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Surgical Repair of Encephaloceles in Gabriel TouréHospital: Review of 17 Cases

Open Journal of Modern Neurosurgery 2018年第4期8卷 375-382页

作者： Youssouf Sogoba Drissa Kanikomo Boubacar Sogoba Djenè Kourouma oumar coulibaly Issa Amadou Seybou Hassane Diallo Moustapha Mangané Hamidou Almeimoune Maiga Madani Thierno Diop Belco Maiga Leonie Diakité Fousseyni Traoré Youssoufa Maiga Yacaria coulibaly Broulaye Samaké Djibo M. Diango Department of Neurosurgery H&#244 pital Gabriel Touré Bamako Mali Department of Neurosurgery H&#244 pital du Mali Bamako Mali Department of Pediatric Surgery H&#244 pital Gabriel Touré Bamako Mali Department of Neurology H&#244 pital Gabriel Touré Bamako Mali Department of Anesthesiology and ICU H&#244 pital Gabriel Touré Bamako Mali Department of Pediatrics H&#244 pital Gabriel Touré Bamako Mali

Background: Encephaloceles are congenital neural tube defects characterized by the protrusion of meninges and/or brain tissue from a defect in the skull. The incidence of the disease is about 0.8 - 5.6/10,000 live births. They are classified based on the location and type of skull defect as occipital encephalocele, encephalocele of the cranial vault, frontoethmoidal encephalocele, and basal encephaloceles. Surgical reduction being the first line treatment and resection of herniated structures may be necessary when the encephalocele is large. In the present study, the authors present their experience in treating 17 patients with encephaloceles. Methods: This study is a retrospective analysis of 17 patients from January 2013 to December 2016 in Gabriel Touré Hospital, Bamako, Mali. A history was obtained from the family at presentation. Medical information before and during the pregnancy was compiled. All patients underwent CT scan as a routine preoperative imaging study, to evaluate the encephalocele and to plan the surgical procedure. The following data were recorded for analysis: age, sex, location of encephalocele, neurological status, operative method, postoperative complications and surgical results. Results: There were 10 (58.8%) female and 7 (41.2%) male patients. The patients ranged in age from 3 days to 36 months. The most common site of encephalocele sac was the occipital region in 14 (82.4%) cases followed by the frontal region in 2 (11.8%) cases and the vertex in 1 (5.9%) case. The sac size was less than 3 cm in 5 (17.6%) cases, 3 - 5 cm in 8 (47.1%) cases and more than 5 cm in 4 (23.5%) cases. Three (17.6%) children presented with CSF leakage. Hydrocephalus was present in the preoperative period in 6 (35.3%) cases;all of them required VP shunt procedure. None of the cases had a preoperative neurologic deficit. Surgical excision was performed in all cases. In the postoperative period, meningitis developed in 2 cases (11.8%), wound infection in 1 case (5.9

关键词： Encephalocele Neural Tube Defect Hydrocephalus Congenital Malformation

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Metaplastic meningioma with pure and extensive cartilaginous transformation: A diagnostic dilemma

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Case Reports in Clinical Medicine 2013年第7期2卷 390-394页

作者： oumar coulibaly Justin Onen Amal Harmouch Boutarbouh Majhouba Adil Melhaoui Yasser Arkha Loubna Rifi Said Derraz Sanaa Sefiani Abdessamad El Ouahabi Abdeslam El Khamlichi Department of Neurosurgery Hopital des SpécialitésCHU Ibn SinaRabat-SaléMorocco Department of Pathology Hopital des SpécialitésCHU Ibn SinaRabat-SaléMorocco

Meningiomas are the most common extra-axial central nervous system tumours and often discovered in the middle to late adult life and especially in women. About 85%-90% of meningiomas are benign, 5%-10% are intermediate-grade, and 3%-5% are malignant. Metaplastic meningioma is a rare subtype of WHO Grade I meningioma histologically characterized by the presence of mesenchymal components. The presence of pure and extensive cartilaginous differentiation in meningiomas is extremely rare and remains a diagnostic dilemma. We report, perhaps the first case of this entity in a 52-year-old woman and discuss the pathogenesis, the imaging features and the histopathologicals data.

