BOOTStrap-SCI: Beyond One Option of Treatment for Spinal Trauma and Spinal Cord Injury: Consensus-Based Stratified Protocols for Intensive Care and Surgical Management.

Objective: Spinal trauma (STx), with or without spinal cord injury (SCI), represents a significant global health burden, particularly in low- and middle-income countries (LMICs). International guidelines often assume the availability of resources for intensive care and surgical management, limiting their applicability in resource-constrained settings. A resource-adapted approach may improve management in these contexts.

Outcome of Nonoperative Management of Selected Cases of Acute Traumatic Intracranial Hematomas in a Rural Neurosurgical Service of a Developing Country.

Objective: In resource-limited settings, the standard of care prescribed in developed countries for either operative or nonoperative management of traumatic intracranial hematomas (TICHs) frequently has to be adapted to the economic and infrastructural realities. This study aims to present the outcome of selected cases of TICHs managed nonoperatively without routine intensive care unit admission, repeated cranial computed tomography (CT) scan or intracranial pressure monitoring at a rural neurosurgical service in a developing country.

Methods: This was a retrospective analysis of a cohort of our patients with cranial CT-confirmed TICHs selected for nonoperative treatment from our prospective head injury (HI) register over a 42-month period.

Awake Craniotomy in Africa: A Scoping Review of Literature and Proposed Solutions to Tackle Challenges.

Background: Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to reduce associated complications and costs. A significant resource limitation in low- and middle-income countries constrains the usage of AC.

Objective: To review the published literature on AC in African countries, identify challenges, and propose pragmatic solutions by practicing neurosurgeons in Africa.

Traumatic Spinal Cord Injury in Children: Clinical Profile and Management Outcome in a Developing Country's Rural Neurosurgery Practice.

Background:  There is paucity of data-driven study on pediatric traumatic spinal cord injury (SCI) in the developing countries. This study aims to define the clinical profile of pediatric traumatic SCI in a rural tertiary hospital in a sub-Saharan African country.

Methods:  This was a prospective observational study of all children with spinal cord injury managed at our center over a 42-month period.

Casemix, management, and mortality of patients rreseceiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study.

Background: Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise differences in casemix, management, and mortality of patients receiving emergency neurosurgery for TBI across different levels of human development.

Mannitol Dosing Error during Pre-neurosurgical Care of Head Injury: A Neurosurgical In-Hospital Survey from Ibadan, Nigeria.

 Inappropriate use of mannitol is a medical error seen frequently in pre-neurosurgical head injury (HI) care that may result in serious adverse effects. This study explored this medical error amongst HI patients in a Nigerian neurosurgery unit.  We performed a cross-sectional analysis of a prospective cohort of HI patients who were administered mannitol by their initial non-neurosurgical health care givers before referral to our center over a 22-month period.

Determinants of discharge against medical advice from a rural neurosurgical service in a developing country: A prospective observational study.

Background: In low-resource regions of the world, discharge against medical advice (DAMA) is one empiric contributory factor to poor in-hospital outcome that is not often mentioned. This study aims to investigate the determinants of DAMA from a rural neurosurgical service in a developing country.

Methods: This was a prospective observational study of all patients who discharged against medical advice in our service between November 2018 and October 2019.

Management and outcomes following emergency surgery for traumatic brain injury - A multi-centre, international, prospective cohort study (the Global Neurotrauma Outcomes Study).

Introduction: Traumatic brain injury (TBI) accounts for a significant amount of death and disability worldwide and the majority of this burden affects individuals in low-and-middle income countries. Despite this, considerable geographical differences have been reported in the care of TBI patients. On this background, we aim to provide a comprehensive international picture of the epidemiological characteristics, management and outcomes of patients undergoing emergency surgery for traumatic brain injury (TBI) worldwide.

Cranioplasty Following Decompressive Craniectomy.

Cranioplasty (CP) after decompressive craniectomy (DC) for trauma is a neurosurgical procedure that aims to restore esthesis, improve cerebrospinal fluid (CSF) dynamics, and provide cerebral protection. In turn, this can facilitate neurological rehabilitation and potentially enhance neurological recovery. However, CP can be associated with significant morbidity.

Outcome of Cerebral Metastasectomy in Select Cases of Brain Metastases from Breast Cancer in Ibadan, Nigeria.

Background: Brain metastasis (BM) from breast cancer is increasingly encountered clinically because of the continuing success in the oncological control of the primary disease. Data-driven reports on the surgical treatment of BM from breast cancer are sparse in sub-Saharan Africa.

Methods: This is a prospective cohort study of the outcome of surgical excision of BM from breast cancer in an academic surgical practice in Ibadan, Nigeria.

Clinical outcome of closed reduction of cervical spine injuries in a cohort of Nigerians.

Study Design: A prospective observational study.

Objectives: To evaluate the effectiveness of closed reduction of cervical spine injuries (CSIs) using cervical traction and identify probable complications.

Setting: Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria.

Determinants of Timing of Presentation of Neurotrauma Patients to a Neurosurgical Center in a Developing Country.

Background: A major goal in neurotrauma management is the prevention of secondary neuronal injuries. This goal is time bound as neurological deficits once established are usually irreversible. Late presentation is the norm in most neurotrauma patients in developing countries.

