African journal of medicine and medical sciences, 2002
Clinical distinction between cerebral haemorrhage (CH) and cerebral infarction (CI) is important ... more Clinical distinction between cerebral haemorrhage (CH) and cerebral infarction (CI) is important in the management of stroke patients in areas where CT scan facility is lacking or access limited by cost and distance. This distinction is necessary in our environment where an increasing proportion of patients are suspected to have haemorrhagic stroke. This study compares Siriraj stroke score (SSS) and the WHO criteria for the acute stroke syndrome as simple tools for this purpose. The computerised tomography (CT) brain scans of all patients referred with clinical diagnosis of stroke at the University College Hospital (UCH), Ibadan, and RADMED diagnostic centre. Lagos were retrieved and reviewed as well as the case notes of these patients at the referral hospitals. Relevant clinical data were extracted from the case records. The patients were classified into either CI or CH using the WHO criteria for acute stroke syndrome and the SSS. This classification was compared with the CT scan d...
African journal of medicine and medical sciences, 2006
A six weeks old infant presented with scalp ulcer and fever. and on examination was found to have... more A six weeks old infant presented with scalp ulcer and fever. and on examination was found to have resonant percussion notes bilaterally. The initial chest radiograph revealed multiple lucencies which were initially thought to be due to diaphragmatic hernia, but the dilemma was resolved by Computerised tomography which revealed the lucencies to be multiple cysts characteristics of Congenital Cystic Adenomatiod Malformation (CCAM) type II.
The latest versions of spiral CT scanners have provided the radiologist with unparalleled capabil... more The latest versions of spiral CT scanners have provided the radiologist with unparalleled capabilities for vascular imaging. Computed Tomographic Angiography (CTA) has the potential of revolutionizing vascular imaging and with evolving improvements may replace conventional angiography in the near future To report our initial experience with CTA in Nigeria; highlighting its usefulness as a non invasive modality and its clinical applications in diagnosis of vascular abnormalities of various parts of the body. We reviewed 62 patients who had CTA between December 2003 and September 2005.. The studies were performed using a spiral technique with GE CT/e single-slice scanner (General Electric Medical Systems) having a gantry rotation period of one second. Details of techniques of data acquisition, methods of 3-D reconstruction and clinical applications are discussed. Vascular abnormalities were demonstrated in 26 (42%) patients including 5 cranial arteriovenous malformations (AVMs), 3 intracranial aneurysms, 1 spinal AVM, 3 aortic aneurysms, 5 carotid artery stenosis, and 2 traumatic peripheral aneurysms. Correlations between CTA and surgical findings were good.
Intracranial arterial calcification (IAC), a recognized marker of atherosclerosis on cranial comp... more Intracranial arterial calcification (IAC), a recognized marker of atherosclerosis on cranial computed tomography (CT), is an independent risk factor for ischaemic stroke. This study aimed to determine the prevalence, distribution, severity, and associations of IAC in adults with acute ischaemic stroke (AIS) at the University College Hospital, Ibadan, Nigeria. Cranial CT images of 130 consecutive adults who presented with AIS were acquired on a 64-slice multi-detector Toshiba Aquilion scanner and evaluated for IAC in bone window on Vitrea® software using a semi-quantitative scoring method for extent, thickness, and length of calcifications in the large intracranial arteries. Associations of IAC with clinical and laboratory data were determined by statistical analysis at p < 0.05. There were 71 males (54.6%), and the mean age of all patients was 63.0 ± 13.2 years. Hypertension was the most common risk factor (83.1%). IAC was found in 121 patients (93.1%), predominantly in the carot...