关键词： Meningioma Metaplastic Meningioma Pure Cartilaginous Differentiation Diagnostic Dilemma

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Endocranial Suppurations of Sinus Origin: Ratio of 3 Cases in Children at the Hospital in Mali

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Open Journal of Pediatrics 2021年第3期11卷 517-531页

作者： Bourama Kané Korotoumou Wélé Diallo Mohamed Maba Traoré Boubacar Mami Touré Mahamadou Dama Mody Abdoulaye Camara Guédiouma Dembélé Daouda Sissoko oumar coulibaly Mamadou Traoré Pediatrics Department of Mali Hospital Bamako Mali Medical Imaging Service Bamako Mali Neurosurgery Department of the Mali Hospital Bamako Mali Pediatric Service of the Commune Reference Health Center V Bamako Mali

Introduction: Intracranial suppurations are neoformed purulent collections including, in decreasing order, cerebral abscesses, subdural empyemas and extradural empyemas. Otorhinolaryngologic infections are one of the main causes, especially in older children and adolescents. We report 3 clinical cases of endocranial suppurations treated at the Mali Hospital. Clinical Cases: 1) Observation 1. IK was a 14-year-old boy, who was hospitalized in our department for fever, headache and left hemiplegia. The emergency brain scan showed a right frontal and interhemispheric subdural empyema associated with multifocal sinusitis. Surgical drainage associated with ceftriaxone: 100 mg/Kg/d in direct intravenous (DI), metronidazole: 10 mg/Kgs/12hours in slow intravenous (SI) for 15 days, gentamycin: 3 mg/Kgs/d in SI for 3 days, paracetamol 15 mg/Kgs/6hours in SI, 10% glucose serum: 100 ml/Kg/d were given. The bacteriological analysis of the pus came back sterile. The postoperative period was calm. 2) Observation 2. This was a 14-year-old boy with a history of headaches who was admitted to our department for left hemiplegia. An emergency brain scan showed a right pre-suppurative encephalitis associated with a right fronto-ethmoidal and maxillary sinusitis. He was put on ceftriaxone 100 mg/kg/d in DI for 21 days, gentamycin: 3 mg/Kg/d in SI for 3 days;metronidazole: 10 mg/kg/12hours in SI for 21 days, paracetamol: 15 mg/kg/6hours in SI. After 3 weeks of medical treatment, a follow-up brain scan revealed an interhemispheric and right subdural empyema. Surgical drainage was associated with the triple antibiotic therapy initially instituted. The bacteriological analysis of the pus was sterile. The postoperative course was calm. 3) Observation 3. N.M was an 11-year-old boy, who was admitted with fever and left hemiplegi

关键词： Sinusitis Endocranial Suppurations Mali Hospital

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Early Management of Nephroblastoma: A Single-Center Study in a Sub-Saharan African Country

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Open Journal of Pediatrics 2021年第4期11卷 797-803页

作者： Abdoul Karim Doumbia Pierre Togo Mariam Maiga Mohamed Elmouloud Cissé Guédiouma Dembélé oumar coulibaly Karamoko Sacko Belco Maiga Djeneba Konaté Abdou Diarra Yakaria coulibaly Fatoumata Léonie Diakité Abdoul Aziz Diakité Boubacar Togo Check Bougadary Traore Adama Bah Department of Pediatrics at CHU Gabriel Touré Bamako Mali Reference Health Center of the Municipality 6 Bamako Mali Pediatric Surgery Department of the Gabriel Touré CHU Bamako Mali Pathological Anatomy and Cytology Department of the “Point G” CHU Bamako Mali

Introduction: Nephroblastoma is the most common renal cancer in pediatrics. The aim of this study was to describe the epidemiological, clinical, histological characteristics and the immediate outcome of patients with nephroblastoma. Methodology: This was a cross-sectional study of 18 cases of unilateral nephroblastoma, carried out in the pediatric oncology unit (UOP) of the CHU Gabriel Touré from January 2015 to December 2016. Results: The mean age of the patients was 33 months old. The sex ratio was 0.63. The average consultation time was 3 months. A case of malformation syndrome (aniridia and mental retardation) had been observed. The main reason for consultation was abdominal mass (100%) associated with deterioration of general condition (44%), pain (44%) and fever (17%). Stage I accounted for 61% and stage II 39%. The postoperative histological classification made it possible to find the high-risk blastematous type (33%), the regressive type of intermediate risk (11%) and the stromal type of intermediate risk (45%). Toxicities (haematological and digestive) were minimal. The 3-year overall survival was 90%. Conclusion: This study is characterized by the predominance of stages I and II and the fairly large percentage of histology at intermediate risk. These results are above all the result of multidisciplinary collaboration.

