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Senegalese Experience in the Surgical Management of Pott's Disease in Children and Adolescents: Diagnostic, Therapeutic and Prognostic Aspects of 53 Cases
Malangu Ntambwe Mhacks,
Faye Mohameth,
Celebre Mualaba,
Magatte Gaye Sakho,
El Hadj Cheikh Sy Ndiaye,
Momar Code Ba
Issue:
Volume 7, Issue 2, December 2023
Pages:
22-27
Received:
12 February 2023
Accepted:
27 February 2023
Published:
8 July 2023
Abstract: Spondylodiscitis is an infection of the intervertebral disc and the adjacent vertebral bodies. The particularity of this pathology in children is that it is often a primary infection. The objective of this work is to evaluate and determine the frequency of surgical management of pott's sore in children and adolescents in neurosurgical services in Senegal. We retrospectively studied 53 files from 6 neurosurgical centers in Senegal, during a period of 6 years and 6 months i.e. from January 2015 to July 2021, Pott's disease in children and adolescents accounted for about 53/212 cases operated on in Senegal, i.e. 25% of this surgery in Senegal and 17% of tuberculous spondylodiscitis in Senegal. The Dakar centers were the most frequent site with 46.36%. The sex ratio was 3.8. The average age was 17 years; tuberculosis infection was found in 26% of cases. Neurological disorders were observed in 64.15% and 35.85% of patients were FRANKEL E. The spinal CT scan was the diagnostic tool in 98.28% and the dorsal segment was the most affected, i.e. 46.08%. Surgery was performed in 100% of cases. Laminectomy + osteosynthesis accounted for 71.69% of cases (n=38). Motor recovery was observed in 83% of cases for a follow-up period of 3 to 12 months in our series, i.e. 44 patients. The surgical management of tuberculous spondylodiscitis in children and adolescents is a rare and under-explored entity. The diagnosis is both clinical and paraclinical, the medical treatment always keeps its place even if some cases required surgery, the functional prognosis is in general good, often associated with functional rehabilitation.
Abstract: Spondylodiscitis is an infection of the intervertebral disc and the adjacent vertebral bodies. The particularity of this pathology in children is that it is often a primary infection. The objective of this work is to evaluate and determine the frequency of surgical management of pott's sore in children and adolescents in neurosurgical services in S...
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Tuberculosis: A More Than One Pathophysiology to Induce Neurological Disorder
Issue:
Volume 7, Issue 2, December 2023
Pages:
28-31
Received:
15 July 2023
Accepted:
5 August 2023
Published:
31 August 2023
Abstract: Tuberculosis (TB) is an infectious disease which can infect all body organs including the central nervous system (CNS). TB has a higher mortality rate worldwide and is a frequent cause of neurologic sequelae. Approximately 10% of TB patients also have a CNS involvement. CNS-TB can take several clinical forms; Therefore, this review concentrates on the most prevalent types of CNS-TB because it is one of the most severe forms of extrapulmonary tuberculosis. Tuberculous meningitis is the most common type of CNS tuberculosis. The patient presents with insidious chronic meningitis or acute fulminant meningitis. Hydrocephalus is usually associated, especially in children, Intracranial vasculopathy, which is a serious complication of Tuberculous meningitis that can cause stroke. CNS tuberculomas is a hard-granulomatous mass that is commonly presented with focal neurologic impairments depending on its location, along with symptoms and signs of increased intracranial pressure. Tubercular Brain Abscess and Tuberculous Encephalopathy are uncommon clinical presentations of CNS tuberculosis; they usually affect children and HIV patients. Spinal TB (Pott illness) is a common form of skeletal TB that usually affects the thoracic and lumbar spines; if the cervical spine is affected, potentially fatal neurological consequences can occur. The definitive diagnosis of CNS tuberculosis is usually based on examining the CSF (as with TB meningitis) and being evaluated by neuroimaging are often the two main components of the final diagnosis of CNS tuberculosis (CT, MRI). Empirical anti-tuberculous medication, steroids, and only in exceptional circumstances, surgery, are used to treat patients.
Abstract: Tuberculosis (TB) is an infectious disease which can infect all body organs including the central nervous system (CNS). TB has a higher mortality rate worldwide and is a frequent cause of neurologic sequelae. Approximately 10% of TB patients also have a CNS involvement. CNS-TB can take several clinical forms; Therefore, this review concentrates on ...
