-
Management of Hydrocephalus in Brain Tumors to Fann Teaching Hospital in Dakar
Alioune Badara Thiam,
Maguette Mbaye,
Rel Gerald Boukaka Kala,
Mbaye Thioub,
Cheick Ndiaye SY,
Mohamet Faye,
Sarah Mutomb Ntshindj,
Ndaraw Ndoye,
Momar Codé BA,
Seydou Boubakar Badiane
Issue:
Volume 4, Issue 1, June 2020
Pages:
1-6
Received:
9 October 2019
Accepted:
28 November 2019
Published:
21 January 2020
Abstract: Introduction: Tumoral hydrocephalus (TH) is an increasingly common pathology in our service. It is a diagnostic and especially therapeutic emergency. Its treatment is mainly surgical and the prognosis closely depends on the type of tumor. The objective of our study was to determine the efficiency of the various bypass procedures used for the treatment of hydrocephalus in patients with brain tumors. Patients and Methods: We conducted a retrospective study of 146 patients with tumoral hydrocephalus, collected from 1 January 2014 to 31 December 2018 (5 years) in the Neurosurgery Department of Fann Teaching Hospital. Results: The frequency of tumoral hydrocephalus cases in our series was rated at 25% of all hydrocephalus operated during this period with 29.2 cases per year. The sex ratio was 1.39 with a mean age of 35 years (range from 1 month to 77 years). Children under 15 accounted for 53.42%. Cerebral computed tomography (CT) was performed in 93.75% of patients and magnetic resonance imaging (MRI) in 20.83%. Tumors of the posterior fossa (PFT) accounted for 60.3% followed by ventricular tumors 15.5% and sellar 7.5%. Surgically, endoscopic third ventriculostomy (ETV), ventriculoperitoneal shunt (VPS), and external ventricular derivation (EVD) were performed respectively in 58.24%, 30.13% and 10.27% of cases. The surgical average time was 3 days with extremes of 24h and 150 days. Two patients benefited from a ventriculo –atrial shunt (VAS) complementary to the persistence of hydrocephalus. The main complications were ascites of great abundance in 4 patients and infections in 10 patients (6.84%). In our series, 30.82% (45 patients) received additional etiological treatment. The average time between the two interventions was 14 days. We noted 17 cases of death including 7 cases attributed to hydrocephalus. Conclusion: The endoscopic third ventriculostomy is currently the gold standard as an alternative to other methods in the management of tumoral hydrocephalus, but remains a palliative treatment. Etiological treatment is the core therapeutic approach for this hydrocephalus.
Abstract: Introduction: Tumoral hydrocephalus (TH) is an increasingly common pathology in our service. It is a diagnostic and especially therapeutic emergency. Its treatment is mainly surgical and the prognosis closely depends on the type of tumor. The objective of our study was to determine the efficiency of the various bypass procedures used for the treatm...
Show More
-
Schneider Syndrome Managed Surgically or by Conservative Treatment
Denlewende Sylvain Zabsonre,
Wendlassida Joelle Stéphanie Zabsonre Tiendrebeogo,
Fulgence Kabore,
Abdoulaye Sanou,
Narcisse Damiba,
Yacouba Haro,
Ibrahim Dao,
Alexandre Korsaga,
Sayouba Tinto,
Abel Kabre
Issue:
Volume 4, Issue 1, June 2020
Pages:
7-10
Received:
2 January 2020
Accepted:
27 January 2020
Published:
18 February 2020
Abstract: Introduction. Schneider's syndrome is acute traumatic cervical central cord syndrome usually in stenotic cervical canal without other traumatic lesions. Early surgical management is controversial. The aim of this work was to study the treatment and evolution of cases of Schneider’s syndrome in our department. Methods. It was a retrospective study run over 5 years Neurosurgery Department of Yalgado Ouedraogo Teaching Hospital. Results. Twenty-six (26) cases were included, all of them male. Average age was 53.69 years. Most frequent reasons of consultation were motor deficits of the 4 limbs (17 cases). On examination, the deficit predominated in thoracic limbs in 14 patients. There were 4 ASIA A, 5 ASIA B, 7 ASIA C and 10 ASIA D. Cervical traumas were mild or moderate in 22 cases. Cervical CT scan showed a narrowed cervical canal in all 24 cases where it was performed. MRI was done in 4 patients. It noted signs of spinal cord injury in all these cases. Ten patients were operated and 16 received conservative treatment. On leaving the hospital, 5 operated patients and 7 of those treated medically had partially recovered (p = 0.536). Conclusion. Schneider's syndrome most often occurred as a result of benign cervical trauma. There is no significant difference in the evolution of operated cases and those who had received conservative treatment. The therapeutic decision must be personalized and concerted.