关键词： Cancer Child Nephroblastoma Diagnosis Prognosis Mali

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Conservative Treatment in Grisel’s Syndrome Following Tonsillectomy

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World Journal of Neuroscience 2018年第1期8卷 38-43页

作者： Youssouf Sogoba Abdoulaye Barry Issa Amadou Boubacar Sogoba Drissa Kanikomo Seybou Hassane Diallo oumar coulibaly Youssoufa Maiga Siaka Soumaoro Dianguina dit Noumou Soumaré Kadidiatou Singaré Mohamed Keita Department of Neurosurgery Hopital Gabriel Touré Bamako Mali Department of Pediatrics Hopital de Kati Bamako Mali Department of Pediatric Surgery Hopital Gabriel Touré Bamako Mali Department of Neurology Hopital Gabriel Touré Bamako Mali Department of ENT Hopital Gabriel Touré Bamako Mali Department of Pneumonology Hopital du Point G Bamako Mali

Grisel’s syndrome is a rare complication that is characterized by non-traumatic atlantoaxial subluxation. It is most commonly seen in children after an upper respiratory tract infection or neck surgery, such as an adenoidectomy, tonsillectomy and mastoidectomy. Grisel’s Syndrome is characterized by torticollis and a limited range of motion of the neck with pain. Here the authors report a case of a Malian 5-year-old girl with Grisel’s syndrome following tonsillectomy. The patient’s complaints were fully resolved after 2 weeks of conservative treatment.

关键词： Atlantoaxial Subluxation Grisel’s Syndrome Torticollis

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Hemorrhagic Stroke: About a Pediatric Case

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Open Journal of Pediatrics 2021年第4期11卷 804-809页

作者： Abdoul Karim Doumbia oumar coulibaly Hawa Gouro Diall Guediouma Dembélé Agaly Hamadassaliha Fatou S. Mangara Pierre Togo Adama Dembélé Belco Maiga Karamoko Sacko Abdoul Aziz Diakité Boubacar Togo Department of Pediatrics of the University Hospital Gabriel Touré Bamako Mali Department of Pediatrics Mali Hospital Bamako Mali Department of Neurosurgery of the University Hospital Gabriel Touré Bamako Mali

Stroke is a rare but serious condition with high mortality and morbidity. We report the case of a 10-year-old child with no known pathological history who was transferred to the pediatric department for hemorrhagic stroke. He had been hospitalized 6 days earlier in a peripheral center for a tonic-clonic seizure accompanied by loss of consciousness and fever. Clinical examination revealed meningeal syndrome, facial paralysis, right hemiparesis, ataxia with disturbed balance, aphasia, and a peripapillary hemorrhage on the fundus. A cerebral computed tomography (CT) scan showed a hemorrhagic stroke with ventricular flooding. A lumbar puncture was performed and a hematic cerebrospinal fluid (CSF) with 12 leukocytes and 8000 red blood cells was obtained. The evolution was marked by the extinction of the infectious and meningeal syndromes, the regression of the pyramidal syndrome and the persistence of the dysarthria justifying a neuropsychological and speech therapy follow-up. Several challenges (diagnostic, therapeutic) exist in the management of children with stroke. Prospective studies with a larger sample are needed to fill the observed gaps.

关键词： Hemorrhagic Stroke Pediatrics Intracerebral Hemorrhage Subarachnoid Hemorrhage Malaria Mali

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Clinical, Aetiological and Evolutionary Aspects of Respiratory Distress in Term Neonates: A Single-Centre Cross-Sectional Study

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Open Journal of Pediatrics 2023年第6期13卷 821-830页