Computed tomography (CT) pelvimetry has largely replaced conventional radiography in the antenata... more Computed tomography (CT) pelvimetry has largely replaced conventional radiography in the antenatal assessment of pelvic dimensions, but its usefulness in the Nigerian setting is yet to be assessed. This study was undertaken to ascertain if there is a relationship between antenatal CT pelvimetric measurements and the mode of delivery at the end of the pregnancy. A group of thirty-one patients who had antenatal pelvimetry were categorised into two groups depending on whether they achieved vaginal delivery or not and the pelvimetric and other obstetrrc characteristics of the two groups were compared. The only parameters that showed statistically significant differences between the groups were the higher maternal height and the lower head circumference in the neonates of women achieving vaginal delivery. The findings suggest that fetal parameters may be more predictive of mode of delivery than absolute pelvic measurements.
We examined the relationship between ventricular size and visual function in 50 children (36 male... more We examined the relationship between ventricular size and visual function in 50 children (36 males and 14 females) with hydrocephalus. The third and lateral ventricular sizes and the visual function scores did not significantly differ between the sexes. Ventricular enlargement was most pronounced at the trigones and least at the level of the foraminae of Monro. The visual function score correlated inversely with the size of the lateral ventricle measured at the levels of the anterior horn and the trigone and expressed as coronal diameter and "Modified" Evans' ratio (r = 0.49; P = 0.001 and r = -0.38, P = 0.01 for the anterior horn; r = 0.48, P = 0.001 and r = -0.35, P = 0.001 for the trigone). The size of the third ventricle did not correlate with visual function score. A "modified" anterior Evans ratio of 0.60 and a trigonal Evans ratio of 0.73 were associated with very low visual function score. Furthermore, there was significant inverse correlation between...
African journal of medicine and medical sciences, 2009
Frontotemporal lobal degeneration (FTLD) is a clinically heterogeneous group of sporadic and fami... more Frontotemporal lobal degeneration (FTLD) is a clinically heterogeneous group of sporadic and familial neurodegenerative diseases characterized by dementia, alteration in language and/or behaviour, loss of executive skills and sometimes Parkinsonian features resulting from degeneration predominantly affecting the anterior frontal and temporal regions of the brain. Three main clinical subtypes including frontotemporal dementia (FTD), semantic dementia (SD) and progressive non-fluent aphasia (PNFA) have been described depending on the clinical phenomenology, the areas of the brain where the disorder begins and where the most extensive degeneration occurs. We describe a case of frontotemporal dementia in a 58 year old Nigerian woman and also review the current literature. Recent genetic studies have expanded the frontiers of knowledge about FTD while the search for appropriate drug treatments continues.
To document our experience with superior vena cava obstruction in a black African population. A r... more To document our experience with superior vena cava obstruction in a black African population. A retrospective study of clinical data collected from cancer registry, patients case noted, cardiothoracic surgical unit's and operating records between June 1975 and May 1999. University College Hospital, Ibadan, Nigeria which hosts a major cancer centre in the West African sub-region and also serves community clinics. All patients with superior vena cava (SVC) obstruction referred for evaluation and treatment. Patients who had clinical features related to SVC obstruction and full investigation including tissue diagnosis were collated. Methods of treatment of acute episodes, definitive treatment and outcome of SVC obstruction were studied. One hundred and twenty nine consecutive patients with SVC obstruction were treated. There were 100 males and 29 females. Mean age was 36 +/- 15 years. The annual incidence increased from 2.3 patients per year during the first 12 years to 8.4 patients...
African journal of medicine and medical sciences, 2005
We present the findings in 14 paediatrics patients with SCA who had CT examination at the Univers... more We present the findings in 14 paediatrics patients with SCA who had CT examination at the University College Hospital Ibadan on account of stroke between 1993 and 2000. There were 8 female and 6 male with a mean age of 11.25 years and SD of 3.66. Cerebral infarction was the most common finding occurring in 57% of the patients while intracerebral bleed was seen in 21%. Two patients had a mixed lesion and atrophy was seen in one patient. Five patients (36%) had their lesion on the right hemisphere while eight (57%) had their lesions on the left side. The frontal and parietal lobes were mainly affected. Prompt CT screening of the brain in a child with sickle cell anaemia who presents with symptoms and signs suggestive of stroke can help identify the particular type of lesion and this may influence mode of therapy given as well as prognosis
Giant pedunculated oesophageal polyps are rare intraluminal tumours which are usually benign. the... more Giant pedunculated oesophageal polyps are rare intraluminal tumours which are usually benign. they include fibrovascular polyp, liposarcoma, harmatomas and lipomas. They may be asymptomatic for a long time and thus attain an enormous size. We present one of such cases of giant oesophageal polyp in a 28 year-old man with a history of difficulty in breathing and vocalisation, easy fatigability and cough. Dysphagia was late in the complaint and he also had lost 7 kg in the last six months before his presentation. A chest radiograph, barium swallow and oesophagoscopy gave the clinical diagnosis. The thoracic CT examination gave a better delineation of the site of the pedicle, the nature and extent of the tumour mass. The tumour was surgically removed and the final pathological diagnosis was afibro-lipoma of the oesophagus. The patient has since been discharged to follow-up in the Surgical out-patient.
