Olufemi Idowu

Lagos State University College of Medicine · Surgery (Neurosurgery Division)

Introduction To report spontaneous surgical acute and chronic intracranial haemorrhage in patients with SARS-Cov-2 infection. Case Presentation We report two cases of SARS-CoV-2 infection that was associated with spontaneous surgical acute and chronic intracranial haemorrhage. The two patients had successful surgical intervention. Conclusion Surg...

Calvarial intrasutural bones (CIB) incidences are known to vary in different populations. The objective of this study was to determine the frequency, location, number and gender difference if any, of CIB in Nigerian skulls. This descriptive observational study included 96 adult skulls. Out of 96 subjects, 58 were males and 38 were females (M:F=1.5:...

IntroductionChronic subdural haematoma (CSH) has multifactorial mechanisms involved in its development and progression. Identifying readily available inflammatory and coagulation indices that can predict the prognosis of CSH will help in clinical care, prognosis, generating objective criteria for assessing efficacy of treatment strategies and compa...

Background: Chronic subdural hematoma (CSDH) is achronic inflammatory and angiogenic condition that is potentially fatal and common among the elderly with a probability of gender, racial and ethnic differences. As our population ages due to increase in our life expectancy, a closer look at this disease in our environment is therefore justified. O...

Background The indications for intracranial pressure (ICP) monitoring in patients with acute brain injury and the effects of ICP on patients’ outcomes are uncertain. The aims of this study were to describe current ICP monitoring practises for patients with acute brain injury at centres around the world and to assess variations in indications for IC...

Visual Abstract for Article in Lancet Neurology

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Su...

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates a...

Introduction Traumatic brain injury management is a leading cause of disability and death in young adults. Our objective was to develop a new multidomain, comprehensive, sensitive, objective and easily reproducible outcome scale with high predictive accuracy to assess patients with traumatic brain injury. The developed outcome assessment tool, the...

We describe the unique case of a 6-year old boy who presented with recalcitrant generalized tonic-clonic seizures and clinicoradiological features of congenital Cirsoid aneurysm. The lesion was supplied by occipital arteries and a large right parietal parasagittal intracranial feeding artery in a Yokouchi type C pattern. The venous drainage was com...

Introduction: The purpose of this study was to define and establish the relationship of clinically diagnosed seizures with electroencephalographic (EEG) pattern and to determine the effective role of EEG in diagnosis of patients suffering from epileptic seizures. Methods: We reviewed the charts of 615 patients with seizure disorder who had an elect...

Methods: A three-year, retrospective review of road traffic injured patients seen at the Surgical Emergency Room (SER) of the Lagos State University Teaching Hospital (LASUTH), Ikeja, Nigeria, from January 1, 2012 to December 31, 2014 was conducted. Parameters extracted from the Institution Trauma Registry included bio-data, date and time of injur...

Background: Traumatic injury to pituitary gland can lead to significant endocrine dysfunctions. The aim of this study is to define the frequency of pituitary gland injury in patients with fatal nonsurgical closed traumatic brain injury (TBI), and to correlate if any, the type of craniocerebral injury associated with the pituitary gland injury. Meth...

Introduction: Significant deaths of between 21% and 38% occur from non-trauma surgical conditions in the accident and emergency room. Access to emergency surgical care is limited in many developing countries including Nigeria. We aimed to study the spectrum of non-trauma surgical emergencies, identify challenges in management and evaluate outcomes...

Giant solitary anterior cervical canal neurofibroma (GSACCN) is rarely reported in the literature. When the large lesion is ventrally located to the spinal cord, an anterolateral approach may not be ideal due to various technical challenges. In this report, we describe a case of intradural extramedullary GSACCN located at the cervical region extend...

Cranial and spinal dysraphisms have different incidence in different parts of the world depending on the geographic region, ethnicity, socioeconomic status of the parents, maternal age and parity. Our aim was to determine the current state of neural tube defects in our environment where there is no policy of food supplementation with folic acid. A...

The cost of medical care and availability of resources (human and facilities) which differs from nation to nation are amongst others, factors driving medical tourism (MT) despite its potential drawbacks. The aim of the study was to analyse all patients that presented with neurosurgical complications following MT. A single institution prospective st...

The management of acromegaly caused by an uncommon growth hormone-secreting pituitary adenoma can be challenging in low-resource African subregion. We conducted a study over a 2-year period to describe the results and challenges following surgical treatment of this rare condition in our centre. The clinical outcome was defined as successful based o...

Introduction: Intracranial suppurations (ICS) of bacterial origin are associated with significant mortality and morbidity. This study aimed to review demography, etiology, level of consciousness, and outcome of surgical ICS in a tropical tertiary hospital. Materials and methods: All patients admitted to the neurosurgical unit within the study pe...

