Mt Shokunbi

The relationship between ventricular dilatation, neuropathological and neurobehavioural changes in hydrocephalic rats

BackgroundThe motor and cognitive deficits observed in hydrocephalus are thought to be due to axonal damage within the periventricular white matter. This study was carried out to investigate the relationship between ventricular size, cellular changes in brain, and neurobehavioural deficits in rats with experimental hydrocephalus.MethodsHydrocephalus was induced in three-week old rats by intracisternal injection of kaolin. Behavioural and motor function were tested four weeks after hydrocephalus induction and correlated to ventricular enlargement which was classified into mild, moderate or severe. Gross brain morphology, routine histology and immunohistochemistry for oligodendrocytes (CNPase), microglia (Iba-1) and astrocytes (GFAP) were performed to assess the cellular changes.ResultsDecreases in open field activity and forelimb grip strength in hydrocephalus correlated with the degree of ventriculomegaly. Learning in Morris water maze was significantly impaired in hydrocephalic rats. Gradual stretching of the ependymal layer, thinning of the corpus callosum, extracellular oedema and reduced cortical thickness were observed as the degree of ventriculomegaly increased. A gradual loss of oligodendrocytes in the corpus callosum and cerebral cortex was most marked in the severely-hydrocephalic brains, whereas the widespread astrogliosis especially in the subependymal layer was most marked in the brains with mild hydrocephalus. Retraction of microglial processes and increase in Iba-1 immunoreactivity in the white matter was associated ventriculomegaly.ConclusionsIn hydrocephalic rats, oligodendrocyte loss, microglia activation, astrogliosis in cortical areas and thinning of the corpus callosum were associated with ventriculomegaly. The degree of ventriculomegaly correlated with motor and cognitive deficits.

Complete ossification of the superior transverse scapular ligament in a nigerian male adult

La osificacion completa del ligamento transverso escapular superior es generalmente considerado como raro y no existen datos previamente descritos en nigerianos. En el diagnostico del sindrome de compresion del nervio supraescapular, variaciones anatomicas del ligamento transverso escapular superior pueden ser consideradas un posible factor etiologico, como es el caso descrito

Non-operative management of benign intracranial hypertension presenting with complete visual loss and deafness.

Benign intracranial hypertension (BIH) may lead to blindness and rarely deafness. We describe the case of a rapidly deteriorating 14-year-old African girl who presented with headaches associated with complete visual and hearing loss due to BIH. This was managed non-operatively with lumbar cerebrospinal fluid tap, weight reduction, nicotinic acid and acetazolamide. Response to treatment was quite dramatic with resolution of severe headaches and regaining of light perception 8 days after commencing treatment. By 3 months hearing recovered to normal and there was resolution of vision. This to the best of our knowledge is the first reported case of complete visual and hearing loss occurring in a patient with BIH, which was managed successfully non-operatively. When indicated, non-operative management is an effective treatment option even in malignant BIH.

Radiation Nephritis: Anti-inflammatory Effect of Dexamethasone in Adult Wistar Rats (Rattus norvegicus)

Fue estudiado el efecto anti-inflamatorio de la dexametasona en rinones irradiados de 18 ratas Wistar adultas (Rattus norvegicus). Luego de la aclimatizacion, aleatoriamente se dividieron en 3 grupos de 6 animales por grupo. El grupo control recibio una solucion salina normal, sin recibir drogas ni radiacion. El segundo grupo recibio solucion salina normal y radiacion. El tercer grupo recibio tratamiento previo con dexametasona con 1 mg / kg de peso corporal / dia, durante 2 dias, seguido de radiacion. Los animales fueron expuestos a radiacion con una fraccion independiente de 2.5 Gy de rayos gamma por una fuente de Cobalto-60, usando una maquina de teleterapia AECL Theatron 780-C. Despues de la exposicion a las diferentes intervenciones, los animales fueron sacrificados el dia 14 post-irradiacion y los rinones de cada uno de los animales fueron disecados. Los tejidos renales fueron sometidos a procesamiento histologico, y luego se estudiaron utilizando un objetivo ocular milimetrado calibrado a 2mm para el estudio histomorfometrico. Se demostro que todos los animales irradiados sufrieron perdida de peso 14 dias despues de esta (p <0.05), independientemente de los tratamientos adicionales con dexametasona , siendo estadisticamente significativo. La histomorfometria mostro que el ancho maximo de la capsula glomerular fue significativamente mayor en los grupos irradiados que en el control en p <0.05. El diametro maximo del glomerulo fue significativamente mayor en los animales irradiados en comparacion con los animales control p <0.05. Los resultados de este estudio mostraron que la administracion intraperitoneal, de 1 mg / kg de peso corporal / dia durante 2 dias, de dexametasona antes de comenzar el tratamiento con irradiacion, no impide la perdida de peso ni permite aliviar el edema de los nefrones, injuria producto de la radiacion a las Ratas Wistar.

