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Paranasal sinus mucocoeles are uncommon, benign clinical entities. They result from obstruction of the sinus drainage ostium with accumulation of secretions within the cavity and slow progressive expansion, resulting in adjacent tissue displacement. The clinical features demonstrated are therefore dependent on the prominent direction of its expansion. Treatment is by surgical intervention to drain the mucocoele with or without extirpation of the sinus mucosa to prevent re-accumulation. Complications result from tissue damage following delay in surgical intervention. We present four cases with sinonasal mucocoeles who underwent surgical drainage and mucosal extirpation in two tertiary eye centres in South-East Nigeria. The first had lost vision prior to surgery from exposure keratopathy and globe perforation. Two had no impairment of vision. Proptosis, diplopia, chronic discharging sinus and cosmetic blemish were the prominent presenting complaints. All complaints were fully resolved following surgery. There has been no report of recurrence of symptoms during the limited follow-up period. [ABSTRACT FROM AUTHOR]

Background: Spina bifida occulta are the most common spinal dysraphisms, yet, the least diagnosed. It is estimated that as much as 30-50% of normal healthy people could harbour this defect. Objectives: To evaluate the incidence of spina bifida occulta and tell-tale signs amongst consecutive patients presenting to a tertiary health facility, under emergency conditions, who had no previously known congenital spinal dysraphisms. Methodology: The study was conducted at the Accident and Emergency Room of Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Anambra State, Nigeria over a 12-month period. The cohort of patients at the Emergency Room were preferred, in order to reduce the interference from overt dysraphisms. Consecutively, consenting patients, were recruited, and data were presented in charts, tables and graphs, and analysed by comparative evaluations with literature. Results: There were 109 recruited subjects, within the age range of 9 to 85years, and most were males 80 (73.4%). Occult dysraphisms were detected in 8 (7.34%) of cases, 6 (5.5%) of whom were males. The affected spinal regions were: cervical 1 (0.92%), thoracic 1 (0.92%), lumbar 5 (4.6%) and sacral 1 (0.92%); a premorbid deficit of unilateral foot drop was found in 2 (1.83%). At presentation, most of the subjects came with neurological deficits; however, their dysraphisms were only discovered at routine imaging. There was no family history of spinal dysraphism amongst them. The tell-tale signs were abnormal hair growth 7 (6.42%), and dermal sinus 1 (0.92%). Spinal magnetic resonance imaging (MRI) and computed tomography (CT) were each employed for 2 (1.83%) cases, respectively. Conclusion: Occult spinal dysraphisms were discovered in 7.3% of our emergency patients, and most had abnormal bands of hair growth. The non-diagnoses of these cases by relatives and healthcare personnel, prior to their presentation, calls for concern. [ABSTRACT FROM AUTHOR]

Background: Spina bifida is a long-known disease arising from the incomplete fusion of the caudal neuropore in the first month of intrauterine life. It is thought to have a multifactorial etiology, the most important of which is folic acid deficiency. In evaluating its etiology, the role of antifolate agents like antimalarial drugs is rarely given a strong mention. Methods/Patients: This is a 44-month prospective study of consecutive cases of spina bifida cystica presenting to the Neurosurgery Unit of Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East Nigeria. Data collection was with a structured proforma from presentation, and collation done with Microsoft Excel broadsheet and data analysis with SPSS and χ2 test. Results: A total of 41 cases of spina bifida were attended to within the period, with 92.7% cases of spina bifida cystica. Most presented by >12-24 months, with a consistent history of maternal ingestion of antimalarial drugs during the first trimester of pregnancy. Conclusion: Spina bifida cystica was diagnosed mostly in children whose mothers ingested antimalarial drugs during the first trimester of gestation. There may be a need to critically evaluate the contribution of antimalarial drugs to the etiopathogenesis of this malformation and develop safer antimalarial treatment in pregnancy. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Over the years, different approaches to the treatment of hydrocephalus have evolved across all age groups; however, ventriculoperitoneal shunting (VPS) remains the most widely used procedure, albeit with many complications. Aims: The aim of our study is to prospectively look at the incidence of complications following VPS in our centre, and to suggest ways of minimizing these complications. Patients and Methods: Between April 2006 and March 2008, all patients who had VPS in our centre were recruited for the study using a structured protocol from the time of admission to the time of discharge; data were augmented with case notes along with clinic and theatre records. Our centre is located in south-east Nigeria, and we commenced neurosurgical services in April 2006. Results: Within this 2-year period, 49 patients were definitively diagnosed with hydrocephalus and 32 underwent VPS, following which 9 (28%) had various complications – with shunt infection being the most common (n = 3; 9.3%). Conclusion: VPS is the definitive treatment modality for hydrocephalus in our centre, and shunt infection (as reported by several other authors) is the most common complication we encounter. Adopting a strict protocol for the prevention of perioperative contamination, as well as educating caregivers, is advocated to reduce this complication in any new neurosurgical centre. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Prior to the commencement of neurosurgical services in our new centre, in 2006, the awareness of and perceptions about this specialty amongst the health workers were studied. One year after, having experienced first-hand the activities of the unit, these perceptions were again re-evaluated amongst the same workers to determine the impact of the unit on the opinions about the specialty. Methods and Materials: This study was carried out with a questionnaire designed with the 5-point Likert scale, and the respondents comprised of doctors, nurses, students, paramedics and administrators, randomly selected. The same questionnaire was used in the first study but was slightly modified for the present study. Results: Out of 400 questionnaires distributed randomly, 342 were completed and returned. Most of the respondents 282 [82.5%] were aged 20 - 30years, mostly students 220 [64.3%], and majority 318 [93%] have heard of neurosurgery prior to the establishment of our unit. The service need was rated very necessary by most 286[83.6%], availability of services in Nigeria rated inadequate by 177 [51.8%], and the quality of services rated fair 155[45.3%]. The services in our centre were rated fair 138 [40.4%] and lack of equipment/facilities was adjudged the greatest hindrance to practice 216 [63.2%], and majority 289 [84.5%] strongly recommended that services continue. Conclusion: Neurosurgical services are still significantly inadequate in Nigeria, and though the establishment of new units has positively changed the perception of health workers about the specialty, provision of more manpower and modern facilities remains the major challenge. [ABSTRACT FROM AUTHOR]