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Toyin A. Oyemolade, Amos O. Adeleye, Ayodele J. Olusola, Busayo A. Ehinola, Ebosetale P. Aikhomu, and Anita A. Iroko

OBJECTIVE

The proportion of the global burden of neurosurgical disease represented by pediatric neurosurgical pathology is unknown, especially in lower-middle income countries (LMICs) where there exists no known data-driven literature on the subject. In this study, the authors aimed to quantify the pediatric neurosurgical disease profile in a rural area of a developing country.

METHODS

This was a prospective observational study of all pediatric neurosurgical patients managed at a single center over a 30-month period.

RESULTS

Overall, 226 pediatric patients were included in the study (150 males and 76 females, male/female ratio 2:1), accounting for 20.4% of the total patient population during the study period. The modal age distribution was the 0- to 4-year-old group (32.3%), and head injury was the most common presentation, occurring alone in 157 patients (69.5%). Hydrocephalus alone was seen in 21 patients (9.3%) and in combination with myelomeningocele in 4 patients (1.8%). Brain tumors were found in 6 patients (2.7%), infective lesions in 6 patients (2.7%), and encephaloceles in 2 patients (0.9%). The treatment outcome was good in 170 patients (75.2%). Fourteen patients (6.2%) were referred to more advanced health facilities for specialized care; 29 patients (12.8%) were discharged against medical advice, mostly because of financial constraints; and 8 patients (3.5%) died. Several surgical cases could not be performed because of sundry logistical constraints.

CONCLUSIONS

Pediatric neurosurgical disease accounted for one-fifth of the neurosurgical workload at a tertiary health facility in southwest Nigeria. Trauma was the most common presentation, and optimal in-hospital treatment, including surgery, was hampered by severe logistical constraints in a significant proportion of the cases.