African journal of medicine and medical sciences, 2002
We report the case of a 3(1/2) year old boy who presented with sudden onset of headache. Fever an... more We report the case of a 3(1/2) year old boy who presented with sudden onset of headache. Fever and swelling of the left eye. He had complete opthalmoplegia of the left eye and 6th cranial nerve paralysis in the right eye. He was thought to have cavenous sinus thrombosis but CT findings suggestive of lymphoma led to the correct diagnosis of HIV associated Lymphoma It view of the rising incidence of HIV infection and the protein clinical manifestations, it is advised that all patients with disseminated tumour masses should be screened for the HIV virus, and CT examination should be made available to patients.
African journal of medicine and medical sciences, 2002
Computed tomography (CT) and Ultrasonography (USS) are commonly used to ascertain the cause of ab... more Computed tomography (CT) and Ultrasonography (USS) are commonly used to ascertain the cause of abdominal symptoms. In a retrospective study of 70 Nigerian patients who had abdominal ultrasonography prior to abdominal CT scans, the most frequent clinical feature was abdominal pain, which was reported in 20.8% of the patients. The prevalent ultrasonographic finding was hepatomegaly (12.2%) while bowel displacement was the most frequently reported CT finding (18.3%). There was no correlation between USS and CT findings in 11 patients (15.7%). There was some agreement in the findings of both tests in 75.7% of cases. Additional findings were noted in 38 (54.3%) of the latter group of patients on CT scans. Hundred percent agreement was reported in both imaging techniques in 5 radiological findings namely: dilated gall bladder, renal cysts, ascites, adrenal mass and utero-cervical mass. These findings suggest a high yield of diagnostic accuracy from abdominal sonography and increased diagn...
This is a case of a neonate with a large cervical mass and respiratory distress at birth. Radiolo... more This is a case of a neonate with a large cervical mass and respiratory distress at birth. Radiological investigations revealed a predominantly solid mass with calcifications and multiple cysts, suggesting a teratoma. Patient died while being prepared for surgery and autopsy confirmed an immature teratoma. The clinical and pathological characteristics of paediatric cervical teratomas are discussed.
Misdiagnosis of stroke has significant implication for definitive therapy. This study assessed th... more Misdiagnosis of stroke has significant implication for definitive therapy. This study assessed the frequency of misdiagnosis of stroke using computerised tomography (CT) scan of the brain. One hundred and fifty-six patients admitted over a five year period (1991-1996) with clinical features suggestive of stroke had their CT brain scan reviewed. Only 89 (57%) had neuroradiological features consistent with stroke, of which 59 (66%) had cerebral infarction while 30 (34%) had cerebral haemorrhage. In 67 (43%) of the cases, there were no features of cerebro-vascular accident (CVA) on the CT scan. In this group, cerebral atrophy was the commonest radiological abnormality (21/67), followed by brain tumor (10/67) and subdural haematoma (9/67). The CT scan was normal in 25 patients. The misdiagnosis of surgically treatable conditions in as many as 21 (13.5%) of the 156 patients calls for better neurological evaluation of patients admitted for stroke in tertiary and non-tertiary hospitals. Wh...
