Background/Aims: For a century since the first cerebrospinal fluid (CSF) shunt surgery, ventriculoperitoneal (VP) shunt insertion for the treatment of hydrocephalus has routinely been performed. A lot of common and rare complications following this procedure have been reported in 24–47% of the cases. The aim of this paper was to present our experience with the treatment of hydrocephalus in our centre and highlight our management of two unusual complications with the available resources. Methods: Retrospective clinical review. Results: A total of 86 patients with hydrocephalus were seen in our unit. There were 52 males and 34 females (male:female ratio 3:2). The age of the patients ranged from 1 day to 68 years. The majority of the patients (92%) were below 5 years of age. Sixty-five patients had shunting procedures [VP shunt: 62 (95.4%); endoscopic third ventriculostomy: 3 (4.6%)]. Of the 62 patients with VP shunts, 16 (25.8%) had complications while 2 of the 3 patients with endoscopic third ventriculostomies had complications. The complications following the VP shunts were CSF shunt sepsis (n = 12; 19.4%), abdominal complications (n = 3; 4.8%), subdural haematoma (n = 2; 3.2%) and scalp necrosis in 1 patient. Conclusion: VP shunt procedures have come to stay and will remain with us despite recent advances such as endoscopic third ventriculostomy. Care should be taken to prevent all complications whether common or rare by paying particular attention to patient selection, shunt selection and surgical details. The adaptation of local technology and justified use of limited facilities and resources can go a long way in the management of both common and rare complications in developing nations.

No abstract

Background: Much has been written on post stroke depression in the last 10 years in developed countries. However little is known about this important condition in this environment, thus the need for this study. Aims: This study intends to estimate the prevalence of post stroke depression (PSD) and identify other associated factors. Methods: One hundred and eighteen stroke survivors, managed at a Nigerian Teaching Hospital (mean post stroke survival duration ¼ 11 months) were compared with 118 hypertensive controls using Beck Depression Inventory (BDI) and the modified Mini Mental State Examination (mMMSE). Sociodemographic variables were controlled for. Results: Sixteen (13.6%) control subjects compared with 47 representing 38.8% had significant depressive symptoms. Cognitive deficit, paresis and low education were identified as predictors of depressive symptoms (PSD) among survivors. Conclusion: Physicians need to be alert to this condition, especially since it can be treated and this will improve the quality of life among this group of patients.

No abstract

No abstract

Introduction: Devic's neuromyelitis optica is an inflammatory demyelinating disease that targets the optic nerves and spinal cord. It has a worldwide distribution and distinctive features that distinguish it from multiple sclerosis. There has been no previous report of neuromyelitis optica from our practice environment, and we are not aware of any case associated with antiphospholipid syndrome in an African person.

Background: The relationship of diet with stroke risk among Africans is not well understood. Aim: To investigate the association between dietary patterns and stroke risk among West Africans. Methods: In this multi-centre case-control study, 3684 stroke patients matched (for age and sex) with 3684 healthy controls were recruited from Nigeria and Ghana. Food consumption was assessed using a food frequency questionnaire, and dietary patterns were summarized using principal component analysis. Stroke was defined using predefined criteria primarily on clinical evaluation following standard guidelines. Conditional logistic regression was applied to compute odds ratio (OR) and 95% confidence interval (CI) for stroke risk by tertiles of dietary patterns. Results: Overall, mean age was 59.0±13.9 years, and 3992(54.2%) were males. Seven dietary patterns were identified. Multivariable-adjusted OR (95%CI) for risk of stroke by second and third tertiles (using the lowest (first) tertile as reference) of dietary patterns were; 1.65 (1.43, 1.90) and 1.74 (1.51, 2.02) respectively for ‘poultry product and organ meat’; 1.69 (1.47, 1.96 and, 1.51 (1.31, 1.75) for ‘red meat’; 1.07 (0.92, 1.23) and 1.21 (1.04, 1.40) for ‘fried foods and sweetened drinks’; 0.69 (0.60, 0.80) and 0.45 (0.39, 0.53) for ‘vegetables’; 0.84 (0.72, 0.97) and 0.81 (0.70, 0.93) for ‘whole-grain and fruit drinks’; and 0.97 (0.84, 1.12) and 0.85 (0.73, 0.98) for ‘fruits’ (P<0.05). Conclusions: These data suggest that plant-based diets are associated with a lower risk of stroke and might be a beneficial dietary recommendation for the primary prevention of stroke among Africans.

No abstract