Posterior decompression and stabilization in a pregnant patient with traumatic lumbar fracture: A case report.

Spine fractures with or without spinal cord injury in the pregnant population are rare, with few reported cases. A 25-year-old primigravida at 24 weeks of gestation presented after falling off a fast-moving motorcycle one month prior. She had sustained a severe back injury and had difficulty walking. Magnetic resonance imaging showed an acute kyphosis secondary to comminuted anterior wedge compression fractures of the L2 and L3 vertebral bodies and L2/3 disc involvement with retropulsion of the fracture fragments into the central canal resulting in severe central canal stenosis. After multidisciplinary discussion, the patient underwent posterior decompression, reduction and stabilization with pedicle screws. The patient had good neurological recovery at discharge and the pregnancy progressed normally. Three months later, at 39 weeks of gestation, the patient had an uneventful spontaneous delivery of a healthy baby. This case illustrates the importance of multidisciplinary management of spinal cord injury in a pregnant patient.

Pediatric Hydrocephalus in Northwest Tanzania: A Descriptive Cross-Sectional Study of Clinical Characteristics and Early Surgical Outcomes from the Bugando Medical Centre.

OBJECTIVES: In this study, we present data from a neurosurgical training program in Tanzania for the treatment of pediatric hydrocephalus. The objectives of the study were to identify the demographics and clinical characteristics of pediatric patients with hydrocephalus who were admitted to Bugando Medical Centre in Mwanza, Tanzania, as well as to describe their surgical treatment and early clinical outcomes. METHODS: This cross-sectional study included 38 pediatric patients. Physical examinations were conducted pre- and postoperatively, and their mothers completed a questionnaire providing demographic and clinical characteristics. RESULTS: There was a slight preponderance of male sex (21/38; 55.3%) with median age at the time of admission of 98.5 days. The majority of patients were surgically treated (33/38; 86.8%). Among those surgically treated, most received a ventriculoperitoneal shunt (23/33; 69.7%), whereas 7 were treated with an endoscopic third ventriculostomy (7/33; 21.2%). At the time of admission, the majority of patients (86%) had head circumferences that met criteria for macrocephaly. The median time between admission and surgery was 23 days (2-49 days). Overall, 5 patients (13.2%) died, including 2 who did not receive surgical intervention. CONCLUSIONS: We found that in our population, pediatric patients with hydrocephalus often present late for treatment with additional significant delays prior to receiving any surgical intervention. Five patients died, of whom 2 had not undergone surgery. Our study reinforces that targeted investments in clinical services are needed to enable access to care, improve surgical capacity, and alleviate the burden of neurosurgical disease from pediatric hydrocephalus in sub-Saharan Africa.

Pathological and Topographical Classification of Craniopharyngiomas: A Literature Review.

Craniopharyngiomas (CPs) are clinically relevant tumors of the sellar region and are associated with high morbidity and occasional mortality. There are two different subtypes of CPs that differ clinically and pathologically: adamantinomatous CP and papillary CP. The differential diagnosis is still challenging even with developments in preoperative imaging as several tumors of the sellar/parasellar region share a continuum of clinical characteristics and imaging similarities. Several topographical classifications of CPs have been mentioned in literature, but to date, there has not been a consensus on a standard reference classification system and there is need to a develop such a model.