Surgically treated intracranial suppurations (ICS) are uncommon, life-threatening neurosurgical emergencies. They can result from complication of chronic suppurative otitis media (CSOM) and bacterial rhinosinusitis (BRS). The objective of this study was to know the frequency of BRS and CSOM and relate it to its rare complication of surgically treat...

Speech and Language, one of the most lateralized of all cerebral functions is located within the pars opercularis (PO) and pars triangularis (PT). There is also inter-hemispheric variability of the sulcal contours bordering these areas. The study was undertaken to note the morphometry, asymmetry and variations of the Sylvian fissure (SF), and the s...

BACKGROUND: This study sets out to establish a database of BID patients presenting at the Lagos State University Teaching Hospital (LASUTH). METHOD: A retrospective study of consecutive "Brought in Dead" (BID) patients seen from April to November 2011 at the surgical emergency room of the Lagos State University Teaching Hospital (LASUTH) was done u...

Background The import of the cavum variation and its prevalence rate in healthy individuals is still not clear, likewise in neurologically diseased patients. Purpose To evaluate the frequency and pattern of caval variations in neurologically diseased patients. Material and Methods The presence or absence of the cavum septum pellucidum (CSP), cavu...

BACKGROUND: This study sets out to establish a database of BID patients presenting at the Lagos State University Teaching Hospital (LASUTH). METHOD: A retrospective study of consecutive ‘’Brought in Dead‘’ (BID) patients seen from April to November 2011 at the surgical emergency room of the Lagos State University Teaching Hospital (LASUTH) was don...

Objectives: Since the first pedestrian road fatality of 1896, pedestrians still remain vulnerable, with fatalities in Africa being 55% of global statistics. Many previous reports from Nigeria have emphasized passengers and drivers over pedestrians; this study was done in the most densely populated Nigerian city with no previous publication exclusi...

Child pedestrian injuries and fatalities in developing countries continue to increase. We examined child pedestrian injuries and fatalities in the most populated urban agglomeration in Africa in order to develop control measures. Two-year prospective study of injured child pedestrians (≤15 years) at the Surgical Emergency Room (SER) to determine de...

Introduction: The Central nervous system (CNS) is a frequent a site of relapse of systemic cancer. There are few data available in literature about the frequency and nature of symptomatic histopathological variants of secondary brain/spinal tumours drawn against the gender/age distribution in our environment. Objective: To study the frequency and...

Congenital hydrocephalus without or with associated myelomeningocoele has impaired visual function as a potential complication. The present study was embarked on to determine the frequency of optic nerve deficits and refractive errors in this group of children and document any relationship to neuroradiological measurements. All infants with congeni...

Background: Surgical congenital malformations of the central nervous system (CNS) are structural defects with potential for morbidity and mortality more so if intervention is delayed. Aim: To determine the frequency and pattern of surgical CNS anomalies in our region. Methods: We carried out a hospital-based prospective observational study of...

The availability of intraoperative fluoroscopy and improved access to varieties of spinal titanium implants has revived posterior spinal stabilization techniques with their distinct advantages. Our aim is to describe the profile of various spine pathologies requiring subaxial posterior spinal decompression, stabilization (using titanium implants),...

Monitored conscious sedation combined with spinal anaesthesia (MCSS) to repair myelomeningocoele (MM) has received little attention in the literature. It has the potential of rapid postoperative recovery, minimal perioperative morbidity and probable reduced cost of management. The objective of this study was to prospectively analyze the safety and...

In the present era of microscopic and neuroendoscopic procedures, the surgical anatomy of the skull base vessels has gained increased significance. The pattern of the vertebrobasilar arterial complex and the posterior circle of Willis (COW) in Nigerians has not been previously reported despite various variants of these complexes existing in differe...

Hydrocephalus is a common condition in the pediatric population. The cause of hydrocephalus, Evans ratio, ventricular index, and cerebral mantle thickness are some of the factors associated with poor surgical outcome. This study was conducted to evaluate the profile of these factors in the authors' patient population. The authors conducted a prospe...

Post-meningitic subdural effusion does not extend extracranially. To our knowledge, the association of hydrocephalus and extracranial extension of a subdural effusion has not been previously reported. We present a case of an 8-year-old boy who presented with progressive head enlargement and worsening pulsatile peri-orbital swelling of 1 year durati...

The endoscopic endonasal transsphenoidal approach (EEA) to treat sellar, parasellar, and suprasellar tumours continues to gain increased significance. Due to the close proximity of the sphenoid sinus to the carotid artery and the optic canal, it is very important for surgeons to know the anatomical features and variations of the sphenoid sinus as r...

Sixty-three adult patients with intracranial neoplasms were studied prospectively over a 2 year period. The various factors related to pre-presentation symptoms interval (PSI) and pre-diagnostic interval (PI) were noted. The mean age at presentation for all patients was 46.8 years (range 18-72 years, median 46 years). Meningiomas (30%), Pituitary t...