Titanium Clamps for a Simple Low-Profile Autologous Osteosynthesis in the Reconstruction of Posttraumatic Craniofacial Convexital Skeletal Disruption.

Attempts at reconstruction of posttraumatic craniofacial defects (PTCDs) can be a challenge in low-resource practice areas of the world where the needed biomaterials are logistically beyond reach. A simple low-profile technique of autologous osteosynthesis for PTCD using the titanium clamps is presented in this report. In addition, a 6-year prospective database on a consecutive cohort of patients who underwent this procedure was analyzed for clinical, functional, and aesthetic outcomes, both in-hospital and at midterm follow-up.

Central nervous system tumours in children in Ibadan, Nigeria: a histopathologic study.

Introduction: Contrary to some earlier teachings that central nervous system (CNS) tumours are uncommon in black children, these neoplasms are the fourth most common paediatric tumours in Ibadan. Our centre is the major referral centre for CNS tumours in Nigeria. The last major study of paediatric CNS neoplasms from Ibadan was in 1985.

Single-Stage Surgical Reconstruction of Posttraumatic Compound Complex Fronto-Basal Cranial Vault Fracture in a Resource-Limited Practice.

Background: The extant literature on the surgical treatment of posttraumatic compound, complex frontal basal calvarial skull fracture suggests that this be a staged procedure. There are many socioeconomic constraints in low-resource regions of the world to the feasibility of this standard practice.

Methods: A single-stage operative procedure for the surgical treatment of these fractures in a neurosurgery practice in Nigeria is here annotated.

A tale of two acute extradural hematomas.

Background: In much of the Western hemisphere, mortality from traumatic acute extradural hematomas (AEDH) has been drastically brought down toward 0%. This is still not the case however in most developing countries.

Case Description: This report represents a tragi-comic tale of two cases of traumatic AEDH managed by an academic neurosurgeon in a neurosurgically ill-resourced private health facility during a nationwide industrial strike action preventing clinical-surgical care in the principal author's University Teaching Hospital.

A Prospective Study on the Causes of Delayed Diagnosis of Childhood Cancer in Ibadan, Nigeria.

Outcome in cancer may be improved by early diagnosis and prompt treatment. The objectives of this study were to determine the prediagnostic intervals (lag time) in childhood cancer and the factors that influence them at the University College Hospital (UCH), Ibadan. The study was prospective and observational and involved children diagnosed with cancer from July 2012 to June 2014 at UCH, Ibadan, Nigeria.

Determinants of folic acid intake during preconception and in early pregnancy by mothers in Ibadan, Nigeria.

Introduction: In order to identify targets for primary preventive strategies, we explored possible predictors of periconceptional folic acid (pFA) intake in a Nigerian population of reproductively active women.

Methods: A cross sectional study of mothers attending immunization clinics at two hospitals was conducted between May and November 2012. Information obtained included sociodemographic and obstetric details and periconceptional usage of FA.

Updates on the epidemiology and pattern of traumatic maxillofacial injuries in a nigerian university teaching hospital: a 12-month prospective cohort in-hospital outcome study.

Many studies have been undertaken in Nigeria on maxillofacial trauma. However, only a few have considered both the skeletal and soft tissue injuries (in general) involving all the aspects of the maxillofacial region or considered other etiological sources of trauma apart from road traffic crashes. Fewer still have reviewed the outcome of management of facial injuries in our low-resource environment.

Prevention of myelomeningocele: African perspectives.

Background: The prevention of neural tube defects (NTDs) is now an issue of major public health concern. Myelomeningocele, the most common NTD, often results in severe disabilities and may be life threatening. In Africa, there is little awareness of the NTDs, and most African countries lag behind in the global efforts at preventing them.

Breaking bad news to a prospective cross-sectional sample of patients' relatives in a nigerian neurosurgical service.

Objectives: Breaking of medical bad news is anecdotally deemed culturally unacceptable, even intolerable, to native Africans. We explored this hypothesis among a cohort of relatives of patients who had difficult neurosurgical diagnoses in an indigenous practice.

Materials And Methods: A semi-structured, interviewer-administered questionnaire was used in a cross-sectional survey among a consecutive cohort of surrogates/relatives of concerned patients.

Post-operative day two versus day seven mobilization after burr-hole drainage of subacute and chronic subdural haematoma in Nigerians.

Introduction: The traditional care of patients with subacute/chronic subdural haematoma (S/CSDH) often involves delayed mobilization after burr-hole drainage. It is thought that delayed mobilization aids brain re-expansion thereby reducing the risk of recurrence. However, there is paucity of information regarding its efficacy and safety over early mobilization.

A giant, complex fronto-ethmoidal ivory osteoma: Surgical technique in a resource-limited practice.

Background: Unlike small and medium size fronto-ethmoidal osteomas which are amenable to surgical excision through limited craniofacial openings, giant lesions require extensive and complex craniofacial dissection, and post lesionectomy reconstruction using an array of modern-day surgical adjuncts. This is a report of our surgical technique for the successful and esthetically fair operative resection of a giant fronto-ethmoidal osteoma in a difficult practice setting.

Case Description: A 32-year-old Nigerian lady harbored a giant complex fronto-ethmoidal ivory osteoma.