Abstract：
Vascular neurosurgery has developed significantly in Nigeria, but its burden and challenges remain unclear. This study systematically reviewed vascular neurosurgical literature from Nigeria.
Four research databases and gray literature sources were searched from 1962-2021. ROBINS-I tool was used to assess risk of bias. Descriptive, narrative, and statistical analyses were conducted on all variables. Where appropriate, paired t-tests and Chi-squared independence tests were used (α = 0.05).
56 articles were included and 3203 patients pooled for analysis. Risk of bias was moderate-high. Most articles were published over the last 20 years with retrospective cohort studies and case reports being the most common study designs. The cohort had a relatively even gender split and an average age of 49 years (±22). Cerebrovascular accidents accounted for over 85% of diagnoses, with most etiologies being traumatic. Headache and motor deficit were the most prevalent clinical features. X-ray and carotid angiography were the most commonly reported imaging modalities, closely followed by computed tomography (CT) and CT angiography. The top two radiological diagnoses were ischemic cerebrovascular disease and intracerebral hematoma. Aneurysmal clipping and hematoma evacuation were the most commonly reported treatment modalities. Outcome at last follow-up was favorable in 48%. The mortality rate was 6%. Post-treatment complications included chest infection and rebleeding.
This study illustrates the epidemiological burden of neurovascular pathology (based on the available data in published literature) in Nigeria, and raises awareness amongst service providers and researchers of the attendant challenges and epochal trends seen within vascular neurosurgery in Nigeria.
Four research databases and gray literature sources were searched from 1962-2021. ROBINS-I tool was used to assess risk of bias. Descriptive, narrative, and statistical analyses were conducted on all variables. Where appropriate, paired t-tests and Chi-squared independence tests were used (α = 0.05).
56 articles were included and 3203 patients pooled for analysis. Risk of bias was moderate-high. Most articles were published over the last 20 years with retrospective cohort studies and case reports being the most common study designs. The cohort had a relatively even gender split and an average age of 49 years (±22). Cerebrovascular accidents accounted for over 85% of diagnoses, with most etiologies being traumatic. Headache and motor deficit were the most prevalent clinical features. X-ray and carotid angiography were the most commonly reported imaging modalities, closely followed by computed tomography (CT) and CT angiography. The top two radiological diagnoses were ischemic cerebrovascular disease and intracerebral hematoma. Aneurysmal clipping and hematoma evacuation were the most commonly reported treatment modalities. Outcome at last follow-up was favorable in 48%. The mortality rate was 6%. Post-treatment complications included chest infection and rebleeding.
This study illustrates the epidemiological burden of neurovascular pathology (based on the available data in published literature) in Nigeria, and raises awareness amongst service providers and researchers of the attendant challenges and epochal trends seen within vascular neurosurgery in Nigeria.
摘要：
目的：血管神经外科在尼日利亚取得了显著发展，但是它的负担和挑战仍然不清楚。本研究系统回顾了尼日利亚的血管神经外科文献。
方法：从1962-2021年检索了四个研究数据库和灰色文献来源。ROBINS-I工具用于评估偏倚风险。描述性的,叙事,并对所有变量进行统计分析.在适当的情况下，使用配对t检验和卡方独立性检验(α=0.05)。
结果：共纳入56篇文章，合并3203例患者进行分析。偏倚的风险是中等高。大多数文章是在过去20年中发表的，回顾性队列研究和病例报告是最常见的研究设计。该队列的性别差异相对均匀，平均年龄为49岁（±22）。脑血管事故占诊断的85%以上，大多数病因都是创伤性的。头痛和运动缺陷是最普遍的临床特征。X线和颈动脉造影是最常见的成像方式，紧随其后的是计算机断层扫描（CT）和CT血管造影。放射学诊断前两位分别为缺血性脑血管病和脑内血肿。动脉瘤夹闭和血肿清除是最常见的治疗方式。最后一次随访的结果为48％。死亡率为6%。治疗后并发症包括胸部感染和再出血。
结论：这项研究说明了尼日利亚神经血管病理学的流行病学负担（基于已发表文献中的可用数据），并提高服务提供商和研究人员对尼日利亚血管神经外科手术中随之而来的挑战和时代趋势的认识。
方法：从1962-2021年检索了四个研究数据库和灰色文献来源。ROBINS-I工具用于评估偏倚风险。描述性的,叙事,并对所有变量进行统计分析.在适当的情况下，使用配对t检验和卡方独立性检验(α=0.05)。
结果：共纳入56篇文章，合并3203例患者进行分析。偏倚的风险是中等高。大多数文章是在过去20年中发表的，回顾性队列研究和病例报告是最常见的研究设计。该队列的性别差异相对均匀，平均年龄为49岁（±22）。脑血管事故占诊断的85%以上，大多数病因都是创伤性的。头痛和运动缺陷是最普遍的临床特征。X线和颈动脉造影是最常见的成像方式，紧随其后的是计算机断层扫描（CT）和CT血管造影。放射学诊断前两位分别为缺血性脑血管病和脑内血肿。动脉瘤夹闭和血肿清除是最常见的治疗方式。最后一次随访的结果为48％。死亡率为6%。治疗后并发症包括胸部感染和再出血。
结论：这项研究说明了尼日利亚神经血管病理学的流行病学负担（基于已发表文献中的可用数据），并提高服务提供商和研究人员对尼日利亚血管神经外科手术中随之而来的挑战和时代趋势的认识。
