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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. Such data, from a large-scale study, are not available for our population. Objective: The study aims to evaluate the dimensions of pedicle that are relevant for pedicle screw fixation in Southeast Nigerian population. Materials and Methods: A prospective multi-slice CT based clinical anatomy study done at Memfys Hospital for Neurosurgery, Enugu. This study is on the lumbar pedicle dimensions that are related to transpedicular fixation (transverse and longitudinal diameters of the pedicle, MLP, pedicle transverse and longitudinal angles of inclination). Sample size (273) was calculated with the confidence interval formula based on the number of patients that present for images. Consent and ethical approval were obtained. Results: The mean values are as follow: LD1 8.22 mm, LD2 7.73 mm, LD3 7.40 mm, LD4 7.16 mm, LD5 6.87 mm TD1 5.05 mm, TD2 5.31 mm, TD3 6.72 mm, TD4 8.27 mm, TD5 11.31 mm, MLP1 46.60 mm, MLP2 47.97 mm, MLP3 47.14 mm, MLP4 45.54 mm, MLP5 43.47 mm TA1 17.8°, TA2 19.34°, TA3 20.80°, TA4 22.00°, TA5 25.70° LA1 19.42°, LA2 18.61°, LA3 18.00°, LA4 17.09°, LA5 16.40°. Unlike transverse diameter, transverse angle, longitudinal dimension, longitudinal angle (LA), MLP there was significant correlation between age and mean LA. The mean values also correlated significantly with the gender. Conclusion: The mean values varied with the different vertebral levels and was good correlations between some of the parameters with age and gender. [ABSTRACT FROM AUTHOR]

Splenic abscess is a life-threatening condition, which is very rare in children. There is usually an infective focus or pre-disposing factors such as immunodeficiencies towards developing splenic abscesses. Only one case of splenic abscess with brain abscesses in an adult has been reported in the English literature. We, therefore, report a case of an 11-year-old boy who was otherwise healthy, but presented with fever and weight loss for 2 months, right upper abdominal pain, vomiting, hypochondrial tenderness for 1 week and later on developed a left hemiplegia and right facioparesis 2 days before presentation. Diagnosis of splenic abscess and right intracerebral abscesses was confirmed with abdominopelvic ultrasound scan and abdominal and cranial computerised tomographic scans. He subsequently had percutaneous ultrasound-guided drainage of the splenic abscess which was not successful necessitating splenectomy with aggressive antibiotics treatment to which the patient responded with resolution of the brain abscesses and recovery of power in affected limbs. This report aimed to highlight the need for increased suspicion of splenic abscesses in children who are apparently immunocompetent and to add to the knowledge of management of this rare condition in children. We conclude that splenic abscess with intracerebral abscess is a rare but life-threatening condition which is amenable to treatment with drainage of abscess and aggressive guided antimicrobial therapy. [ABSTRACT FROM AUTHOR]

Background: Symptomatic Tarlov cysts are extremely rare, and there is no consensus regarding their optimal surgical management. Here, we encountered a patient with a symptomatic sacral Tarlov cyst and reviewed the appropriate literature. Case Description: A 40-year-old male presented with right lower extremity pain and hypoesthesia in the right S2 dermatome. The lumbosacral MR demonstrated a right S2 Tarlov cyst compressing the S2-S3 perineural sheaths. After the patient underwent microscopic cystectomy with obliteration of the subarachnoid connection to the cyst, the patient's symptoms resolved. Here, we reviewed our operative approach, and others proposed in the literature for the surgical management of these lesions. Conclusions: Here, we present a 40-year-old male who was symptomatic from a right S2 Tarlov cyst compressing the S2-S3 perineural sheaths and successfully underwent microscopic cystectomy with obliteration of the subarachnoid connection. Additionally, the appropriate Tarlov cyst literature was reviewed. [ABSTRACT FROM AUTHOR]

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. After resection, histopathology revealed the mature teratoma. Conclusion: To the authors' best knowledge, this is the first documented diploic origin of mature teratoma at the orbital roof. [ABSTRACT FROM AUTHOR]

Background Cerebral sparganosis is a rare zoonotic infestation that often mimics glioma and metastatic tumors. Case Description A 71-year-old man presented with disturbing dysarthria. Initial neuroimages were suggestive of glioma. However, the histology was suggestive of inflammatory lesion. Follow-up neuroimages and serology were suggestive of sparganosis. He subsequently had craniotomy with ultrasound-guided aspiration of a live worm. Saline-soaked Surgicel was used to provide an acoustic window. Conclusions Ultrasonography was helpful in the intraoperative localization of the worm and is recommended when intraoperative magnetic resonance is not readily available. [ABSTRACT FROM AUTHOR]

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., Methodology: Retrospective analysis of intracranial abscesses managed at Memfys Hospital, Enugu (2004-2014) and University of Nigeria Teaching Hospital (2009-2014). Patients were followed up for at least 6 months. All patients had neuroimaging before intervention. Microscopy and culture were performed for the specimens. Intravenous antibiotics were given for 2 weeks before conversion to oral., Results: Seventy-nine parenchymal abscesses (eight cases per year) were managed. Peak age was the second decade of life. Previous head injury (21.5%) and meningitis (16.5%) were the most common predisposing factors. The frontal lobe was most common anatomical location (32%). Only 24% had positive culture result. Three cases were fungal infections. Seventy percent of patients managed with burr hole drainage and 37.5% of craniotomy made complete recovery. Overall, 58% of patients made complete recovery, whereas 19.0% died. Nine percent of cases died before definitive intervention. Among the 24% of patients that presented in coma, 47% died within 6 months. Most important factor influencing mortality was admission level of consciousness. Abscess recurred in 6% of cases., Conclusion: Intraparenchymal abscesses in Enugu were mostly solitary lesions resulting from poorly managed head injury and meningitis. Predisposition from otitis media and systemic diseases has reduced. The proportion of fungal organisms is increasing. A significant proportion of the patients present in coma. Burr hole and aspiration of abscess is less invasive and has very good outcome., Competing Interests: There are no conflicts of interest.