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Background: Complications associated with ventriculoperitoneal shunt insertion constitute a significant cause of morbidity and mortality among hydrocephalus patients. Despite this, VP shunt placement has remained the mainstay of treatment for hydrocephalus. The aim of this study is to evaluate the complications of VP shunt surgery in our environment and to identify the risk factors associated with it. Methodology: Patients who had VP shunt surgery over a period of two years (Jan 2015-December 2016) were evaluated retrospectively by reviewing their hospital records. The patients' demography, aetiology and clinical presentation of the hydrocephalus, and complications were analysed using SPSS version 26.0. Results were presented in tables and figures. Results: A total of 69 patients who had VP shunt over the study period had complete medical records available for review. Their age ranged between 2days and 68years with a male to female ratio of 1.8:1. Overall complication rate was 30.4%. Shunt malfunction (11.5%) and shunt infection (7.2%) were the commonest complications recorded. Late presentation was the most important risk factor for shunt complications. Conclusion: The rate of shunt complications seen in this study compares fairly with studies in other parts of the world.
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An encephalocele is a congenital tube defect in which there is an extension of intracranial structures outside the normal confines of the skull. Its presentation at birth provokes a lot of anxiety amongst parents, guardians and care providers with regards to compatibility with life, surgical treatments and effects on developmental milestones and higher mental functions. This report is on our initial experience in the first six months following surgical treatment of four consecutive cases presenting in infancy. The aim of this case series is to report our initial experience of the management of encephaloceles using four consecutive cases that presented in infancy. A review of four infants who presented to our neurosurgery service was conducted including patterns of presentation, neuroimaging findings, scope of surgical intervention and neurological outcome at the six-month review. The results are presented in short case reports and summarized in a table. Two five-month-old females, one six-month-old female and one two-month-old female infants presented to our neurosurgery clinic with progressively increasing encephaloceles at different locations. Brain MRI revealed meningo-encephalocele in all, but with associated hydrocephalus in two cases only. They all had excision and repair of encephalocele under the same general anaesthesia while only two had a ventriculoperitoneal (VP) shunt. Developmental milestones were on course at 6 months follow-up following discharge. Although the presentation of encephaloceles can be frightening to parents and care providers, careful clinical and radiological evaluation is a recipe for sound surgical planning and improved outcome.
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Background Acute traumatic subdural hematoma is life-threatening and is associated with high unfavorable outcomes in developing countries. Objective We aim to identify factors contributing to outcomes after severe traumatic brain injury (TBI) due to acute subdural hematoma (SDH) in patients admitted to National Hospital Abuja, Nigeria. Methods This was a retrospective review of 34 patients who consecutively underwent neurosurgery for acute SDH over five years (from January 2015 to December 2019). Demographic data, clinical characteristics, and the time intervals from injury to surgery were investigated to determine the interactions between all these factors and outcome. Outcome was graded according to the Glasgow outcome scale at the three-month follow-up. Results Out of 34 patients who had surgical evacuation for traumatic acute subdural hematoma, 15 patients died (44.1%). A significant correlation was identified between outcome and the Glasgow coma scale score at admission. No significant correlation was seen between the outcome and the age, gender and the time from injury to surgery (chi2 test, p>0.05). Conclusion The rate of unfavorable outcomes in acute subdural hematoma is high. The Glasgow coma score at admission is an important predictor for outcome in traumatic acute subdural hematoma.
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Objective: The objective is to determine the prognostic factors affecting the surgical outcome of patients surgically treated for acute epidural haematoma. Materials and Methods: A retrospective review of 71 consecutive patients who underwent neurosurgery for acute epidural haematomas over a 5-year period (from January 2015 to December 2019) was conducted. Clinical characteristics and the time intervals were investigated to determine the interactions between all these factors and the outcome. The outcome was graded according to the Glasgow Outcome Scale (GOS) at subsequent follow-up clinic visits. Results: The severity of traumatic brain injury using the Glasgow Coma Scale score (chi-square test, P = 0.033) had a statistically significant relationship with the outcome. The patients' age, gender, and total length of time until surgical intervention (P > 0.05) were of no statistical significance in relation to the outcome. The mortality rate of patients presenting at our centre is 16.9%. Overall, after surgery, 47 of 71 with epidural haematoma had good recovery (GOS 5). Twelve of 71 patients had GOS of 2-4. Twelve patients died. The median duration from injury to presentation was 15 hours with an interquartile range of 15 hours. Conclusion: Our results indicate that the severity of brain injury is an independent risk factor in determining the outcome of epidural haematoma in traumatic brain injury.