Research Article
Mechanism of Burst-Suppression During General Anesthesia: Review of Narrative Literature
Halladain Mpung Mansoj*,
Anna Modji Basse,
Adjaratou Dieynabou Sow
Issue:
Volume 8, Issue 1, April 2024
Pages:
1-7
Received:
3 October 2023
Accepted:
1 November 2023
Published:
8 January 2024
Abstract: Burst suppression is an electroencephalography pattern that is characterized by periods of high-voltage electrical activity alternating with periods of no activity in the brain. The pattern is found in patients with inactivated brain states, such as from general anaesthesia, coma, or hypothermia. The pseudo-rhythmic pattern of burst suppression is dictated by extracellular calcium depletion and the ability of neurons to restore the concentration. Bursts are accompanied by depletion of extracellular cortical calcium ions to levels that inhibit synaptic transmission, which leads to suppression periods. During suppression, neuronal pumps restore the calcium ion concentrations to normal levels, thus causing the cortex to be subject to the process again. As the brain becomes more inactive, burst periods become shorter and suppression periods become longer. The shortening of bursts and lengthening of suppression is caused by the central nervous system's inability to properly regulate calcium levels due to increased blood brain permeability.
Abstract: Burst suppression is an electroencephalography pattern that is characterized by periods of high-voltage electrical activity alternating with periods of no activity in the brain. The pattern is found in patients with inactivated brain states, such as from general anaesthesia, coma, or hypothermia. The pseudo-rhythmic pattern of burst suppression is ...
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Case Report
Cerebral Venous Thrombosis Post COVID 19 in Neurological Unit of Fann Teaching Hospital, Dakar – Senegal
Adjaratou Dieynabou Sow,
Anna Modji Basse,
Halladain Mpung Mansoj,
Abdou Aziz Fall,
Ndiaga Matar Gaye,
Marième Soda Diop,
Maouly Fall,
Ngor Side Diagne,
Lala Bouna Seck,
Kamadore Touré,
Moustapha Ndiaye,
Amadou Gallo Diop
Issue:
Volume 8, Issue 1, April 2024
Pages:
8-11
Received:
12 November 2023
Accepted:
5 December 2023
Published:
11 January 2024
Abstract: Introduction: The new coronavirus constitutes a public health problem due to its many often fatal complications such as thromboembolic diseases. Upper this infectious state, neurological diseases are reported mainly ischemic stroke and rarely cerebral venous thrombosis. Observation: We report the case of a 76-year-old diabetic, hypertensive patient who was well monitored and who presented neurological manifestations 24 hours after home returning from hospitalization for COVID 19 infection fifteen days before. Major signs were dehydration grade I according to the WHO, confusional syndrom, left pyramidal syndrom of cortical type predominantly on facial and arm and regular tachycardia. The brain imagery revealed a double thrombus in sinus and diagnosis of cerebral thrombosis (CVT) was made. Biological abnormalities were noted, such as neutrophilic hyperleukocytosis and thrombocytopenia. The evolution was favorable with symptomatic treatment and after putting on oral curative dosis anticoagulant. Conclusion: Cases of cerebral venous thrombosis are increasingly reported in the literature, but Cases of CVT in the field COVID 19 remain rare, especially in Africa. Elderly age and vascular risk factors could favorite occurrence of cerebral venous thrombosis in cases of Sars-Cov infection. It is important to think about it in the face of any brain neurological picture given the thrombogenic nature of COVID 19, mainly in geriatric population. However, guidelines must been done for better management of these patients even if outcomes evolution are generally favourable.
Abstract: Introduction: The new coronavirus constitutes a public health problem due to its many often fatal complications such as thromboembolic diseases. Upper this infectious state, neurological diseases are reported mainly ischemic stroke and rarely cerebral venous thrombosis. Observation: We report the case of a 76-year-old diabetic, hypertensive patient...
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Case Report
Identifying Cryptococcus Neoformans Neuroinfection Through Neuropsychological Examination
Issue:
Volume 8, Issue 1, April 2024
Pages:
12-18
Received:
26 December 2023
Accepted:
6 January 2024
Published:
18 January 2024
Abstract: Cryptococcus neoformans is a highly letal and hard-to-be-identified fungal disorder, being its neurocognitive impairment practically non-documented in literature. In this experience-based report, integrated analysis of symptomatology, history of life and neurocognitive assessment regarding a clinical case, provided a quick and easy-access identification of cryptococcus neoformans in a 77-year male (right-handed, 12 years of education). A semi-structured interview explored a variety of risk, favorable and influential factors. Neuropsychological battery included MMSE-2, Digit-Span, STROOP, RAVLT, COWAT, and Clock-Drawing Test. Quantitative and qualitative (verbalizations, test execution procedures and attitude) results have been integrated for his neuropsychological characterization. Main impairment occurred in semantics (mental confusion), processing speed and self-regulatory executive functions. Together, these cognitive functions rely on integrity of cortico-subcortical circuits. His verbal episodic memory was null, but this absent condition might be at least partially attributed to history of alcohol abuse. Motor disturbance slightly affected visuospatial praxia. Recommendations to identify rare neuroinfection through a neuropsychological approach include, beyond quantitative test results of a discriminant neurocognitive battery, proper identification of: an episode-related pattern of symptom evolution; a neurocognitive profile which resembles symptom evolution; and qualitative measures of transitory impairment. Thus, the proposed neuropsychological assessment approach is expected to fasten neuroinfection diagnosis and burn letal possibilities, in simplified, yet fidedign and specialized, clinical contexts.
Abstract: Cryptococcus neoformans is a highly letal and hard-to-be-identified fungal disorder, being its neurocognitive impairment practically non-documented in literature. In this experience-based report, integrated analysis of symptomatology, history of life and neurocognitive assessment regarding a clinical case, provided a quick and easy-access identific...
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