作者： Abdoul Karim Doumbia Doumbia Aminata coulibaly oumar Pierre Togo Adama Dembélé Abdoul Aziz Diakité Mohamed Elmouloud Cissé Hawa Diall Belco Maïga Aminata coulibaly Mariam Kané Tati Simaga Karamoko Sacko Yacouba Aba coulibaly Djéneba Konaté Ibrahima Ahamadou Hawa Konaré Lala Ndrainy Sidibé Kalirou Traoré Fatoumata Léonie Diakité Guédiouma Dembélé Fatoumata Dicko Fousseyni Traoré Boubacar Togo Department of the CHU Gabriel Touré Bamako Mali

Introduction: Respiratory distress is a frequent cause of morbidity and mortality in neonates. The aim of this study was to assess its frequency and describe its clinical and evolutionary characteristics in the neonatology department of the Gabriel Touré University Hospital in Bamako. Methodology: This was a prospective cross-sectional study conducted from 1 January 2021 to 30 June 2021. All term neonates aged 0 to 28 days hospitalised with signs of respiratory distress (tachypnoea, nasal flaring, expiratory whining, intercostal and subcostal indrawing, xiphoid funneling and cyanosis) were included. The sociodemographic and clinical variables of the newborns and their mothers were analysed using SPSS.20 software. Results: During the study period, 1272 newborns were admitted to hospital, including 705 born at term, of whom 188 were included in the study. The mothers’ ages ranged from 14 to 45 years, with an average of 24 years. The pregnancy was not followed up in 15% of cases. Newborns were resuscitated at birth in 51% of cases. The main clinical signs observed were hypoxia, neurological disorders and fever. Perinatal asphyxia (55%), neonatal infections (34%) and congenital malformations (6%) were the main causes of respiratory distress. Mortality was estimated at 37%. Conclusion: Neonatal respiratory distress is a major cause of death. Most causes can be avoided if pregnancy and delivery are properly managed.

关键词： Respiratory Distress Neonate Asphyxia

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Management of Spinal Schwannomas in Gabriel TouréHospital: Review of 11 Cases

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Surgical Science 2018年第8期9卷 256-261页

作者： Youssouf Sogoba Boubacar Sogoba Drissa Kanikomo Seybou Hassane Diallo Djenè Kourouma oumar coulibaly Issa Amadou Moustapha Mangané Hamidou Almeimoune Madani Thierno Diop Youssoufa Maiga Broulaye Samaké Djibo M. Diango Department of Neurosurgery H&#244 pital Gabriel Touré Bamako Mali Department of Neurology H&#244 pital Gabriel Touré Bamako Mali Department of Neurosurgery H&#244 pital du Mali Bamako Mali Department of Pediatric Surgery H&#244 pital Gabriel Touré Bamako Mali Department of Anesthesiology and ICU H&#244 pital Gabriel Touré Bamako Mali

Background: Spinal schwannomas are common tumors of spinal neoplasm and account for about 25% of intradural spinal cord tumors in adults. They are generally benign and slow-growing. Advanced in radiologic and surgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. In this report, the authors present the incidence, clinical presentation, localization, and results of surgically treated spinal schwannomas. The results of a literature review are also presented. Methods: Eleven consecutive patients with histologically confirmed spinal schwannomas were treated from January 2013 to December 2016 in the neurosurgical department of Gabriel Touré Hospital, Bamako, Mali. Neuroradiological diagnosis was made, CT scan in 7 patients, and MRI in 4 patients. All patients were operated on via the posterior approach. All cases were surgically excised, and they were confirmed to be schwannomas by pathologists. The patients were followed for 6 to 38 months (mean 28 months). Functional outcome was assessed using the motor grade and sensory change. Results: There were 11 patients with 7 (63.6%) males and 4 (36.4%) females. The mean age was 40.3 years (range 23 - 62 years). The most common symptom at the time of diagnosis was radicular pain in 9 (81.8%) patients followed by motor weakness in 8 (72.7%) patients. The most frequent site of spinal schwannomas was the thoracic region in 5 (45.5%) patients. During surgery, Gross-total resec-tion was achieved in 8 patients (72.7%) and subtotal removal in 3 (27.3%) patients. Histological findings were benign schwannoma in all cases. Postoperative complications developed in two patients, including one with cerebrospinal fluid leakage and other one with wound infection. In the short-term follow-up period, most of the patients (90.9%) appeared to be improved in comparison with their preoperative neurological status. There was no operative mortality. Conclusion: In this study

关键词： Spinal Schwannoma Spine Surgery Recurrence

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Giant Intracranial Arachnoid Cyst Causing Acute Neurologic Symptoms

