Barbed spear injury to the skull base: case report.

A case of a barbed spear injury to the left orbit and skull base is presented. The unusual nature and circumstances of the injury and the management problems related to the proximate neurovascular bundles are discussed.

Childhood intracranial neoplasms Enugu, Nigeria.

This paper reviews children with intracranial neoplasms seen at the University of Nigeria Teaching Hospital, (UNTH), Enugu, over an 8-year period (1978-1985). There were 21 children, aged 4-14 years, with histologically confirmed intracranial neoplasms. The male to female ratio was 2:1. Of all cases, there was a preponderance of cranio-pharyngiomas (38.1%), followed by the astrocytomas and medulloblastomas with 14.3% each, a result which is at variance with findings elsewhere. The poor prognosis was partly due to late presentation complicated by relatively inadequate diagnostic and therapeutic facilities. A plea is made for the improvement of neurodiagnostic and therapeutic facilities in some regional hospitals in developing countries.

Intracranial tumors in Enugu, Nigeria.

Over a five-year period, there were 48 cases of intracranial tumors at the University of Nigeria Teaching Hospital, Enugu, Nigeria. All the patients were Nigerian Negroes. Glial tumors accounted for 20.8%, pituitary tumors 18.8%, and meningiomas 16.7%. There were five cases of tuberculomas and five cases of metastatic tumors. Miscellaneous tumors contributed 22.9% of the total. There were more males than females, especially in the meningioma and tuberculoma groups. Nearly one-half of the tumors were in people in their first and second decades of life; two-thirds of the tumors were in those under 30 years of age. One-third of the patients have died within the five years under review. The results of this survey are strikingly different from Caucasian series. The relatively low incidence of gliomas and the high incidence of meningiomas and pituitary tumors in this study are interestingly similar to the results of other workers who studied Negro populations and may underscore the importance of genetic factors in the development of some brain tumors.

Experience with brain abscesses treated by simple aspiration.

No deaths have occurred in 15 consecutive cases of intraparenchymatous brain abscesses in Nigerian patients who were treated by aspiration, systemic antibiotics, dexamethasone and anticonvulsants. Four patients had persistent convulsions which responded well to drug therapy and two patients had hemiparesis but were able to return to their jobs. The simplicity of this method of treatment and the results, achieved without the benefit of computerised tomographic scan, raise the question as to whether the recent trend towards excision of brain abscess is justifiable.

Tuberculoma of the central nervous system in Eastern Nigeria.

Although tuberculosis is prevalent in Eastern Nigeria, only 5 cases of tuberculoma of the central nervous system (CNS) were recorded over a 5 year period in a hospital in which about 4000 tuberculosis patients were treated. All the patients were Igbo males. In 4 cases the tuberculoma was supratentorial and in 1 case there was an extradural extraosseous spinal tuberculoma.