African journal of medicine and medical sciences, 2002
Clinical distinction between cerebral haemorrhage (CH) and cerebral infarction (CI) is important ... more Clinical distinction between cerebral haemorrhage (CH) and cerebral infarction (CI) is important in the management of stroke patients in areas where CT scan facility is lacking or access limited by cost and distance. This distinction is necessary in our environment where an increasing proportion of patients are suspected to have haemorrhagic stroke. This study compares Siriraj stroke score (SSS) and the WHO criteria for the acute stroke syndrome as simple tools for this purpose. The computerised tomography (CT) brain scans of all patients referred with clinical diagnosis of stroke at the University College Hospital (UCH), Ibadan, and RADMED diagnostic centre. Lagos were retrieved and reviewed as well as the case notes of these patients at the referral hospitals. Relevant clinical data were extracted from the case records. The patients were classified into either CI or CH using the WHO criteria for acute stroke syndrome and the SSS. This classification was compared with the CT scan d...
African journal of medicine and medical sciences, 2006
A six weeks old infant presented with scalp ulcer and fever. and on examination was found to have... more A six weeks old infant presented with scalp ulcer and fever. and on examination was found to have resonant percussion notes bilaterally. The initial chest radiograph revealed multiple lucencies which were initially thought to be due to diaphragmatic hernia, but the dilemma was resolved by Computerised tomography which revealed the lucencies to be multiple cysts characteristics of Congenital Cystic Adenomatiod Malformation (CCAM) type II.
The latest versions of spiral CT scanners have provided the radiologist with unparalleled capabil... more The latest versions of spiral CT scanners have provided the radiologist with unparalleled capabilities for vascular imaging. Computed Tomographic Angiography (CTA) has the potential of revolutionizing vascular imaging and with evolving improvements may replace conventional angiography in the near future To report our initial experience with CTA in Nigeria; highlighting its usefulness as a non invasive modality and its clinical applications in diagnosis of vascular abnormalities of various parts of the body. We reviewed 62 patients who had CTA between December 2003 and September 2005.. The studies were performed using a spiral technique with GE CT/e single-slice scanner (General Electric Medical Systems) having a gantry rotation period of one second. Details of techniques of data acquisition, methods of 3-D reconstruction and clinical applications are discussed. Vascular abnormalities were demonstrated in 26 (42%) patients including 5 cranial arteriovenous malformations (AVMs), 3 intracranial aneurysms, 1 spinal AVM, 3 aortic aneurysms, 5 carotid artery stenosis, and 2 traumatic peripheral aneurysms. Correlations between CTA and surgical findings were good.
Intracranial arterial calcification (IAC), a recognized marker of atherosclerosis on cranial comp... more Intracranial arterial calcification (IAC), a recognized marker of atherosclerosis on cranial computed tomography (CT), is an independent risk factor for ischaemic stroke. This study aimed to determine the prevalence, distribution, severity, and associations of IAC in adults with acute ischaemic stroke (AIS) at the University College Hospital, Ibadan, Nigeria. Cranial CT images of 130 consecutive adults who presented with AIS were acquired on a 64-slice multi-detector Toshiba Aquilion scanner and evaluated for IAC in bone window on Vitrea® software using a semi-quantitative scoring method for extent, thickness, and length of calcifications in the large intracranial arteries. Associations of IAC with clinical and laboratory data were determined by statistical analysis at p < 0.05. There were 71 males (54.6%), and the mean age of all patients was 63.0 ± 13.2 years. Hypertension was the most common risk factor (83.1%). IAC was found in 121 patients (93.1%), predominantly in the carot...
Computed tomography (CT) pelvimetry has largely replaced conventional radiography in the antenata... more Computed tomography (CT) pelvimetry has largely replaced conventional radiography in the antenatal assessment of pelvic dimensions, but its usefulness in the Nigerian setting is yet to be assessed. This study was undertaken to ascertain if there is a relationship between antenatal CT pelvimetric measurements and the mode of delivery at the end of the pregnancy. A group of thirty-one patients who had antenatal pelvimetry were categorised into two groups depending on whether they achieved vaginal delivery or not and the pelvimetric and other obstetrrc characteristics of the two groups were compared. The only parameters that showed statistically significant differences between the groups were the higher maternal height and the lower head circumference in the neonates of women achieving vaginal delivery. The findings suggest that fetal parameters may be more predictive of mode of delivery than absolute pelvic measurements.
