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Diagnosis and management of brain tumours at Jos University Teaching Hospital, Nigeria.

OBJECTIVE: To report on the incidence of brain tumours in Jos Plateau of Nigeria and to highlight areas of interest regarding diagnosis, management and outcome. DESIGN: A retrospective study. SETTING: Jos University Teaching Hospital (JUTH), Jos, Nigeria. SUBJECTS: Thirty patients with brain tumours. INTERVENTIONS: Specific management of primary lesions was carried out in cases of metastatic brain tumours. Steroids were administered in one case of cerebellar oligodendroma. Craniotomy and excision was achieved in two cases of meningioma and two of sarcoma. Palliative excision was employed in another two cases of meningioma. Two cases each of pituitary adenomas were managed by craniotomy and excision and trans-nasal transsphenoidal excision. RESULTS: Brain tumours ranked third in frequency relative to other tumours. The relative frequency of different histological types in percentages were: metastatic (30%), anterior pituitary (21%), meningeal (18%), neuroepithelial (15%) and nerve-sheath (6%). The mean age of presentation was 33 years. The three commonest clinical features in percentages included headaches (43%), cranial masses (39%) and visual defects (26%). Eighty three per cent of the total number of patients died within three weeks to one year irrespective of management modality employed. Two patients who had transnasal excision of pituitary tumours abroad are, however, well and alive at one and two years post-operation respectively. CONCLUSION: In this study, roentgenograms of the skull had a diagnostic value of 76% for tumours of meningeal origin and pituitary adenomas. CT scan is the mainstay for diagnosis of brain tumours. The outcome was poor with a mortality of 83%.

Adult↗

Concentric lamination of glial processes in oligodendrogliomas.

Tissues were obtained by open biopsy of a series of human intracranial neoplasms, fixed in Veronal-buffered osmium tetroxide, and embedded in Vestopal-W. In two instances in which specimens were obtained from oligodendrogliomas in regions where the tumor had infiltrated but not entirely destroyed cortical tissues, glial processes were found to be arranged in a highly organized laminar fashion. This feature was not observed in two additional oligodendrogliomas nor in other types of intracerebral neoplasms. Three types of laminar structures were recognized: (a) perikaryal sheaths composed of several layers of overlapping or concentrically orientated glial processes, (b) layers of longitudinally orientated glial processes along the outer aspect of myelinated axons, and (c) small laminated figures composed of several concentrically disposed glial processes. Spirally constituted lamellar systems were not demonstrated. These findings indicate that under certain circumstances glial cells have the capacity to form sheaths and sheath-like structures by concentric lamination of several processes, rather than by spiraling of a single process.

Brain Neoplasms↗