Background: There has been steady and progressive advancement in spine surgery in Nigeria with the increase in spine surgeons, availability of magnetic resonance imaging (MRI), intraoperative fluoroscopy and some spinal titanium implants. We decided to study the frequency of various spine pathologies requiring surgery in our centre and the outcome...

Endoscopic third ventriculostomy (ETV) the main alternative to ventriculoperitoneal shunt (VPS) is just beginning to have a foothold in West Africa. It provides a great opportunity for a hydrocephalic child to be shunt free. The purpose of this paper is to compare outcome following ETV and VPS (using the cheap Chhabra shunt) in children with noncom...

Background: Information regarding the occurrence of hydrocephalus (HC) in twins is important in establishing the significance of environmental factors as well as a genetic basis in congenital HC aetiology. This was the basis for this study. Methods: A single institution retrospective study was conducted between August 1, 2006 and July 31, 2008. Onl...

SUMMARY: The histology of the middle cerebral artery (MCA) in Nigerian Africans has not been previously studied. One hundred MCAs obtained at autopsy from fifty adult Nigerians were studied. The vessels were processed and stained with Ehrlich’s haematoxylin and eosin, elastic Van Gieson and Masson’s trichrome stains. Early branches were given off b...

Sorry, there is no abstract. Read the first few lines of the text instead!

Early repair of myelomeningocoele (MM) is associated with decreased morbidity and mortality. In sub-Saharan Africa, the peculiar harsh economic and social realities make late presentation, malnutrition and sepsis at presentation prevalent. As these factors may affect surgical repair, the aim of this study was to review the outcome of repair of MM i...

Brain tumours hitherto said to be rare in Africans are now known to be common. They cause considerable concern due to their relatively high morbidity, mortality and enormous cost of care, especially in the developing world. An understanding of the aetiology is particularly important in our region for planning strategies for effective prevention of...

Endoscopic third ventriculostomy (ETV) as an alternative to traditional shunt surgery in the management of hydrocephalus of different etiologies is new in Nigeria and West Africa, with no published data till date. This initial study was done to determine the success rate and complication among our patient population. This series consists of a prosp...

Objective: Intracranial tumours hitherto said to be rare in Africans is one of the most devastating forms of human cancers. There are many differences reported according to the geographic distribution, histological type, gender predisposition and anatomic location of these tumours. Our aim was to determine the frequency of histopathological variant...

logical inherent proof that history is rich in lessons. The history of Anatomy is not an exception. It is full of imperative lessons in the Art and Science of the discipline of Anatomy, which following generations ought to learn. We present a defined brief survey with this in mind.

The well-known fact that history writers always seem wiser than the subjects on whom they write is the most logical inherent proof that history is rich in lessons. The history of Anatomy is not an exception. It is full of imperative lessons in the Art and Science of the discipline of Anatomy, which following generations ought to learn. We present a...

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 an...

The jugular foramen (JF) varies in shape and size from side to side in the same cranium, and in different crania, racial groups and sexes. Side dominance is also said to be common. The foramen's irregular shape, its formation by two bones and the numerous nerves and venous channels that pass through it further compound its anatomy. A morphometric s...

Meningioma in twin pregnancy is rare. The tumor has an accelerated growth during the pregnancy and may enlarge or become symptomatic during this period. This relationship makes management of patients with this tumor quite challenging. We describe a case of a rapidly deteriorating 35-year-old woman harboring an extensive tuberculum sellae meningioma...

Traumatic dislocation of the hip is an orthopaedic emergency for which early reduction is indicated. This article describe our experience of the pattern and choice of management of traumatic dislocation of the hip joint in a tropical African population. Majority of the dislocation (87%) were Thompson and Epstein's grades I and II which were easily...

The pattern of hip fractures, treatment, outcome of treatment, and complications of forty-four consecutive patients treated over a five-year period were retrospectively studied. This represents 3.5% of the hospitalised patients in orthopaedic services. The male:female ratio was 1:1.3. Seventy percent of the fractures occurred in those over 65 years...

To determine the size, course, distribution and anomalies of the middle cerebral artery in adult Nigerians. A retrospective study. Department of pathology, University College Hospital, Ibadan between April and September 1999. One hundred middle cerebral arteries from patients' asymptomatic for central nervous system lesions, obtained at autopsy fro...

The current therapeutic modalities for the treatment of patients with cancer are surgery, radiotherapy, chemotherapy, immunotherapy and hormonal therapy. The spontaneous regression of advanced disease in immunogenic tumours and the discovery of several gene classes involved in carcinogenesis has opened new avenues for exploring the control of cellu...

Continuous beliefs in traditional bone setters (TBS) and traditional healers remain rife in the sub-Saharan African1. The morbidity, mortality and financial loss resulting from patient management by this sect of health providers are still a burden in our society. Atlanto-axial joint is the most complex joint of the body. Approximately 55% of the en...