Biomedical subjects
Publications and source records attributed to A Adeloye.
Sixty-six cases of mass lesions compressing the spinal cord are presented. The masses were neoplastic in 86.36% of the cases. Epidural masses (80.30%) remain by far the largest group, consisting chiefly of Burkitt's lymphoma and various metastatic carcinomas. Only 6.06% of the lesions were intramedullary and the glioma/paraglioma remains virtually absent.
Although chorion carcinoma of the uterus is the seventh commonest in the comparative frequency of malignant tumours seen at the Cancer Registry of the University College Hospital, Ibadan, Nigeria (being exceeded in order of commoness by the reticuloendothelial tumours, carcinoma of the cervix, liver, breast, stomach and ovary), it is the most frequent source of tumour deposit of the brain in this hospital. Between 1960 and 1969, 197 Nigerians with chorion cancer of the uterus were admitted to UCH; in twenty-five of them the nervous system was involved during the course of their disease. The neurological involvement presented as acute cerebrovascular accident in fourteen, encephalitis in five; as primary intracranial space-occupying lesion in three cases and in one patient, as cord compression. There were no obvious neurological features in two cases in which necropsy revealed brain metastases. Involvement of the nervous system carries a poor prognosis in chorion cancer of the uterus.
At the UCH in Ibadan, Nigeria, we have seen forty-three patients with verified neoplasms of the brain comprising most histologic types of the glioma/paraglioma series. The astrogliomas formed the largest group, followed by the pinealomas in 16.27% and the medulloblastomas and ependymomas, each occurring in 13.95% of the patients. By the end of the third decade of life 83.7% of these neoplasms have become clinically manifest; the largest number being found in the first decade. Just over half (51.16%) of all the neoplasms and also two-thirds of the patients in whom the masses were found in the posterior fossa were children under 15 years. In nearly all cases the duration of symptomatology on admission to hospital was under 6 months. Headaches, papilloedema and altered states of consciousness were frequent; and the prognosis in general has been poor. The classical glioblastoma multiforme and the acoustic neurinoma are quite uncommon in the Nigerian African; but a fairly full spectrum of the 'gliomas' has been clearly identified in the group of primary brain tumours at Ibadan.
Fifty-two cases of secondary tumours of the brain and its enveloping structures which were encountered at the University College Hospital (UCH), Ibadan, Nigeria bewteen January 1965 and December 1970 are reported. All lesions were hisologically verified, forty-six at autopsy and the remaining six from biopsy specimens of the skull deposits. There were forty females and twelve males; 77% of the subjects were in the third, fourth and fifth decades of life, 15% in the sixth and seventh, and the rest in first two decades. Thirty-four of the metastases were found in the substance of the brain and the remaining eighteen in its enveloping structures (the scalp, skull and dura-mater). Of the thirty-four brain secondaries, twenty-four (70%) originated from chorion carcinoma of the uterus, six from the lungs and two each from the breast and kidney. Metastases to the skull came from many sources--cervix, uterus, prostate, adrenals, liver, bladder colon and the thyroid gland. Of the later group, follicular thyroid carcinoma was the commonest single source of secondaries.
A series of 525 patients with head injuries was analyzed. Males and young people, especially children under 10, predominated. More injuries were sustained on Sunday than any other day, and were mostly caused by road traffic accidents and domestic accidents. Limb injuries were the most common associated wounds. The more severely disturbed the level of consciousness on admission, the worse was the prognosis.
Two unusual cases are reported in which nails were driven into the heads of victims of criminal assults in Nigeria. The special risk to the superior sagittal sinus is discussed.
Normal skull thickness has been measured in a general hospital population of 300 blacks and 200 whites in America. In both groups, there is a rapid increase in skull thickness during the first two decades of life, followed by a small uniform increase reaching a peak in the fifth and sixth decades. The sex differences are variable, but in certain age groups the females in both races have significatly thicker parietal and occipital bones than their male counterpart. The frontal bone is thicker in the white male than in the black, and the parietooccipital thicker in the blacks than in the whites. Some suggestions are offered to explain the sex and racial difference noted.
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We have carried out clinical, radiological and some hematological evaluation of post-traumatic subgaleal hematoma in 55 Nigerians who were treated for head injuries at the he University College Hospital, Ibadan, Nigeria, in 1970. Most hematomas spontaneously resolved within four weeks of the injury, so that masterly inactivity should be the first line of treatment for this entity.
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This paper presents a four-year-old Nigerian male child who developed volvulus of the small intestine three years after the successful establishment of ventriculo-peritoneal shunt for his hydrocephalus. There is only one other report in the literature of this complication. In view of the increasing use of ventriculo-peritoneal CSF diversion for hydrocephalus, it is necessary to be aware of the rare and unusual cause of an acute abdomen.
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