We examined the relationship between ventricular size and visual function in 50 children (36 male... more We examined the relationship between ventricular size and visual function in 50 children (36 males and 14 females) with hydrocephalus. The third and lateral ventricular sizes and the visual function scores did not significantly differ between the sexes. Ventricular enlargement was most pronounced at the trigones and least at the level of the foraminae of Monro. The visual function score correlated inversely with the size of the lateral ventricle measured at the levels of the anterior horn and the trigone and expressed as coronal diameter and "Modified" Evans' ratio (r = 0.49; P = 0.001 and r = -0.38, P = 0.01 for the anterior horn; r = 0.48, P = 0.001 and r = -0.35, P = 0.001 for the trigone). The size of the third ventricle did not correlate with visual function score. A "modified" anterior Evans ratio of 0.60 and a trigonal Evans ratio of 0.73 were associated with very low visual function score. Furthermore, there was significant inverse correlation between...
African journal of medicine and medical sciences, 2009
Frontotemporal lobal degeneration (FTLD) is a clinically heterogeneous group of sporadic and fami... more Frontotemporal lobal degeneration (FTLD) is a clinically heterogeneous group of sporadic and familial neurodegenerative diseases characterized by dementia, alteration in language and/or behaviour, loss of executive skills and sometimes Parkinsonian features resulting from degeneration predominantly affecting the anterior frontal and temporal regions of the brain. Three main clinical subtypes including frontotemporal dementia (FTD), semantic dementia (SD) and progressive non-fluent aphasia (PNFA) have been described depending on the clinical phenomenology, the areas of the brain where the disorder begins and where the most extensive degeneration occurs. We describe a case of frontotemporal dementia in a 58 year old Nigerian woman and also review the current literature. Recent genetic studies have expanded the frontiers of knowledge about FTD while the search for appropriate drug treatments continues.
To document our experience with superior vena cava obstruction in a black African population. A r... more To document our experience with superior vena cava obstruction in a black African population. A retrospective study of clinical data collected from cancer registry, patients case noted, cardiothoracic surgical unit's and operating records between June 1975 and May 1999. University College Hospital, Ibadan, Nigeria which hosts a major cancer centre in the West African sub-region and also serves community clinics. All patients with superior vena cava (SVC) obstruction referred for evaluation and treatment. Patients who had clinical features related to SVC obstruction and full investigation including tissue diagnosis were collated. Methods of treatment of acute episodes, definitive treatment and outcome of SVC obstruction were studied. One hundred and twenty nine consecutive patients with SVC obstruction were treated. There were 100 males and 29 females. Mean age was 36 +/- 15 years. The annual incidence increased from 2.3 patients per year during the first 12 years to 8.4 patients...
African journal of medicine and medical sciences, 2005
We present the findings in 14 paediatrics patients with SCA who had CT examination at the Univers... more We present the findings in 14 paediatrics patients with SCA who had CT examination at the University College Hospital Ibadan on account of stroke between 1993 and 2000. There were 8 female and 6 male with a mean age of 11.25 years and SD of 3.66. Cerebral infarction was the most common finding occurring in 57% of the patients while intracerebral bleed was seen in 21%. Two patients had a mixed lesion and atrophy was seen in one patient. Five patients (36%) had their lesion on the right hemisphere while eight (57%) had their lesions on the left side. The frontal and parietal lobes were mainly affected. Prompt CT screening of the brain in a child with sickle cell anaemia who presents with symptoms and signs suggestive of stroke can help identify the particular type of lesion and this may influence mode of therapy given as well as prognosis
Giant pedunculated oesophageal polyps are rare intraluminal tumours which are usually benign. the... more Giant pedunculated oesophageal polyps are rare intraluminal tumours which are usually benign. they include fibrovascular polyp, liposarcoma, harmatomas and lipomas. They may be asymptomatic for a long time and thus attain an enormous size. We present one of such cases of giant oesophageal polyp in a 28 year-old man with a history of difficulty in breathing and vocalisation, easy fatigability and cough. Dysphagia was late in the complaint and he also had lost 7 kg in the last six months before his presentation. A chest radiograph, barium swallow and oesophagoscopy gave the clinical diagnosis. The thoracic CT examination gave a better delineation of the site of the pedicle, the nature and extent of the tumour mass. The tumour was surgically removed and the final pathological diagnosis was afibro-lipoma of the oesophagus. The patient has since been discharged to follow-up in the Surgical out-patient.