Pattern of presentation of pressure ulcers in traumatic spinal cord injured patients in University College Hospital, Ibadan

The neurosurgery division in University College Hospital (U.C.H.) admits approximately one traumatic spinal cord injured (SCI) patient per week, most of whom stay a minimum of 42 days on admission. A common complication in these patients is the development of pressure ulcers, which contributes to a longer hospital stay and increased hospital expenses. The purpose of this study was to investigate the pattern of presentation of pressure ulcers in patients on admission and to propose policies or protocols to reduce the incidence. It is a prospective study of traumatic SCI patients managed on the neurosurgery ward from January 2003 to June 2004. The data was analysed using descriptive statistics. Sixty‐seven patients were studied. The average hospital stay was 73 days. Thirteen (20%) of the patients were admitted with pressure ulcers, 32 (47·7%) developed it after admission. As much as 87·5% of pressure ulcers seen in the course of this study which occurred on admission in U.C.H. was in the first week of admission, 6·25% in the second week and the remaining 6·25% in the third week. Pressure ulcers were distributed as follows; 69% (42) in the sacral region, 18% (11) trochanteric, 5% (3) scalp, 1·5% (1) ankle, 1·5% (1) ischial tuberosity, the remaining 5% in other sites. Preventive measures for pressure ulcers consisted of basic skin care, pressure dispersion using fenestrated foams and alternating weight‐bearing sites by regular turning. Pressure ulcers are commonest in the sacral and gluteal regions and tend to occur within the first week of admission in the neurosurgical wards.

Factors influencing visual and clinical outcome in Nigerian patients with cranial meningioma

We retrospectively analysed the impact of selected clinicopathological factors on visual and clinical outcome in patients with histologically verified cranial meningioma. The 60 patients analysed for tumour characteristics consisted of 32 females and 28 males (sex ratio 1.1:1) aged 9-77 years (mean 40 years) seen between 1977 and 1999 at the University College Hospital, Ibadan, Nigeria. The patients for whom sufficient clinical data was available (n=35) presented within 2-60 months (mean 18 months) of symptom onset with large tumours (mean size 52 mm), and perifocal oedema (26/35), poor vision, focal neurological deficits, seizures and clinical evidence of intracranial hypertension. The most common tumour site was the convexity. There was loss of vision in 30/35 (85.7%) patients. Loss of vision was significantly related to tumour site and tumour size as well as perifocal oedema, (P<0.05). The case-mortality rate was 11.4% at 1 month and 20% at 6 months post-operation and was significantly correlated with intracranial hypertension. Neither age nor sex affected the outcome (P>0.05).

A comparison of visual function scores in hydrocephalic infants with and without lumbosacral myelomeningocoele.

Purpose The cerebrum is frequently malformed in children with myelomeningocoele. This anomaly renders them potentially susceptible to cerebral visual impairment. In these patients, hydrocephalus is an important and frequent complicating lesion which compromises intellectual function and may also cause cerebral visual impairment. In this study, we determined whether hydrocephalic patients with lumbar myelomeningocoele (HLM) are at a greater risk of visual impairment than hydrocephalic patients without this lesion (H).Methods In this prospective study, we assessed five parameters of visual function in 20 hydrocephalic children with lumbar myelomeningocoele and compared the total visual function scores (TVFS) obtained with those from hydrocephalic children without overt spinal dysraphism, but similar in age, sex and ventricular size. The parameters, which were assessed with the aid of a quantitative grading scale, were pupillary size and reaction, optic atrophy, visual fixation and tracking.Results The age and sex distributions of the patients in the two groups were similar. The anterior and posterior dimensions of the lateral ventricles were also similar. The mean (SD) of the TVFS were 24.25 (3.63) and 24.20 (3.47) respectively for the two groups (P = 0.90).Conclusions The results suggest that, in hydrocephalic infants with lumbar myelomeningocoele, visual function is not further diminished by the associated dysraphism and that ventricular dilatation is the major determinant of visual impairment.

Effect of Preconception Gamma Irradiation on Morphometric Assessment of Adult Female Mice and Embryo

El objetivo fue estudiar el efecto de la irradiacion gamma antes de la concepcion sobre la morfometria macroscopica de ratones hembra adultos y los embriones de sus crias. Veinte y siete ratones, 18 hembras y 9 machos, divididos en 3 grupos (control, sin irradiacion e irradiado) con 6 hembras y 3 machos cada uno en proporcion 2:1. Una dosis de radiacion gamma de 1 Gy/min fue aplicada a uno de los ratones expuestos por un equipo Cobalt 60, Theratron modelo 780c, Atomic Energy of Canada Limited (AECL) en el departamento de radioterapia del Hospital University College de Ibadan. Todos los animales se aparearon 1 semana despues de la irradiacion. Se confirmaron los tapones vaginales, y las hembras prenadas fueron sacrificadas en el dia 14 de la gestacion por inhalacion de cloroformo. La morfologia general de los ratones hembras y sus camadas fueron evaluadas y analizadas estadisticamente. Un total de 113 embriones se recolectaron en todos los grupos, 54 del grupo control, 50 del grupo no irradiados y 9 del grupo irradiado. Las evaluaciones morfologicas macroscopicas de los fetos fueron estadisticamente significativas (p<0,05) para los 3 grupos de comparacion. Estos hallazgos sugieren que una irradiacion previa a la concepcion afecta a la morfologia de los ratones hembra y su progenie.

