Nigeria.

Materials And Methods: A retrospective analysis of prospectively recorded data of patients managed for intracranial gliomas at our Hospital for Neurosurgery, between year 2006 and 2015.

Care related and transit neuronal injuries after cervical spine trauma: state of care and practice in Nigeria.

Suboptimal care during extraction and transfer after spinal trauma predisposes patients to additional spinal cord injury. This study examines the factors that contribute to care related and transit injuries and suggests steps to improve standard of care in spinal trauma patients in Nigeria. It is a questionnaire-based prospective study of patients admitted with cervical cord injury to two neurosurgical centers in Enugu, Nigeria, between March 2008 and October 2010.

Intracranial meningiomas managed at Memfys hospital for neurosurgery in Enugu, Nigeria.

Introduction: The epidemiology and pathology of meningioma in Nigeria are still evolving and little has been published about this tumor in Nigeria, especially in the southeast region. The aim of this paper is to compare the characteristics of intracranial meningioma managed in our center with the pattern reported in the literature worldwide.

Materials And Methods: Retrospective analysis of prospectively recorded data of patients managed for intracranial meningioma between January 2002 and December 2010 at a Private neurosurgery Hospital in Enugu, Nigeria.

Management of intracranial meningiomas in Enugu, Nigeria.

Background: Meningiomas may range on presentation from incidentally identified small lesions to large symptomatic tumors in eloquent areas of the brain. Management options correspondingly vary and include careful observation, surgical excision, and palliative application of very limited therapeutic maneuvers in select cases. This paper discusses the options and difficulties in the management of meningiomas in a developing country.

Traumatic extradural hematoma in enugu, Nigeria.

Aim: Acute traumatic extradural hematoma (EDH) is life threatening and requires prompt intervention. This is a study of incidence and outcome of consecutive patients with EDH managed in Enugu, Nigeria against a background of delayed referral.

Materials And Methods: We retrospectively examined all consecutive trauma cases managed between 2003 and 2009 and analyzed patients with acute traumatic extradural hematoma in isolation or in combination with other intra cranial lesions.