African journal of medicine and medical sciences, 2002
We report the case of a 3(1/2) year old boy who presented with sudden onset of headache. Fever an... more We report the case of a 3(1/2) year old boy who presented with sudden onset of headache. Fever and swelling of the left eye. He had complete opthalmoplegia of the left eye and 6th cranial nerve paralysis in the right eye. He was thought to have cavenous sinus thrombosis but CT findings suggestive of lymphoma led to the correct diagnosis of HIV associated Lymphoma It view of the rising incidence of HIV infection and the protein clinical manifestations, it is advised that all patients with disseminated tumour masses should be screened for the HIV virus, and CT examination should be made available to patients.
African journal of medicine and medical sciences, 2002
Computed tomography (CT) and Ultrasonography (USS) are commonly used to ascertain the cause of ab... more Computed tomography (CT) and Ultrasonography (USS) are commonly used to ascertain the cause of abdominal symptoms. In a retrospective study of 70 Nigerian patients who had abdominal ultrasonography prior to abdominal CT scans, the most frequent clinical feature was abdominal pain, which was reported in 20.8% of the patients. The prevalent ultrasonographic finding was hepatomegaly (12.2%) while bowel displacement was the most frequently reported CT finding (18.3%). There was no correlation between USS and CT findings in 11 patients (15.7%). There was some agreement in the findings of both tests in 75.7% of cases. Additional findings were noted in 38 (54.3%) of the latter group of patients on CT scans. Hundred percent agreement was reported in both imaging techniques in 5 radiological findings namely: dilated gall bladder, renal cysts, ascites, adrenal mass and utero-cervical mass. These findings suggest a high yield of diagnostic accuracy from abdominal sonography and increased diagn...
This is a case of a neonate with a large cervical mass and respiratory distress at birth. Radiolo... more This is a case of a neonate with a large cervical mass and respiratory distress at birth. Radiological investigations revealed a predominantly solid mass with calcifications and multiple cysts, suggesting a teratoma. Patient died while being prepared for surgery and autopsy confirmed an immature teratoma. The clinical and pathological characteristics of paediatric cervical teratomas are discussed.
Misdiagnosis of stroke has significant implication for definitive therapy. This study assessed th... more Misdiagnosis of stroke has significant implication for definitive therapy. This study assessed the frequency of misdiagnosis of stroke using computerised tomography (CT) scan of the brain. One hundred and fifty-six patients admitted over a five year period (1991-1996) with clinical features suggestive of stroke had their CT brain scan reviewed. Only 89 (57%) had neuroradiological features consistent with stroke, of which 59 (66%) had cerebral infarction while 30 (34%) had cerebral haemorrhage. In 67 (43%) of the cases, there were no features of cerebro-vascular accident (CVA) on the CT scan. In this group, cerebral atrophy was the commonest radiological abnormality (21/67), followed by brain tumor (10/67) and subdural haematoma (9/67). The CT scan was normal in 25 patients. The misdiagnosis of surgically treatable conditions in as many as 21 (13.5%) of the 156 patients calls for better neurological evaluation of patients admitted for stroke in tertiary and non-tertiary hospitals. Wh...
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Papers by A. Ogunseyinde