Background/Objective: The morbidity and mortality of neurological patients managed in the intensive care unit reflect the causes of neurological disorders and the effectiveness of management. Method: The morbidity and mortality patterns of neurological patients admitted into the intensive care unit of the University of Benin Teaching Hospital (UBTH), a tertiary health institution in Nigeria, was examined over an 18-year period (January 1985 to December 2003. A complete sampling frame was used with all patients' records scrutinized. Results: A total of 187 patients, (16.6% of the total ICU admissions) with neurological morbidity were admitted during the period. We observed that morbidity was high for preventable etiologies -head injury (119 patients constituting 63.7%), tetanus (26 patients constituting 13.9%), hypertensive encephalopathy (12 patients constituting 6.4%) and meningitis (8 patients constituting 4.8%). The case fatality rates for these causes were 50.4%, 61.5%, 66.7% and 62.5% respectively. The case fatality rate for cerebral malaria was 100%. In addition, males (67.9%) were more likely to have trauma-related morbidity (P<.001) than females (32.1%). Overall mortality rate was high (52.4%) and calls for urgent attention. Conclusion:We concluded that preventable morbidities (head injury, tetanus, meningitis and hypertensive encephalopathy) accounted for fatality among neurological patients in the ICU, Benin City, Nigeria. Mortality was higher among those that required significant intensive interventions. Improved public awareness, traffic legislation, prompt emergency medical care and immunization against tetanus and meningitis should reduce morbidity and mortality. Key words: Morbidity, mortality, neurological patients, intensive care unitRésumé Introduction/Objectif: La morbidité et la mortalité des malades neurologiques traités dans le Service de soins intensifs a montré les causes des troubles neurologiques et l'efficacité de la prise en charge. Méthodes: La tendance de la morbidité et de la mortalité des malades neurologiques admis dans le service des soins intensifs du centre hospitalier universitaire du Benin (CHUB), un centre de la sente tertiaire au Nigeria, a été étudié au cours d'une période de 10 ans (janvier 1985 au décembre 2003). Un plan de sondage complet a été utilisé avec tous les dossiers des patients étudiés. Résultats: Un total de 187 patients, (16,6% du total des admissions ICU) atteints de la morbidité neurologique ont été admis au cours de la période. Nous avons noté que le taux de la morbidité est élevé pour les étiologies évitables -blessures de tête (119 patients recensés en 63,7%) ; le tétanos (26 malades recensés en 13,9%) ; hypertension encéphalopathie (12 malades recensés en 6,4%) et la méningite (8 malades recensés en 4,8%) ; Le taux du cas de la fatalité pour ces causes étaient 50,4%, 61,5%, 66,7% et 62,5% respectivement. Le taux du cas de la fatalité pour la fièvre cérébrale était 100%. En outre, sexe masculin (67,9(%) étaient plus susceptibles d'avoir des tra...

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E a s t a f r i c a n M E d i c a l J o u r n a l 253 therapeutic non-disclosure of adverse health information to an obstetric patient: case report o.P. adudu and o.G. adudu summarY the non-disclosure of foetal exomphalos discovered on intra-uterine ultrasound to the mother and anaesthesiologist in this case report, was based on the obstetricians' assumption that it will reduce maternal stress in the antenatal period. there was mis-information that all was well in the antenatal period in spite of maternal informed consent. however, it led to maternal stress and dissatisfaction with the physician. the patient was referred to the psychiatrist for management of her stressful encounter in the postoperative period. ethical and medico-legal issues raised by therapeutic non disclosure of health information to the patient beforehand was addressed and physician knowledge updated by a review of current literature on the subject.

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