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World Journal of Neuroscience 2018年第3期8卷 363-369页

作者： Youssouf Sogoba Boubacar Sogoba Seybou Hassane Diallo Drissa Kanikomo Djenè Kourouma oumar coulibaly Issa Amadou Moustapha Mangané Hamidou Almeimoune Madani Thierno Diop Youssoufa Maiga Broulaye Samaké Djibo M. Diango Department of Neurosurgery Hopital Gabriel Touré Bamako Mali Department of Neurology Hopital Gabriel Touré Bamako Mali Department of Neurosurgery Hopital du Mali Bamako Mali Department of Pediatric Surgery Hopital Gabriel Touré Bamako Mali Department of Anesthesiology and ICU Hopital Gabriel Touré Bamako Mali

Intracranial arachnoid cysts (IAC) are benign lesions containing cerebrospinal fluid (CSF). Most of them are clinically silent and remain static in size. However some may present with mild and slow progressive symptoms caused by the cyst. The authors present the case of 54-year-old woman who presented with acute symptoms of severe headache, vomiting, and gait disturbance of 2 day’s duration. She had no history of head trauma. On admission, neurological examination revealed that the patient had a Glasgow Coma Scale score of 15, and a left side hemiplegia. A CT scan revealed a hypodense fluid collection in the right frontoparietal region that mimicked an arachnoid cyst. The symptoms were improved after an emergency marsupialisation via craniotomy.

关键词： Arachnoid Cyst Neuroendoscopy Microsurgical Fenestration

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Management and Outcome of Acute Subdural Hematoma in Gabriel TouréHospital

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Open Journal of Emergency Medicine 2022年第1期10卷 48-53页

作者： Youssouf Sogoba Drissa Kanikomo Quenum Kouassi Jean Marie Kisito Moussa Diallo Bakary Dembélé Boubacar Sogoba Djènè Kourouma Izoudine Blaise Koumaré Seybou Hassane Diallo Hamidou Almeimoune Moustapha Mangané Thierno Madane Diop oumar coulibaly Mamadou Salia Diarra Mahamadou Dama oumar Diallo Youssoufa Maiga Djibo Mahamane Diango Department of Neurosurgery Gabriel Touré Teaching Hospital Bamako Mali Neurosurgeon University of Parakou Parakou Benin Department of Neurology Gabriel Touré Teaching Hospital Bamako Mali Department of Emergency Care Gabriel Touré Teaching Hospital Bamako Mali Department of Neurosurgery H&#244 pital du Mali Bamako Mali Department of Neurosurgery H&#244 pital Luxambourg Bamako Mali

Background: Traumatic Brain Injury (TBI) is a major health problem worldwide. It is the main cause of trauma mortality. Acute subdural hematoma (ASDH) has a reputation for being the most serious of all posttraumatic head injuries. Its frequency is estimated to be 1% to 5% of all head injuries and 22% of severe head injuries. The aim of this study was to assess the epidemiological, clinical and prognosis aspects of ASDH in our department. Material and Methods: This prospective study, from January to December 2019, included 57 patients admitted to the Gabriel Touré Teaching Hospital for ASDH. Patients underwent detailed clinical and radiological evaluation and ASDH was diagnosed by non-contrast computed tomography (CT) scan. Functional outcome was evaluated 6 months after injury by Glasgow Outcome Scale. Results: During the study period, 662 patients were admitted for TBI including 57 (8.61%) cases of ASDH. The mean age was 34 years with extremes of 2 and 77 years. There was a male predominance with 52 (91.2%). The main cause of trauma was motor vehicle accidents in 38 (66.6%) patients. According to the Glasgow coma scale (GCS), 33 (57.9%) patients were classified mild (Table 2). The thickness of the hematoma was more than 1 cm in 13 (22.8%) patients and less than 1 cm in 44 (77%) patients. Surgical treatment was performed in 13 (22.8%) patients. The outcome was favorable in 30 (52.6%) patients and the mortality rate was 33.3%. Conclusion: ASDH remains a difficult challenge because of the high mortality. The mortality rate remains high particularly in patient with poor GCS score at admission.

关键词： Acute Subdural Hematoma Traumatic Brain Injury Outcome

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