Lagoon Hospitals group, Lagos, Nigeria
Lagos, Lagos state | Nigeria
Main Specialties: Neurological Surgery
Additional Specialties: Neurosurgery
A Consultant neurosurgeon, based in Nigeria, with interest in neuro-oncology, neurotrauma, paediatric neurosurgery functional and vascular surgery. Did undergraduate medical training at the University of Benin in Nigeria and had specialist training in the field of neurosurgery at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife, University College Hospital in Ibadan and Amrita Institute of Medical Sciences and Research in Kerala, India.
Primary Affiliation: Lagoon Hospitals group, Lagos, Nigeria - Lagos, Lagos state , Nigeria
Neurosurgery 2019 Jan;84(1):E110
Neurosurgery Unit Department of Surgery Lagos University Teaching Hospital Lagos, Nigeria.
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Asian J Neurosurg 2018 Oct-Dec;13(4):1128-1133
Division of Spine Surgery, Department of Neurosurgery, Amrita Institute of Medical Sciences and Research, Kochi, Kerala, India.
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Pediatr Neurosurg 2017 10;52(4):225-233. Epub 2017 Jun 10.
Division of Paediatric Neurosurgery, Department of Neurosurgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, India.
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Childs Nerv Syst. 2018 May 12; [DOI: https://doi.org/10.1007/s00381-018-3798-6]
Childs Nerv Syst.
J Neurosurg. 2018 Jan 12:1. [doi: 10.3171/2017.5.JNS171107]
Journal of Neurosurgery: Pediatrics
East Cent Afr J Surg.
Background: Head injury is frequently associated with death and disability and imposes considerable demands on health services. Outcome after head injury is closely related to prompt management, including prevention of secondary brain injury and intensive care unit (ICU) management. This study aimed at determining the aetiological spectrum, injury characteristics, ICU admission patterns, and treatment outcomes of adult head-injured patients at a sub-Saharan tertiary hospital. Methods: A retrospective study on adult head-injured patients admitted to the ICU of a subSaharan tertiary hospital between July 2000 and June 2010. Results: A total of 198 head-injured adult patients were managed in the ICU during the study period. This included 128 males and 70 females with a male-to-female ratio of 1.8:1. The most common mode of injury was road traffic accident. All the patients admitted to ICU had either moderate or severe head injury, with 73.7% having severe head injury. About 26.3% of the patients had associated cervical spine injuries and 50% had various musculoskeletal and soft tissue injuries. Cranial computed tomography findings included brain contusions and intracranial haematomas. Mean duration of ICU stay was 18 days (range 24 hours-42 days), with 89.9% discharged out of ICU care. The overall mortality was 10.1%, although only 36.9% had satisfactory outcomes, as determined by the Glasgow Outcome Scale. Outcome had statistically significant (P < 0.05) relationship with severity of head injury and surgical intervention. Conclusions: Head injury management in the ICU requires an approach to ensure prevention of secondary brain injury; appropriate and early neuroimaging to diagnose lesions that would benefit from timely surgical intervention; as well as management of fluid, electrolyte and haematological derangements. Keywords: head injury, admissions, ICU
J Neurosurg Pediatr. 2017 Nov 3:1-2
Journal of Neurosurgery: Pediatrics
No abstract available
J Neurosurg Spine. 2017 Oct 27:1-2. [doi: 10.3171/2017.5.SPINE17511]
J Neurosurg Spine
Child's Nervous System
Purpose - Spina bifida is a common congenital anomaly of the nervous system. It is frequently associated with significant morbidity and sometimes mortality in affected children. In this paper, we review the clinico-epidemiological pattern, peculiarities, and therapeutic challenges of this condition in our practice setting. Methods -This is a retrospective study of all cases of spina bifida managed from July 2000 to March 2016 at a tertiary health facility located in the southwest region of Nigeria. Relevant information was retrieved from the medical records. The data was collected using a pro forma and analyzed with SPSS version 22. Results - Data from 148 patients was reviewed and analyzed. There were 78 males and 70 females. Only 5.8% of these children were delivered at the health institution. A fifth (20%) of the patients were first born of their mothers. The mean maternal age was 29 years. Few (10.1%) mothers