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Conditions for the Transfer of Patients with Cranial Trauma to the University Hospital Center of Brazzaville
Ekouele Mbaki Hugues Brieux,
Bianza Eloïse Marthe Anasthasia,
Elombila Marie,
Tiafumu Konde Christ Arnaud,
Mbou Essie Darius Eryx,
Boukaka Kala Rel Gerald,
Boukassa Léon,
Otiobanda Gilbert Fabrice
Issue:
Volume 7, Issue 2, December 2023
Pages:
32-35
Received:
28 August 2023
Accepted:
14 September 2023
Published:
25 September 2023
Abstract: The aim of this study was to assess the conditions under which patients suffering from traumatic brain injury (TBI), initially admitted to a peripheral hospital, were cared for and then transferred to the emergency department of the University Hospital Center (UHC) of Brazzaville. We conducted a descriptive study, with a prospective data collection, from March to August 2021, i.e., a period of six months, in the emergency department of the UHC of Brazzaville. We included all adult patients referred from another hospital and who had consented to participate in the study. The variables studied were related to the care at the secondary hospital and the conditions of transfer to the emergency department of the UHC of Brazzaville. We selected 150 cases of TBI, including 43 cases (28.7%) from a peripheral hospital. The age was between 18 and 40 years old in 104 cases (69.3%), a sex ratio of 4. The Glasgow coma scale from periphal hospital was between 13-15 in 7 cases (16.3%) and unspecified in 30 cases (69.7 %). The parameters regarding peripheral oxygen saturation were unspecified in 76.7%, blood pressure was unspecified in 72.1%. The mode of transport used during the transfer was ambulance in 23 cases (53.6%), followed by taxi in 14 cases (32.6%) and personal vehicle in 5 cases (11.6%). Information relating to the initial management of patients is insufficient. Transfer conditions are poorly coordinated. Strengthening inter-hospital cooperation and developing teleconsultation can help improve the quality of transfers.
Abstract: The aim of this study was to assess the conditions under which patients suffering from traumatic brain injury (TBI), initially admitted to a peripheral hospital, were cared for and then transferred to the emergency department of the University Hospital Center (UHC) of Brazzaville. We conducted a descriptive study, with a prospective data collection...
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Research Article
Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report
Shuchi Lv,
Jianyu Zou,
Guowei Zhang,
Hua Yang,
Zhisheng Ji,
Hongsheng Lin
Issue:
Volume 7, Issue 2, December 2023
Pages:
36-40
Received:
11 September 2023
Accepted:
9 October 2023
Published:
31 October 2023
Abstract: Kyphosis refers to a deformity in which the spine protrudes abnormally backwards, which involves changes in the anatomical shape of the vertebral body itself and its subsidiary tissues. Kyphosis can cause abnormal appearance, inability to look up and lie down, psychological disturbance, and severe cases can cause dyspnea. We have reported a 40-year-old female patient who was admitted to the hospital due to a 37-year history of kyphosis following a fall. The measurement of preoperative imaging parameters indicated: pelvic incidence (PI) = 40°, pelvic tilt (PT) = 9°, sacral slope (SS) = 31°, lumbar lordosis (LL) = 80°, thoracic kyphosis (TK) = 57°, local kyphosis angle = 137.7°. Based on thorough preoperative planning and discussion, we performed deformed Complex vertebral osteotomy (DCVO). After the surgery, the patient's height was 151cm, which increased by 5cm compared to preoperative height. The postoperative measurements were as follows: pelvic incidence (PI) = 35°, pelvic tilt (PT) = 4.8°, sacral slope (SS) = 40°, lumbar lordosis (LL) = 73°, thoracic kyphosis (TK) = 63°, and local kyphosis angle = 59°. After the operation, the patient recovered well, the treatment effect was satisfactory, and the quality of life was significantly improved. The DCVO technique is a high-risk, demanding procedure that needs to be performed by an experienced spinal surgery team.
Abstract: Kyphosis refers to a deformity in which the spine protrudes abnormally backwards, which involves changes in the anatomical shape of the vertebral body itself and its subsidiary tissues. Kyphosis can cause abnormal appearance, inability to look up and lie down, psychological disturbance, and severe cases can cause dyspnea. We have reported a 40-year...
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Research Article
Treatment of Chronic Subdural Hematoma in Adults at the University Hospital of Brazzaville (Congo)
Ekouele Mbaki Hugues Brieux,
Gapoula Syntiche Cécilia,
Boukaka Kala Rel Gerald,
Thouassa Gédéon Colin,
Ngackosso Olivier Brice,
Kinata Bambino Sinclair Brice,
Boukassa Léon,
Otiobanda Gilbert Fabrice
Issue:
Volume 7, Issue 2, December 2023
Pages:
41-45
Received:
21 September 2023
Accepted:
20 October 2023
Published:
31 October 2023
Abstract: The aim of this study was to describe the treatment of chronic subdural hematoma (CSDH) in a neurosurgical setting, at the University Hospital Centre of Brazzaville. We conducted a descriptive study with retrospective data collection from 2014 to 2021 (a period of eight years). We included adult patients treated at the hospital for this condition. The variables studied were diagnostic, therapeutic and evolutionary. We selected 81 patients. They were over 60 years old in 49 cases (60.5%). The Glasgow coma scale was between 13 and 15 in 50 cases (61.7%). The Markwalder grade was 1 in 34 cases (42%) and 3 in 24 cases (29.6%). The hematoma was unilateral in 62 cases (76.6%) and bilateral in 19 cases (23.4%). The thickness of the hematoma was greater than or equal to 2 cm in 64 cases (79%). All patients underwent surgery. Single burr hole surgery was performed in 68 patients (84%). Drainage was placed in all the patients. The outcome was favourable in 43 cases (53.1%). Complications were noted in 38 cases (46.9%). Five patients (6.2%) died, including two cases of empyema, two cases of neurological deterioration and one case of postoperative sepsis. In univariate analysis, we found a statistically significant association between the Glasgow coma scale (P = 0.0004) and the thickness of the CSDH (P = 0.02) with the occurrence of complications. In multivariate analysis, the Glasgow Coma Scale and bilateral nature were factors influencing the occurrence of complications, adjusting for age and the hematoma thickness. Patient care may be improved by early surgical treatment in a patient with a favourable Glasgow score. Surgical techniques are varied, but postoperative drainage seems essential.