Neuroprotective Effect of Dexamethasone on the Morphology of the Irradiated Post Natal Developing Cerebellum of Wistar Rat (Rattus norvegicus)

Se estudio el efecto neuroprotector de la dexametasona, sobre el cerebelo post-natal en desarrollo irradiado de ratas Wistar. 75 neonatos de 1 dia de edad fueron separados en 3 grupos; el grupo control no recibio ni drogas ni irradiacion, un grupo irradiado y el otro irradiado con aplicacion de dexametasona. Esta droga fue administrada una hora antes de la exposicion de 5Gray (5Gy) de rayos gamma. El tejido cerebelar de cada grupo con 5, 9, 14, 21 y 25 dias fueron procesados para estudios histologicos e histomorfometricos. El resultado del estudio demostro que la sola irradiacion redujo significativamente el grosor de la capa granular externa, en los grupos con 5 y 14 dia,s con un p0,05; la capa molecular en los ejemplares de 5, 9, 14 y 21 dias con un p0,05 y la capa granular en las ratas de 5,9,14 y 25 dias, con un p0,05. Cuando se combino la dexametasona con irradiacion, se observo un grosor significativamente diferente en la capa granular externa, en especimenes con 5, 9 y 14 dias; en la capa molecular en los animales de 5, 14 y 21 dias y en la capa granular en los que tenian 5 y 14 dias, al compararlos con el grupo irradiado, con un p>0,05. El diametro de las celulas de Purkinje (capa de Purkinje) aunque fue significativamente reducido en el grupo irradiado de 14 y 21 dias, no fue significativamente diferente cuandos se administro dexametasona a los animales irradiados de 5, 9, 14, 21 y 25 dias con un p0,05. Histologicamente, las celulas de la capa molecular, en el grupo irradiado de 9 y 14 dias, fueron marcadamente gliosadas comparadas con las medianamente marcadas en los grupos control e irradiados-dexametasona. Hubo distorsion de la monocapa de Purkinje, con algunas celulas encontradas en la capa molecular o en la capa de Purkinje, en el grupo irradiado de 5, 9, 14 y 25 dias. De los resultados de este estudio, se puede afirmar que la administracion de 0,005 ml de dexametasona intraperitonealmente, una hora antes de una exposicion a una irradiacion, parece proteger el desarrollo del cerebelo de la rata, de lesiones producidas por irradiacion

Features and Outcome of Surgical Management of Spinal Tumors in a Cohort of Nigerian Patients

OBJECTIVE There is a dearth of information on operated cases of spinal tumors in patients in sub-Saharan Africa. The objective of this study was to evaluate the histologic pattern, anatomic distribution, and extent and outcome of surgery of Nigerian patients with spinal tumors. METHODS This retrospective study comprised a cohort of Nigerians who underwent surgery for spinal tumors. Data obtained included patient demographics, duration of symptoms, anatomic location, imaging findings, Frankel grading before and after surgery, and type and outcome of surgery. Univariate analysis was performed, and results were compared with results from other parts of the world. RESULTS There were 59 patients (male-to-female ratio 1:1.1) with a bimodal age distribution. The highest (20.34%) incidence was seen in the 20-29 age group. More than half (58.06%) of the patients presented with a duration of symptoms of at least 6 months (duration of symptoms was >12 months in 35.48%). Motor deficit was present in 97.73% of patients at presentation. Functional grading was Frankel A in 38.10% of patients, Frankel C in 26.19%, Frankel B in 16.67%, Frankel D in 16.67%, and Frankel E in 2.38%. The tumors were mostly in the thoracic region (65.45%), and 58% were extradural in location. Gross total tumor excision was performed in 50.88% of the cases, and subtotal resection was performed in 24.56%. Spinal stabilization was performed in 17.86% with spinous process wiring and vertical strut being the most common method of stabilization (80%) among this group. Metastasis was the most common histologic tumor type (23.21%). Meningioma accounted for 12.50% of tumors, and ependymoma, astrocytoma, and hemangioma each accounted for 7.14%. The most common source of metastasis was the prostate (38.46%). Postoperatively, 45% of patients improved neurologically, 52.5% remained the same, and 2.5% deteriorated. There was no perioperative mortality. CONCLUSIONS Metastasis was the most common histologic type of spinal tumor in this study, and the most common location was extradural. The outcome was satisfactory in most cases with neurologic function remaining the same or improving after surgery in most patients.