use folate medication prior to conception and only 58% of the mothers use folate during antenatal care. Mean duration of pregnancy was 38 weeks. The most common anatomical site was lumbosacral region (74.3%) while the most common pathology was myelomeningocele 80.4%. Mean age at surgery was 88.68 h. Mean duration of surgery was 92.8 min. Mean follow-up duration was 46.8 weeks. As many as 59% of the patients had some neurologic improvement noticed during follow-up clinic visits. Conclusion - Spina bifida occurs frequently in our environment. Low socio-economic status and poor antenatal clinic visits contributes significantly to its occurrence. Keywords Spinal bifida . Pattern . Peculiarities . Challenges
Neurosurg Focus 2017 October 2; 43 (4):E13, 2017
OBJECTIVE Neurogenic kyphoscoliosis in pediatric patients has varied causes and diverse management options. The most common management strategy is to stage the orthopedic and neurosurgical aspects of the correction at an interval of 3–6 months from each other. The aim of this study was to report the authors’ experience with correction of deformity in children with associated neurological abnormalities requiring intervention as a single-stage surgical treatment. METHODS Of 591 pediatric patients with scoliosis treated at the Amrita Institute of Medical Sciences and Research Centre between January 2001 and January 2011, the authors identifid all patients with neurogenic kyphoscoliosis who underwent deformity correction and a neurosurgical procedure in the same surgical session when they were younger than 15 years. Data regarding the demographic details, preoperative Cobb angle/kyphotic angle, surgical details, postoperative complications, cost of the procedure, and long-term neurological outcome were collected for each case and analyzed. Based on the results of this analysis, the authors propose a 2-category risk stratifiation system for the timing of deformity correction depending on the primary neurogenic etiology. RESULTS Ten cases involving patients with neurogenic kyphoscoliosis requiring both deformity correction and neurosurgical procedure met the criteria and were included in the analysis. All 10 patients were younger than 15 years; their mean age was 10.8 years. The average Cobb angle was 59.5°. Five patients underwent foramen magnum decompression, 5 patients underwent spinal cord detethering, and 1 patient had intraspinal intradural tumor excision. The mean estimated blood loss was 1177 ml (range 700–1550 ml), and the mean operative time was 4.4 hours (range 3–5.5 hours). There were no intraoperative complications. None of the patients had any new postoperative neurological defiits. The mean postoperative Cobb angle of the main thoracic curve was 12.6°. CONCLUSIONS Simultaneous deformity correction along with a defiitive neurosurgical procedure in patients with neurogenic kyphoscoliosis can be performed without added morbidity and avoids both the added costs and the risk of complications associated with a second surgery. The risk stratifiation system proposed in this paper may serve as a guideline for case selection and help to optimize outcome.
J Neurosurg Pediatr.
Journal of Neurosurgery: Pediatrics
No abstract available.
British journal of Neurosurg.
British journal of Neurosurgery
World Neurosurg. 2017 Aug; pii: S1878-8750 (17) 31244-5
J Neuropathol Exp Neurol. 2016 Sep; 75: 1000 – 1004
Journal of Neuropathology & Experimental Neurology
The present state of pediatric neuropathology practice is in rudimentary developmental stages in most parts of sub-Saharan Africa. We sought to determine the pattern of neurosurgical lesions in children diagnosed in southwestern Nigeria and briefly address issues surrounding the practice of this aspect of pathology in Africa. We performed a retrospective review of histopathologic results of biopsies obtained from pediatric patients with neurosurgical lesions at the Department of Pathology, Obafemi Awolowo University Teaching Hospitals Complex, Ile–Ife, Nigeria, between January 2001 and December 2011. Demographic and clinical data were extracted from the Ife-Ijesha cancer registry and histopathological diagnoses were confirmed. A total of 111 biopsies were reviewed with a maximum of 17 in 2001 and minimum of 3 in 2005. Patient ages ranged between 1 day and 16 years with a male:female ratio of 1.02:1. There were 53 spinal lesions, 15 intracranial lesions, 36 scalp masses, 6 skull lesions and 1 muscle biopsy. Most of the specimens were from myelomeningoceles. This documentation of the major types of pediatric neurological conditions encountered in clinical practice in this relatively resourcelimited setting indicate the need for collaboration with better developed centers to improve training in neurosurgery and neuropathology to enhance the quality of clinical care for young patients in Africa
