Objectives: The aim of study was to determine the pattern and management of neural tube defects (NTD). Methodology: It was a hospital based descriptive cross-sectional retrospective study on patients who consulted and/or were admitted at the Douala General hospital for neural tube defects from January 2005 to April 2015. Results: A total of forty-nine (49) patients were enrolled. Males constituted 59.8% and females 40.2% giving a sex ratio of 1.5 in favour of males. Most of the parents of the patients (71.5%) had a low socio-economic status. Myelomeningocele was the most common type (80.4%) followed by 17.4% cases of meningocele and 2.2% cases of lipomeningocele. Three cases (3) of encephaloceles were seen during this period. The commonest site of these defects was the lumbosacral region (47.8%). Other sites included lumbar (19; 41.3%), sacral (3; 6.5%) and thoracolumbar (2; 4.3%) ones. About half of the patients (24; 48.9%) presented with ruptured lesions. Hydrocephalus was also recorded in 65.3% of patients. Talipes equinovarus and talipes calcaneovalgus were the most common associated orthopedic birth defects found. Surgical closure was done for 44 (89.9%) patients. Ventriculoperitoneal shunting was done in 78.1% of those who presented with hydrocephalus. Post-operative complications were more frequent in patients with ruptured lesions (P = 0.001). The most common post-operative complications were wound infections (22; 44.9%) and wound dehiscence (20; 40.8%). Conclusion: Lumbosacral Myelomeningocele was the most common type of NTD in our region. Low socio-economic status was a common risk factor.

Tethered cord syndrome (TCS) is spinal cord fixation from multiple pathological entities. No case of TCShas been reported in our region. The goal of this case report was to describe a TCS managed at the Douala General hospital. Mrs. EEL, 23 year old consulted in 2012 for urinary and fecal incontinence. She had a past history of a spina bifida at birth operated on day two of life. On admission, lumbar MRI showed an abnormally low lying conus medullaris ending at S. Microsurgery permitted to gradually detach the spinal cord from subcutaneous tissue and carefully free the spinal nerves. A 12 months post-surgery, the patient could control defecation, and achieve proper micturition. TCS should also be ruled out in patients who present with urinary and ano-rectal symptoms especially of childhood onset; more so with present day availability of modern radiological tools like MRI.

Background Brain tumors represent group of neoplasms originating from intracranial tissues and the meninges. The aim of this study was to determine the epidemiological profile of brain tumors seen in a referral health center in Cameroon. We carried out a 10-year retrospective study in the neurosurgical, neurology, pathology, oncology and radiotherapy units of our hospital. Results We found 150 complete case files accounting for 0.7% of total admissions in the various units. Males accounted for 50.7% of the cases. Children less than 14 years represented 12.7% of cases (n = 19). Primary brain tumors constituted 92% (n = 138). Most patients with primary brain tumors were between 25 and 54 years of age, making up 57% of cases (n = 79). The most prevalent histological type of brain tumor was meningioma (26%, n = 39), followed by astrocytoma (24.7%, n = 37), and pituitary adenomas (18%, n = 27). The majority of cases presented with signs of raised intracranial pressure with headache being the most frequent symptom (88%). Some patients presented with seizures (34%), neurological deficit (13%), visual disturbances (10%), and cognitive disorders (7%). Conclusion Young adults represent the most affected age group. Meningioma, astrocytoma and pituitary adenomas were the most frequent brain tumors in adults. Further studies are needed to assess the long-term outcome of patients with BTs.

No abstract

Traumatic brain injury is the most common injury during childhood comprising 60% to 90% injuries in children. Pediatric traumatic brain injury has peculiarities as compared to adults, such as less severe injuries and better prognosis. The purpose of this work was to study the pattern of pediatric traumatic brain injury at the General Hospital, Douala, Cameroon. This was a retrospective cross-sectional study, from January 1st, 2008 to December 31st, 2017. Included were all complete medical records of children aged 0 to 15 years old treated for traumatic brain injury, and excluded records of obstetric trauma. Data analysis was done by SPSS software version 18.0. One hundred and three cases of pediatric head injuries were recorded during the study period (frequency 10.43%). The mean age was 7.42 ± 5.028 years, and the sex ratio was 2.67 in favor of boys. Road traffic accidents were the most common etiology (44.7%). 83.5% of the patients were transferred to the emergency department of the Douala General Hospital in second intention and by non-medical transport. The traumatic brain injury was mild in 61.20%. The brain computed tomography scan was performed in 99% of the cases and the most observed lesion was cerebral edema (32.74%). Twenty-eight patients underwent surgical operation. 90.28% of patients have recovered fully, and the global mortality was 3.88%. The prevalence of pediatric traumatic brain injuries at the General Hospital, Douala during the last ten years was 10.43%. Most of the patients recovered fully and the mortality was low.

The diagnosis and management of cerebral gliomas are challenging. The goal of this study was to evaluate the pattern of cerebral gliomas at the General Hospital Douala, Cameroon. A retrospective study was carried out over a period of 10 years. Non-glial lesions were not included. Data were analyzed with Epi info version 7.2.2.6 (Microsoft, Seattle, USA). 220 cases of brain tumors, comprising 56 gliomas (25.46% of all brain tumors) were managed during the study period. The mean age of the patients was 42.93 ± 16.90 years. 35 cases (62.5%) were males. Patients over 15 years of age represented 91.07% (n = 51) of the cases. The most frequent presenting complaints were headache and vomiting with 52 cases (92.86%) and 47 cases (83.93%) respectively. Brain computed tomography was done for all patients. The most frequent histological type was astrocytoma with 22 cases (39.29%) followed by glioblastoma with 20 cases (35.71%). The most performed surgical technique was partial removal with 33 cases (58.93%), followed by open biopsy with 14 cases (25.00%). Radiotherapy was administered to 54 patients (96.43%). The outcome ranged from full recovery in 8 cases (14.29%), recovery with persisting symptoms, in 15 cases (26.79%) and death in 26 cases (46.43%). Seven patients (12.50%) were lost to view. In this series, cerebral gliomas affected most often adult males. Most of them presented with signs of raised intracranial pressure. The outcome was poor with 46.43% of patients dying before 2 years after diagnosis.