Clinical Parameters, Management, and Outcomes of Childhood Traumatic Brain Injury in Ilorin.

BACKGROUND: Traumatic brain injury (TBI) is common among children, accounting for 75% of children hospitalized for trauma. Childhood TBI is a leading cause of death from trauma in the pediatric age group and the incidence is on the rise globally. OBJECTIVE: The objective of this study was to determine the etiology, management, and outcome of childhood TBI in our setting. SUBJECTS AND METHODS: This is a retrospective study of all cases of childhood TBI. Relevant data extracted from case records were analyzed using a 2011 Statistical Package for the Social Sciences (SPSS; IBM, Armonk, New York) software for Windows, version 20. RESULTS: A total of 168 children with TBI were studied. Of which, 109 (65%) were males and 59 (35%) were females (male/female ratio of 13:7, mean age, 7 ± 4 years). Most of the injuries (138, 82%) occurred outdoor; road traffic crash and fall accounted for 101 (60.1%) and 47 (27.9%) cases, respectively. Pedestrian motor vehicular accident accounted for 41 (41.8%) cases, whereas 30 (30.6%) were due to motorcycle road traffic crash. Good recovery was recorded in 138 (81%) patients, 22 (13.1%) had moderate disability. Mortality rate was 6%. CONCLUSION: Brain injury from trauma still constitutes a significant part of childhood morbidity and mortality in our setting; these deaths are avoidable in most cases. The outlook can be better if preventive efforts are geared toward domestic and road safety campaign.

Cerebellar Vermian Epidermoid Tumor: A Report of 2 Cases.

BACKGROUND: Epidermoid tumors are rare, benign slow-growing congenital tumors, most frequently located in the cerebellopontine angle of the intracranial cavity. They usually grow to a large size before patients become symptomatic. Although these tumors are amenable to surgery, their adherence to neurovascular structures poses a surgical challenge that results in subtotal resection, thus increasing the risk of recurrence. CASE DESCRIPTION: We report 2 adult patients whose imaging studies revealed epidermoid tumors located in the cerebellar vermis, an uncommon site for such tumors. The patients presented with variable symptomatology. We highlight the imaging features and challenges of surgery. Both patients had good outcomes, with resolution of symptoms and neurologic deficits. CONCLUSIONS: A safe complete excision of epidermoid tumor and its capsule is possible with a good understanding of their clinical and radiologic features and a high index of suspicion. To the best of our knowledge, this is the first report of cerebellar vermian epidermoid tumors from sub-Saharan Africa.

Suprasellar Clear Cell Meningioma in an Infant.

Clear cell meningiomas are an uncommon subtype of meningioma rarely seen in infancy. We report a case of clear cell meningioma in an 8-month-old male infant. He presented at the Lagos University Teaching Hospital, Lagos, Nigeria, in 2015 with persistent vomiting, poor feeding and failure to thrive over a four month period. Generalised hypertonia and hyperreflexia were noted on examination. Computed tomography of the brain revealed a huge largely isodense suprasellar mass with a hypodense core. The tumour, which measured 6 × 5 × 4 cm, enhanced non-uniformly with contrast injection and extended to occlude the third ventricle. The patient underwent a bifrontal craniotomy with subtotal tumour excision. Six hours postoperatively, he went into cardiac arrest and could not be resuscitated. A histological diagnosis of clear cell meningioma was made as the tumour cells were immunoreactive to epithelial membrane antigen, S100 protein and vimentin. This case of clear cell meningioma was unusual due to its early occurrence and supratentorial location.