Afr J Paediatr Surg. 2016 Apr-Jun;13:76-81
African Journal of Paediatric Surgery
Background: It has been generally observed that children achieve better convalescence in the home environment especially if discharged same day after surgery. This is probably due to the fact that children generally tend to feel more at ease in the home environment than in the hospital setting. Only few tertiary health institutions provide routine day-case surgery for paediatric neurosurgical patients in our sub-region. Objective: To review the pattern and practice of paediatric neurosurgical day-cases at our hospital. Patients and Methods: A prospective study of all paediatric day-case neurosurgeries carried out between June 2011 and June 2014. Results: A total of 53 patients (34 males and 19 females) with age ranging from 2 days to 14 years were seen. Majority of the patients (77.4%) presented with congenital lesions, and the most common procedure carried out was spina bifia repair (32%) followed by ventriculoperitoneal shunt insertion (26.4%) for hydrocephalus. Sixty-eight percentage belonged to the American Society of Anesthesiologists physical status class 2, whereas the rest (32%) belonged to class 1. General anaesthesia was employed in 83% of cases. Parenteral paracetamol was used for intra-operative analgesia for most of the patients. Two patients had post-operative nausea and vomiting and were successfully managed. There was no case of emergency re-operation, unplanned admission, cancellation or mortality. Conclusion: Paediatric daycase neurosurgery is feasible in our environment. With careful patient selection and adequate pre-operative preparation, good outcome can be achieved.
Childs Nerv Syst. 2016 Jan; 32(1): 159 – 61
Childs Nervous System
Introduction: The need and advantages of rigid fixation of the head in cranial surgeries are well documented (Berryhill et al., Otolaryngol Head Neck Surg 121:269-273, 1999). Head fixation for neurosurgical procedures in infants and in early years has been a challenge and is fraught with risk. Despite the fact that pediatric pins are designed, rigid head fixation involving direct application of pins to the head of infants and slightly older children is still generally not safe (Agrawal and Steinbok, Childs Nerv Syst 22:1473-1474, 2006). Yet, there are some surgeries in which some form of rigid fixation is required (Agrawal and Steinbok, Childs Nerv Syst 22:1473-1474, 2006). We describe a simple technique to achieve rigid fixation of the head in infants for neurosurgical procedures. Technical note This involves applying a head band made of Plaster of Paris (POP) around the head and then applying the fixation pins of the fixation frame directly on to the POP. Conclusion: We have used this technique of head fixation successfully for infants with no complications.
Clin Neurol Neurosurg. 2015 Dec; 139: 248 – 251
Clinical Neurology and Neurosurgery
Cerebrospinal fluid (CSF) leak is a common complication of surgery involving the lumbar spine. Over the past decades, there has been significant advancement in understanding the basis, management and techniques of treatment for post-operative CSF leak following lumbar spine surgery. In this article, we review previous work in the literature on the various factors and technical errors during or after lumbar spine surgery that may lead to this feared complication, the available options of management with focus on the various techniques employed, the outcomes and also to highlight on the current trends. We also discuss the presentation, factors contributing to its development, basic concepts and practical aspects of the management with emphasis on the different techniques of treatment. Different outcomes following various techniques of managing post-operative CSF leak after lumbar spine surgery have been well described in the literature. However, there is currently no most ideal technique among the available options. The choice of which technique to be applied in each case is dependent on each surgeon’s cumulative experience as well as a clear understanding of the contributory underlying factors in each patient, the nature and site of the leak, the available facilities and equipment.
