|Journal of Clinical and Applied Neurosciences Volume 1; Issue 1 Jan-Jun 2015|
Brain astrocytomas in South-East Nigeria: a 3-centre experience
Enoch O UCHE1, Jude-Kennedy C EMEJULU3, Emeka OKORIE1,4, Ephraim E ONYIA1, Izuchukwu ILOABACHIE1, Nkechinyere J UCHE5, Francis NNAKENYI6, Obinna AJUZIEOGU2, Martin NZEGWU6, Martin NNOLI7, Angela MUOBIKE8
2Department of Anaesthesia
5Dept of Ophthalmology
6Department of Pathology
University of Nigeria
Ituku-Ozalla, Enugu, NIGERIA
Nnamdi Azikiwe University
Teaching Hospital, Nnewi
Anambra State, NIGERIA
7Department of Anatomic
and Forensic Pathology
Federal Medical Centre Umuahia, Abia State, NIGERIA
8Division of Surgery
Annunciation Specialist Hospital, Emene, Enugu
Dr Enoch O UCHE
Department of Surgery
University of Nigeria
Ituku-Ozalla, Enugu State NIGERIA
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Background: Although astrocytomas are the most common primary brain tumours worldwide, they are still poorly reported in our environment.
Methodology: We retrospectively studied adult patients with astrocytic tumours treated over a 5-year period in 3 tertiary hospitals within South-East Nigeria. Patients’ clinical data as well as radiology and histology reports were analyzed. Follow-up interval was 3months to 4.5 years. Data analysis was performed using SPSS version 16 with evaluation of confidence limits at the 95% level of significance.
Results: A total of 231 patients with computed tomography / magnetic resonance imaging diagnoses of brain tumours were seen, 61 patients had features of brain astrocytoma and were studied, while 46 had histological confirmation. Age range was 16-77 years with a mean of 43.4±1.7 years (95% CI). The mean age for those with low grade tumours was 35.3±0.9years (95%CI) and 49.6±0.4years for high grade tumours (95%CI), and the male:female ratio was 1.5:1. Major complaints were headache and seizures in 70.5% (43 patients) and 58.3% (35 patients), respectively, while duration of symptoms was 2 to 17months, with a mean of 9.6±1.7 (95%CI) months. The tumours in 41 cases were supratentorial, 17 cases were infratentorial, while 3 cases were transtentorial. Of the cases that had operative treatment, 33patients had microsurgical resections, 11 had biopsy only, while 31 had cerebrospinal fluid diversion. Histologically, 13 patients had low grade tumours (WHO grades I and II), while 36 patients had high grade (WHO grades III and IV). Survival rates after 1year and 3years follow-up were 77% and 61% for low grade tumours and 27% and 8.3% for high grade tumours.
Conclusion: There is a need to establish a national brain tumour registry to properly evaluate the profile of brain tumours including astrocytomas.
Keywords: Brain tumours, computed tomography, histology, magnetic resonance imaging, survival
Received: 10th February, 2015 Accepted: 25th March, 2015