Abstract: The aim of this study was to describe the treatment of chronic subdural hematoma (CSDH) in a neurosurgical setting, at the University Hospital Centre of Brazzaville. We conducted a descriptive study with retrospective data collection from 2014 to 2021 (a period of eight years). We included adult patients treated at the hospital for this condition. ...
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Research Article
The Feasibility and Safety of Day Case Brain Tumour Biopsy: An Eight-Year Experience in the United Kingdom
William Bolton,
Fozia Saeed,
Sandeep Solanki,
Gnanamurthy Sivakumar,
Robert Corns,
John Goodden,
Paul Chumas,
Simon Thomson
Issue:
Volume 7, Issue 2, December 2023
Pages:
46-51
Received:
30 August 2023
Accepted:
14 September 2023
Published:
31 October 2023
Abstract: Purpose: Day-case surgery for selected procedures has the potential to reduce healthcare costs and improve patient experience. In neurosurgery, brain biopsies have been performed as day-case procedures for selected patients. The purpose of this study is to demonstrate the safety and feasibility of a clinical pathway that facilitates day-case brain biopsy surgery to improve the generalisability of the evidence and inform wider adoption of this practice. Materials and methods: A single centre, retrospective study of patients aged ≥18 years requiring a brain biopsy for presumed tumour between November 2009 and December 2017 was performed. All patients received pre-admission radiology imaging +/- trajectory planning (as required), an operation on a morning theatre list and post-biopsy CT head 4-6 hours to rule out haemorrhage or other complications. Discharge was aimed at 6 hours post-biopsy if observations and CT were satisfactory. All data was collected via an institution operative database and descriptive statistical analysis was conducted. Results: A total of 447 brain tumour biopsies performed over the eight-year study period of which a total of n=160 (35.8%) were planned day-case. The proportion of biopsies performed as day-case increased over the study period, from four in 2009 to 33 per annum in 2017, an increase from only 10% (n=4) to 66% (n=33) of the total annual biopsies for this centre. Of the 160 planned day-cases, 135 (84.4%) were actual day-cases and successfully discharged on the same day as the operation. The mean patient age was 58 years. Twenty-five cases had at least one overnight unplanned stay, revealing a failure rate of 15.6%. Conclusions: This study demonstrates the safety of our day-case brain tumour biopsy service and is consistent with other centres’ experiences. This represents an opportunity for neurosurgeons to confidently contribute to an increasing provision of day-case surgery across the service.
Abstract: Purpose: Day-case surgery for selected procedures has the potential to reduce healthcare costs and improve patient experience. In neurosurgery, brain biopsies have been performed as day-case procedures for selected patients. The purpose of this study is to demonstrate the safety and feasibility of a clinical pathway that facilitates day-case brain ...
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Case Report
Epidermoid and Dermoid Cyst of the Anterior Fontanelle About 2 Cases
Cissé Mohamed El Hassimi,
Diarra Mamadou Salia,
Koumaré Izoudine Blaise,
Sissoko Diankinding,
Kouma Alassane,
Dembélé Guediouma
Issue:
Volume 7, Issue 2, December 2023
Pages:
52-55
Received:
26 November 2023
Accepted:
12 December 2023
Published:
22 December 2023
Abstract: Introduction: Epidermoid cysts and dermoid cysts are uncommon benign tumors of congenital origin who result from the aberrant inclusion of ectodermal elements during closure of the neural tube between the 3rd and 5th week of embryonic development. The location of these cysts at the anterior fontanelle level is very rarely reported. These cysts evolve by gradually increasing in volume, causing aesthetic problems. Our aim is to report a case of epidermoid cyst (EC) and a case of dermoid cyst (DC) diagnosed and operated in our department. Observations: We report one case of epidermoid cyst and one case of dermoid cyst in female infants aged 10 and 4 months who presented with a subcutaneous medial fronto-parietal mass of the anterior fontanelle. These mobile, painless masses with a wide base of implantation measured 6 x 5.5 cm and 5 x 3.5 cm. After brain scan exploration, the total excision of the cysts was carried out. The postoperative progress was good without recurrence. The diagnoses of epidermoid and dermoid cysts were confirmed by histology. Conclusion: Anterior fontanelle epidermoid and dermoid cysts are congenital benign tumors who is rarely reported. They are often diagnosed in the first months of life. One piece excision gives excellent results without recurrence.
Abstract: Introduction: Epidermoid cysts and dermoid cysts are uncommon benign tumors of congenital origin who result from the aberrant inclusion of ectodermal elements during closure of the neural tube between the 3rd and 5th week of embryonic development. The location of these cysts at the anterior fontanelle level is very rarely reported. These cysts evol...
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