J Spinal Surg. 2015 Jul-Sept; 2(3): 85-96
Journal of Spinal Surgery
Background: Over the past decades, significant progress has been made in our understanding of the basics and techniques of surgical treatment for intradural tumours. However, the management which is most ideal for these lesions has remained a controversial topic. Objective: To review previous work on available operative optionsfor intradural tumours with focus on both advantages and the disadvantages in each case, the outcomes and also highlight on the current trends in this aspect of spine surgery. Materials and Methods: A systematic literature review of previous publications on the various techniques employed in the management of intradural tumours. We discuss their presentation, basic concepts and practical aspects of their management with emphasis on the techniques of operative treatment. Results: Different outcomes following the application of various techniques in the surgical management of intradural spinal tumours have been well documented in the literature. However, there are currently no algorithms to guide the surgeon on the surgical care of intradural spinal tumours. The choice of which surgery to do in each case is a function of each surgeon's philosophy, knowledge and cummulative experience as well as a clear understanding of the anatomy of the lesion in each patient, the available facilities and equipment.
Childs Nerv Syst. 2015; 31(5): 637 – 41
Childs Nervous System
Background Beckwith–Wiedemann syndrome (BWS) is an unusual complex of abnormalities that includes mainly omphalocele, macroglossia, gigantism, visceromegaly, and neonatal hypoglycemia. Type I Chiari malformation, on the other hand, is defined as ectopia of the cerebellar tonsils below the plane of the foramen magnum. Only one case of association of BWS with Chiari I malformation has been previously reported in the literature. D i s c u s s i o n: Several conditions involving congenital hemihypertrophy have been previously reported in association with Type I Chiari malformation. The pathophysiological mechanism for most of these associations is thought to be quite complex and still remains unclear. However, the presence of tonsillar herniation in BWS has been explained by Tubbs and Oakes in the only one existing case report of BWS with Type I Chiari malformation in the literature, to be due to associated hemihypertrophy of the skull base. We additionally suggest that cerebellar hypertrophy may also contribute to the tonsillar herniation and fourth ventricular outlet obstruction. Illustrative case: We now report our recent experience on this association following a review of the literature on association of other hemihypertrophy syndromes with the central nervous system anomalies. Conclusion: We believe that a common pathogenesis of Type I Chiari malformation occurs in conditions of hemihypertrophy including BWS, probably secondary to dysmorphology involving the posterior cranial fossa, and is not just an associated finding
Super-refractory status epilepticus is known to typically arise either from a distinct underlying cause or, in patients with no history of epilepsy, from no overt cause. It has recently presented in an unclear pattern, and thus there are various challenges in its management in resource-poor settings. This case report presents a recent experience and lessons learnt from a case of super–refractory status epilepticus preceeded by atypical features in a 50-year-old Nigerian woman, and briefly reviews the current concepts in management of this form of epilepsy, especially in the context of resource-poor settings. Super-refractory status epilepticus can present with a confusing clinical picture. A good outcome in the management of this difficult problem is highly dependent on accurate diagnosis and prompt treatment. In view of the difficulties resource–poor countries have in accessing the resources and facilities required for optimal care of patients with super–refractory status, any future treatment protocols should allow for the provision of readily available therapy options in such settings.
S Afr J HIV Med 2014;15(4):144-147
South African Journal of HIV Medicine
Background. In the face of increasing HIV/AIDS prevalence in subSaharan Africa, we evaluate the effctiveness of ‘doublegloving’ during surgery as a means of protecting the surgeon operating on patients with a known or unknown HIV status. Methods. A prospective study was conducted to determine the rate of glove puncture and intraoperative injury in categories of patients with known positive, known negative or unknown HIV status. Results. Th surgeon and the fist assistant double-gloved in all the 1 050 procedures performed between 2009 and 2013, and a total of 8 400 surgical gloves were used. Sixty-nine patients (6.6%) were HIV-positive, 29 patients (2.8%) were HIV-negative, and the HIV status was unknown for the remaining 952 patients (90.7%). Th overall glove puncture rate in the study was 14.5%. Th glove puncture rate was 0%, 31% and 15% for HIV-positive, HIV-negative and HIV status unknown, respectively, and this diffrence was statistically signifiant. Th mean operating time in the group with glove punctures was 148 min (95% confience interval (CI) 135 - 161), while mean operating time in the group without glove puncture was 88 min (95% CI 84 - 92). Conclusion. Double-gloving offrs protection against intraoperative injury. Knowing the HIV status of the patient offrs additional protection to the operating surgeon. While we recommend routine double-gloving for surgeons working in HIVprevalent patient populations, we also advocate for the routine screening for HIV in all surgical patients.