BackgroundDepressed skull fractures (DSFs) are features of traumatic brain injury (TBI), frequently associated with intracranial damage and long-term functional impairments. The neurological outcomes of the perioperative management are yet to be evaluated. This study aimed to assess the effect of surgical timing and perioperative clinical radiological factors on functional outcomes in DSFs.MethodsThis prospective cohort study enrolled 205 patients with DSFs at a tertiary neurosurgical center in Uganda. Patients underwent surgical management, with the primary exposure variable being surgical timing (<= 48 h vs. >48 h). Functional outcomes at six months were assessed using the…

IntroductionMyasthenia gravis is a neuromuscular autoimmune condition characterized by the presence of antibodies against acetylcholine receptors. It may present as a generalized disorder or remain limited to specific muscle groups. Myasthenia gravis can occur independently or alongside other autoimmune conditions, including Hashimoto s thyroiditis and Graves disease. Although the co-occurrence of these disorders is recognized, it is an extremely rare clinical phenomenon.Case presentationA 20-year-old woman of Muganda ethnicity, with a 2-year history of Graves disease confirmed by thyroid scintigraphy, developed a myasthenic syndrome leading to acute respiratory failure. Her condition…

BACKGROUND AND OBJECTIVES: This study investigates the prevalence and determinants of defensive medicine among neurosurgeons in Sub-Saharan Africa (SSA). It examines how economic, cultural, and legal factors unique to SSA influence these practices, providing insights to guide regional policy-making and medical education. METHODS: A cross-sectional survey of 71 neurosurgeons in SSA was conducted via WhatsApp, LinkedIn, and conferences. The questionnaire, adapted to the SSA context from a Canadian study, explored demographics, practice types, liability profiles, defensive behaviors, and perceptions of the medicolegal environment. Data were analyzed using descriptive statistics in R…

Background and Objectives: Depressed skull fracture (DSF) is a traumatic injury characterized by a segment of the skull vault being displaced below its anatomical position, frequently accompanied by intracranial injuries such as vascular damage, brain injury, and long-term complications. The optimal timing for surgical intervention in DSFs, particularly in low- and middle-income countries (LMICs), remains undefined. Objectives: This study aimed to evaluate the impact of surgical timing on short-, medium-, and long-term outcomes, including functional recovery, systemic inflammation, surgical site infections (SSIs), and post-traumatic epilepsy (PTE). Methods: This thesis presents findings…

Objective:This study aimed to identify perioperative clinical and radiological factors that predict the risk of developing late posttraumatic seizures (PTS) within 24 months of injury among surgically managed traumatic brain injury (TBI) patients with depressed skull fracture (DSF). Methods:A prospective cohort study was conducted at Mulago Hospital, Uganda, involving mild-to-moderate TBI patients with DSF, followed up perioperatively and at outpatient clinics, and additionally via phone interviews for up to 24 months. The study monitored the incidence and recurrence of late PTS. Results:The cohort included 171 patients with DSF, with a median age of 24 years (interquartile range = 15-31…

Background Surgical site infections (SSI) are a significant concern following traumatic brain injury (TBI) surgery and often stem from the skin s microbiota near the surgical site, allowing bacteria to penetrate deeper layers and potentially causing severe infections in the cranial cavity. This study investigated the relationship between scalp skin microbiota composition and the risk of SSI after TBI surgery in sub-Saharan Africa (SSA).Methods This was a prospective cohort study, enrolling patients scheduled for TBI surgery. Sterile skin swabs were taken from the surrounding normal skin of the head and stored for analysis at -80 degrees Celcius. Patients were monitored postoperatively…

Surgical site infections (SSIs) remain a major cause of life-threatening morbidity following surgery for depressed skull fractures (DSFs) among patients with traumatic brain injury (TBI). The timing of the surgery for DSF has been questioned as a risk of SSI without a clear cutoff. We aimed to compare the risk of SSI within 3 months between surgery done before versus after 48 h of injury and with its preoperative predictors. We conducted a prospective cohort study at Mulago Hospital, Uganda. Patients with mild-to-moderate TBI with DSF were followed up perioperatively from the operating time up to 3 months. The outcome variables were the incidence risk of SSI, types of SSI, microbial…

Background: The safe timing window for surgery during the acute phase of inflammation due to traumatic brain injury (TBI) has not been studied extensively. We aimed to elucidate the relationship between the timing of surgery and changes in perioperative serum levels of inflammatory cytokines and factors associated to optimize TBI management in low-middle-income countries. Methods: A prospective cohort study was conducted among TBI Patients with depressed skull fractures with a GCS>8 operated at different timing from injury and followed up peri-operatively. We collected the clinical-radiological data, as well as pre-and postoperative venous samples from participants; we then did…

Introduction Brain abscesses are rare but potentially fatal condition and can be associated with cyanotic congenital heart disease of which 5-18.7% of these patients that develop cerebral abscess commonly have tetralogy of Fallot (TOF).Case presentation We report a case of 3-year-old Muganda male that presented with convulsions, cyanosis and difficulty in breathing. The patient had a combination intervention of medical treatment and surgical drainage of the abscess. Post-operative Computerized tomography scan images and pre-operative brain Computerized tomography scans were compared. The multiple rings enhancing lesions were reduced in number and sizes. The largest measured ring was 44 x…

Introduction: Post-traumatic seizures (PTS) are common among patients with depressed skull fractures (DSF). Understanding the burden of post traumatic seizures and the factors associated among adult patients with DSF is important to improve clinical care. Objective: To determine the prevalence and factors associated with post-traumatic seizures among adult patients with DSF at Mulago National Referral hospital (MNRH). Methods: A cross-sectional study was conducted among 333 study participants between March 2021 and February 2022. Socio-demographic, clinical laboratory factors and anti-seizure medications were collected using a study questionnaire. Data was analysed to determine the…