Research
Incidence of physiological pineal gland and choroid plexus calcifications in cranio-cerebral computed tomograms in Douala, Cameroon
Background - Intracranial calcifications are veritable radiological pointer to pathologies. Therefore there is need to differentiate physiological and pathological calcifications. Objective - Todetemine the incidence of physiological intracranial calcifications and relationship to age and sex. Materials And Methods - A cross sectional descriptive study of the computed tomograms (CT) of the brain was done from 8/4/09 to 18/10/2009 using a Schumadzu CT scan machine with continuous rotationalsystem. Data was analysed using SSPS3. Results - 132 patients were studied with 75 males and 57 females. Age range is 0-89. The highest studied population is in the 40-49 years with 38(28.78%) patients These 116 had a total of 136 seperate calcifications due to co-existent calcifications. No calcifications wasseen in patients less than 9years of age. The number of patients with choroid plexus calcifications (75) exceeds the number of patients with pineal gland calcifications (61). This corresponds to incidence of 56.8% for choroid plexus calcifications and 46.2% for pineal gland calcifications. In terms of total numberof calcifications, it is shared into 55.15% for choroid and 44.85% for pineal calcifications. the incidence of pineal gland calcification is 46.21% while choroid plexus calcification is 56.82%. Both calcifications aremore common in males than females. In choroid plexus calcifications, the incidence of calcifications in males is greater than females by 14.67% whereas in pineal gland calcifications, male incidence is greaterthan female incidence by 18.04%. Conclusion - Choroid plexus calcification is more than pineal gland calcifications and no calcification was seen before 9 years.
EVALUATION OF PATTERN OF MAGNETIC RESONANCE IMAGES OF LUMBO-SACRAL SPINE IN CAMEROON- A PIONEER STUDY.
Low back pain is a common debilitating disease with negative effect on productivity. Magnetic resonance imaging (MRI) with its excellent soft tissue contrast and absence of bone artefact is the current modality used in evaluating the possible aetiologies of low back pain. MRI availability in Central Africa is recent, with only two existing machines including the newly installed one in Polyclinic Bonanjo, Douala. Aim : To evaluate lumbo-sacral spine MR images with elucidation of possible causes of low back pain. Methodology : A pioneer prospective study of patients who were referred to Department of Radiology, Polyclinic Bonanjo, Douala, Cameroon for MRI of the lumbo-sacral spine from June –November, 2009 was done. Equipment used was 0.3Tesla Hitachi AIRIS 11. Sagital, coronal and axial images were acquired. When indicated T1W-Gd-DTPA and STIR were adjunctive sequences used. Patients with either claustrophobia or having MRI incompartible medical implants were excluded. Results : 48 Patients with age range 20-79 years with mean age of 49.5 were studied. Males were 29(60.4%) and females were 19 (39.6%). The commonest aetiology of low back pain was disc hernia 16(33.3%) with 62,5% occurring at L4/L5 disc level while 25% was at L5/S1. Gender difference decreases with age. Conclusion : Thus disc herniation is the commonest cause of low back in Cameroon, often accompanied by spondylosis.
UNCOMMON TYPES OF DISC HERNIA ( A REPORT OF THREE CASES AND REVIEW OF LITERATURE)
Background : Spinal disc hernia is prolapse of nucleus pulposus through a defect in annulus fibrosus. Over 90% of cases occur in the lumbar spine with only 1% being thoracic. Sequestered disc hernia is the last spectrum of progression of disc hernia with formation of mobile free fragment. Aim : To add to literature documentation of uncommon types of disc hernia Case Reports : CASE 1 : A 63year old Cameroonian man with L4/L5 sequestered disc hernia, seen posterior to L5 vertebral body. He had discectomy and symptomatic reliefs were better than pre-operative status conforming to McCulloch’s clinical outcome grade 3. CASE 2 : A 34year old male Cameroonian with chronic back pain and paraesthesia following trauma. Thoracic spine Magnetic resonance imaging (MRI) revealed T11/T12 disc hernia with severe epidural compression. He declined discectomy for an Overseas treatment. CASE 3 : A 72year old male Nigerian who had L3/L4 iatrogenic spinal fusion 5years ago. Lumbo-sacral spine MRI following recurrent low back pain showed L2/L3 and L4/L5 disc hernias. The L2/L3 hernia above the bony ankylosis interestingly is severer than L4/L5 hernia. He was managed conservatively. Conclusion : MRI increasing availability in Central Africa will detect more cases of uncommon types of disc hernias.
