Cranial Surgeries in a New Neurosurgery Centre in an Urban Specialist Hospital in Southeast Nigeria: A 40-Month Review

Background: The Imo State Specialist Hospital (IMSSH) commenced neurosurgical services in April 2021 with outpatient consultations, and a cranial surgery performed in the same month was her first neurosurgical procedure. This is an audit of cranial pathologies surgically managed in the hospital in her first 3 years since the commencement of neurosurgical procedures.

Aims: The study aimed to look at the pattern of cranial pathologies surgically managed in the hospital from the commencement of neurosurgery services, including their age and gender distribution, the cranial pathologies and their distribution.

Methods: The surgical records of all neurosurgery patients who had cranial surgical operations at IMSSH, Owerri, from April 2021 to July 2024 (40 months) were retrospectively reviewed.

Results: One hundred and ninety-two (192) patients had cranial surgical operations during the study period (an average of 5 surgeries per month). The mean age of patients was 39 years with a male-to-female ratio of 1.5:1. The mean age for male patients was 43 years while that of female patients was 32 years. The peak age range at presentation was in the paediatric age group, 0 – 19 years (n=69, 36%), followed by the elderly age group, 60 – 79 years (n=55, 28.6%). The highest frequency of cranial surgeries was performed for hydrocephalus (n=85, 44.3%). This was followed by cranial haematomas (n=52, 27.1%), cranial tumours (n=33, 17.2%) and cranial infections (n=13, 6.8%). Among cases of hydrocephalus, hydrocephalus in children (n=46) accounted for the highest number of cranial surgeries, while among cranial haematomas and cranial tumours, chronic subdural haematoma (n=27, 59.1%) and meningiomas (n=13, 39.3%) accounted for the highest frequencies respectively.

Conclusion: The study showed a male preponderance for cranial pathologies surgically managed in the hospital, with hydrocephalus in children and chronic subdural haematoma in the elderly having the highest presentation in our environment. A focus on preventive measures against hydrocephalus and chronic subdural haematoma may help in reducing the burden of these diseases in our environment.