Abstract: Introduction. Schneider's syndrome is acute traumatic cervical central cord syndrome usually in stenotic cervical canal without other traumatic lesions. Early surgical management is controversial. The aim of this work was to study the treatment and evolution of cases of Schneider’s syndrome in our department. Methods. It was a retrospective study r...
Show More
-
An Unusual Intraoperative Lumbar Disc Herniation Migrating into the Posterior Epidural Space
Alihonou Thierry,
Quenum Kisito,
Ouiminga Karim,
Takin Romulus,
Fatigba Olatundji Holden
Issue:
Volume 4, Issue 1, June 2020
Pages:
11-13
Received:
28 January 2020
Accepted:
20 February 2020
Published:
3 March 2020
Abstract: Background: The migration of a herniated fragment of the intervertebral disc towards posterior epidural space remains an exceptional phenomenon and Its clinical presentation is not unequivocal. Its diagnosis in modern imaging can cause confusion with other lesions of the posterior epidural space. We report an unusual migration of a herniated disc fragment into the posterior epidural. Method: we describe a case of an unusual migration of disc fragment into the posterior epidural space admitted in Neurosurgery department of University Teaching Hospital of Cotonou in 2019. Result: A 33-year-old man was admitted for progressive bilateral radiculopathy, gait disturbances and constipation. The clinical examination noted a moderate perineum and right buttock hypoesthesia, a flaccid paraparesis, bilatéral straight leg raising limitation (45°). The right patellar and achilean reflexes were depressed. MRI of the lumbar spine showed a right L4L5 herniated disc and its migration into the anterolateral epidural space. Surgery was performed with posterior approach. After an L4 and L5 laminectony, we discovered a very compressive large fragment of L4L5 intervertebral disc. The fragment was delicately dissociated from its dural adhesions. Histological examination confirmed the fibrocartilaginous nature of the sample. The post-operative period was uneventful. Three months post-operatively, he had regained his autonomy with a strength score of 5/5 in both pelvic limbs. Conclusion: Migration of intervertebral disc fragment into the posterior epidural space is a rare phenomenon. Diagnosis errors are possible. In case of posterior migration with cauda equina syndrom, we recommend laminectomy with removal of herniated disk fragment. This approach remains a simple and secure.
Abstract: Background: The migration of a herniated fragment of the intervertebral disc towards posterior epidural space remains an exceptional phenomenon and Its clinical presentation is not unequivocal. Its diagnosis in modern imaging can cause confusion with other lesions of the posterior epidural space. We report an unusual migration of a herniated disc f...
Show More
-
Overview of Six Months Activities in a New Unit of Management of Head Trauma in West Africa
Ouiminga Habib Abdoul Karim,
Alihonou Thierry,
Zoungrana Noelie,
Ndzana Diane,
Ouedraogo Anatole Jean Innocent,
Compaore Linda Christelle,
Tamboura Habibata
Issue:
Volume 4, Issue 1, June 2020
Pages:
14-17
Received:
8 May 2020
Accepted:
27 May 2020
Published:
9 June 2020
Abstract: Background: The aim of this study was to describe and compare with the literature data, the epidemiological and evolutionary aspects of the management of traumatic brain injury after six months of activities in a new hospital. Methods: This was a retrospective study that was performed at the neurosurgery unit of the Tengandogo Teaching Hospital. The analysis covered all admitted head trauma patients from May 1, 2014 to October 31, 2014. The variables studied were: frequency, age, sex, circumstances, mechanism, Glasgow score (GCS), care and evolution. Results: Over six months, 302 traumatized head injuries were recorded. The average age was 34.8 years old. The sex ratio was 3.79 (239 M / 63 W). Road traffic accidents accounted for 85.43% (n=258) of etiologies, 80% of which were due to two-wheeled machines, followed by falls from a high place with 7.61% (n=23). In 5% (n=15) of cases, it was assault. Severe forms (GCS 3-8) accounted for 33.7% (n=102) of which 65.7% were associated with polytrauma. Moderate forms (GCS: 9-12) accounted for 21% (n=63) of the cases, 45.3% (n=137) were benign forms (GCS: 13-15). Patients were medically treated in 73.5% (n=119) of the cases, and 21% (n=63) were operated upon. Twenty-one patients (6.6%) refused medical care. The mortality rate in severe forms was 38%. Conclusion: Despite advances in resuscitation, overall mortality remains heavy. Sequelae are frequent, leading to difficulties in socio-professional and family reintegration in our low-income country. Prevention of these traumas plays a vital role.
Abstract: Background: The aim of this study was to describe and compare with the literature data, the epidemiological and evolutionary aspects of the management of traumatic brain injury after six months of activities in a new hospital. Methods: This was a retrospective study that was performed at the neurosurgery unit of the Tengandogo Teaching Hospital. Th...
Show More
