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Cervical Spondylodiscitis Revealed by Tracheostomy Infected: A Rare Case Report Management and Outcome

Open Journal of Modern Neurosurgery 2023年第1期13卷 18-24页

作者： José Dimbimakoso djimrabeye alngar Moune Michèle Yolande Mustapha Hamama Nizaireel Fatemi Rachid El Maaquil Faculty of Medicine and Pharmacy Université Mohamed V Rabat Morocco Department of Neurosurgery CHU ibnSina Rabat Morocco

Background: Spondylodiscitis is a spinal infection rare affecting primarily the intervertebral disk and the adjacent vertebral bodies. His diagnosis is difficult and often delayed or missed due to the rarity of the disease. Cervical spondylodiscitis has quite rare findings regarding the common location of spinal abscesses in the lumbar and thoracic regions. To obtain the best patient outcomes, these spinal infections require prompt diagnosis and appropriate treatment. Case description: A 44-year-old boy was admitted to the neurosurgery department of our hospital for heaviness in 4 limbs without gait disorders in context infected tracheostomy after staying in intensive care. MRI spine showed a spine deformity with lyse C4C5 epiduritis and spinal cord compressed. Antibiotics intravenous were started for 1 month the patient benefited from a corpectomy with an iliac graft and anterior cervical plate. The anatomopathological examination revealed an inflammation not specific. He was therefore put on antibiotics for 6 weeks. Three months later the neck pain and limb pain resolved after treatment and a complete return of lower extremity strength. Conclusion: Cervical spondylodiscitis has increased and become more aggressive. While radical surgical debridement, stable reconstruction together with antibiotic therapy remained a reliable approach to achieve complete healing of the inflammation, anterior alone surgery became more applicable.

关键词： Cervical Spondylodiscitis Spinal Tracheostomy Infection

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Metastases Extracranial Mimicking Meningioma: A Case Report

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Open Journal of Modern Neurosurgery 2023年第4期13卷 175-182页

作者： Dimbi José Makoso Touati Lina Mouné Michel Yolande djimrabeye alngar Moussa Elmi Saad Nizaire el Fatemi Rachid el Maaqili Department of Neurosurgery Center Hospital University of IBN SINA Rabat Morocco Faculty of Medicine University of Mohamed V Rabat Morocco

Background: Skull vault lesions are rare and represent 1% - 2% of all bone masses. Most cerebral metastases are the intra axial tumors, whereas extra-axial masses mimicking meningioma are extremely rare. Case presentation: A 35-year-old woman with a history of mastectomy left breast cancer 5 years below radiotherapy was referred to the neurosurgery department with a parietal extra-axial mass parietal evolving for one year. CT scan with Magnetic resonance imaging revealed an extra-axial tumor with lysis bone. A craniotomy was performed to remove the mass that was located extra-axial. Histopathological examination revealed metastasis. Conclusions: Lesion skull vaults are rare but they should be considered in the differential diagnosis of intraosseous meningioma lesions. In this report, we discuss the clinical aspects of cases we observed, in which the metastasis bone was found thanks to the histological examination of a calvarial mass after surgery.

关键词： Metastases Calvarial Meningioma Exerese

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Risk Factors of Reoperation and Outcome of Patients Operated for Chronic Subdural Hematoma in a Teaching Hospital in Rabat

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Open Journal of Modern Neurosurgery 2023年第2期13卷 60-68页

作者： Yolande Michèle Moune Jose Dimbi Makosso Mustapha Hemama alngar djimrabeye Dognon Kossi François de Paul Adjiou Saad Elmi Moussa Nourou Dine Adeniran Bankole Nizar El Fatemi Rachid El Maaqili Neurosurgery Department Ibn Sina Hospital Rabat Morocco

Background: chronic subdural hematoma is a common pathology, especially in the elderly. Although it has a good prognosis, it poses the problem of recurrence after surgical evacuation. Objective: To analyze the risk factors of reoperation in patients surgically treated for chronic subdural hematoma (cSDH) and evaluate the outcome of patients who benefited from a reoperation. Materials and Methods: A retrospective review was conducted in a single University Hospital Center in Rabat (Morocco) on 49 patients operated on from January 2020 to June 2021 for cSDH. Possible risk factors described in the literature were analyzed and the outcome of post-operative course was evaluated. Statistical significance was defined by p-value Results: 49 patients underwent surgical evacuation of cSDH. The sex ratio of male/female was 3.08. The mean age was 70.6 years. Concerning the medical history, 8.2% were diabetics, 10.2% had heart disease, 18.4% had hypertension, 16.3% associated of comorbidities, 2% had pulmonary embolism, and 2% had neoplasm. 18.4% were on anticoagulation therapy, no patients were on new oral anticoagulants. The clinical findings upon admission were motor deficit at 57.1%, signs of intracranial hypertension at 20.4%, altered consciousness at 16.9% and impaired behavior at 6.1%. 28.6% of patients had a past history of head trauma. The pre-operative CT scan showed unilateral cSDH at 81.6%, midline shifts at 77.6%, and false membranes at 34.7%. Blood appeared chronic at 40.8%, subacute at 24.5%, and mixed densities at 34.7%. The post-operative course was uneventful in 73.5%. According to Ibanez grading 8 patients had mild complications (grade I) and 5 moderate complications (grade II) after the first surgery. We recorded 10.2% of patients who needed a second surgery because of the deterioration of neurologic status or motor deficit associated with an abnormal CT scan. According to the GOS, 85.7% of patients had a good recovery while 10.2% died. None of the factors as

关键词： Chronic Subdural Hematoma Risk Factors of Reoperation Outcome

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