Results: Sixty six subjects were seen during the study period. Females were more commonly affected and were mostly middle aged. Adhesive capsulitis was the most common condition while septic arthritis and avascular necrosis were least diagnosed 22.7% of the subjects could not, however, be categorised. Conclusion: Shoulder pain syndrome is common among Nigerians. Diagnosis and management are mostly based on the clinical presentations, especially considering the lack of sensitivity of plain radiographs and the high cost of more sensitive MRI. The treatment of these conditions are standard.
Background:This study explored the outcome of children with patent anterior fontanelles who were treated with trans-fontanelle ultrasound scan (TFUSS), which is more affordable and available than CT scan and MRI in the diagnosis of childhood intracranial pathologies and treatment of subdural empyema, in developing countries.Patients and Methods:Seventeen infants with post-meningitic subdural empyema, diagnosed using trans-fontanelle ultrasound alone and treated with subdural tapping over a 31-months period, were studied.Results:Eleven patients presented with grades II and III Bannister and William grading for level of consciousness in intracranial subdural empyema. Aspirate from 7 (41.2%) patients were sterile. The most common organisms isolated were Streptococcus faecalis 3 (17.6%), Haemophilus Influenza 2 (11.8) and Staphylococcus aureus 2 (11.8), multiple organisms were isolated in three of the patients. Ninety-four percent (94%) of the patients had good outcome. Five subjects developed hydrocephalus, one patient had a recurrence of subdural empyema, four patients had residual hemiparesis, two of the four patients had speech difficulties, while one patient (~6%) died.Conclusion:While CT and MRI remain the gold standard for investigating intracranial lesions, transfontanelle ultrasonography is adequate for diagnosis of infantile subdural empyema in resource-challenged areas. Percutaneous subdural tap is an affordable and effective therapy in such patients with financial challenges.
Subdural empyema (SDE), a common neurosurgical emergency in the developing countries, accounts for 15%-20% of localised paediatric intracranial infections. In regions where modern diagnostic tools are scarce and inaccessible, detection of SDE may be delayed with subsequent poor outcome. Percutaneous subdural aspiration in patients with open anterior fontanel may be the only surgical option in resource-poor regions of the world. This review focuses on the management outcome, including neurological outcome of these children. Clinical charts of children with SDE and treated by percutaneous subdural tap between February 2006 and August 2014 were reviewed. Demographic, clinical, radiological, bacteriological parameters and outcome data were analysed. Forty-five children with a mean age of 10.6 ± 6.2 months (range:
Despite the rising percentage of women accessing the medical profession over the last few decades, surgical specialties are still largely male-dominated; in particular, a remarkable gender disparity is evident in neurosurgery, where only 19% of practitioners are females. Although women may be reluctant to choose a challenging specialty like neurosurgery due to concerns around how to balance family and career, it must be admitted that prejudices against female neurosurgeons have been deeply rooted for long, prompting many to give up and switch track to less demanding subspecialties. Among those who have persisted, many, if not most, have experienced difficulties in career progression and received unequal treatment in comparison with their male counterparts. In 1989, a group of 8 female neurosurgeons founded Women in Neurosurgery (WINS), an organization that aimed to guarantee inclusivity in neurosurgery, encouraging a better and more egalitarian working environment. Thereafter, WINS sessions were regularly promoted at international conferences, offering female neurosurgeons a platform to report issues related to gender discrimination. Over recent years, the mission of WINS sessions in national and international conferences has taken an unexpected deviation; they have progressively become supplementary scientific sessions with only women neurosurgeons as speakers, thus paving the road to a form of self-segregation. This tendency has also resulted in the establishment of sections of only female neurosurgeons within some national societies. Although there remains a faction that fiercely supports the WINS mindset of reserved spaces for women, such segregation is an upsetting prospect for those who believe that science and professionalism have no gender; a growing part of the global neurosurgical community believes that the conception of a “female neurosurgery” and a “male neurosurgery” is misguided and counterproductive and consider the existence of the WINS as anachronistic and no longer necessary.
Background: Endoscopic third ventriculostomy (ETV) is becoming a popular option of treatment in carefully selected patients with hydrocephalus (Drake et al., Childs Nerv Syst 25:467-472, 2009). The success or possible outcome of its application in treating hydrocephalus can be predicted by employing a preoperative scoring system. An example of such a system is the endoscopic third ventriculostomy success score (ETVSS). It could form a basis for decision-making and prognostication. This study aimed to evaluate ETVSS as a preoperative predictive tool in children with hydrocephalus who satisfy the inclusion criteria for the option of ETV procedure as treatment modality. Methodology: This is a prospective hospital-based study of 68 children under 2 years of age that presented at the Lagos University Teaching Hospital (LUTH) out of 161 children with hydrocephalus from November 2014 to April 2016. The predicted ETVSS was calculated by the addition of patients' age, presumed aetiology and prior shunting. These children were stratified into three groups according to ETVSS as higher score predicts better ETV outcome and vice versa. They were followed up for 6 months to determine the success rate of ETV. Results: The age of the study population ranged from 0 to 24 months with a mean age of 5.52 ± 5.48 months. 69.1% of these patients were male and 30.9% were female with a male to female ratio of 2.2:1. The mean predicted ETVSS (48.82 ± 19.20%) and actual ETV success score (56.20 ± 15.10%) using the ANOVA were significantly related (p value < 0.05). Conclusion: This study concluded that the early outcome of ETV in children below 2 years of age with hydrocephalus is directly related to the preoperative ETVSS.
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