ABSTRACT
Spinal cord injury is a global problem. It is a devastating life altering condition that is associated with permanent disability and reduced life expectancy. Road traffic accident has been described in global literature as the commonest aetiology and second to it is falls. Identifying these factors have led to development of policies and advocacy to reduce these causes of spinal cord injuries. We present three cases of spinal cord injuries from unusual aetiologies viz-a-viz an accidental hanging which resulted in a C4 traumatic myelopathy Frankel A in a 30-year old artisan, playful neck manipulation in a 23-year old male student, resulting in Brown-Sequard syndrome, which resolved with non-operative spinal cord injury management protocol over six weeks and a C4 traumatic myelopathy Frankel D with a 50% anterior listhesis of C4 on C5 in a 50-year old man who sustained injuries from a choke hold 10 weeks prior to presentation. He recovered fully on non-operative management and discharged home Frankel E.
ABSTRACT
Choroid plexus papillomas are rare benign tumours, which are found in both adult and paediatric age groups. The 'atypical' histological subclass is rarer still. The commonest site of occurrence is in the lateral ventricles; rare locations are the cerebellopontine angle and the third ventricle. The goal of care is a gross total excision of the tumour. The histologic subtype determines further adjuvant care given to the patient. The outcome of the care of these patients depends on the histological grade, extent of surgical resection adjuvant care. We present a case of a 12 week-old infant with obstructive hydrocephalus, secondary to a third ventricular atypical choroid plexus papilloma. He had a 'two-staged' resection of the choroid plexus papilloma, using an endoscopic access via the right Kocher's point in the right anterior fontanelle, in the same position as that proposed for access in endoscopic third ventriculostomy because of the observed sutural diastasis. Histology confirmed an atypical choroid plexus papilloma. He made progressive recovery post-surgery but unfortunately there has been default with follow-up clinic visits.
ABSTRACT
Traumatic brain injury (T.B.I.) has an annual incidence of 200/100000. There is little or no information onneuroendocrine sequelae following T.B.I. in the Nigerian population. The purpose of the study is to evaluate the effect ofT.B.I on the thyroid axis and relate it to outcome by outlining the change in thyroid axis of head injured patients. One hundredand fifteen patients were recruited with 85% male and 15% female. Of these patients, 71.7% presented within 24 hours ofinjury. The head injury was mild in 53%, moderate in 16% and severe in 31% of the patients. Serum T3 was high in 52.2%,low in 7.8% and normal in 40%. Serum T4 was high in 4.3%, low in 68.7%, and normal in 27%. Serum TSH was high in16.5% TSH levels, low in 6.1% and normal in 77.4%. There was no correlation between the severity of head injury measuredby the Glasgow coma score and patterns observed in the thyroid function test. With respect to outcome of head injury, serumT4 was low in patients who died or had persistent vegetative state (p=0.012). Traumatic brain injury in Nigerian patients isassociated with an elevation of T3, low levels of T4 and normal TSH values. Death and persistent vegetative state wereassociated with low T4.
