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Spontaneous Disappearance of a Ruptured Intracranial Aneurysm

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Open Journal of Modern Neurosurgery 2019年第2期9卷 164-171页

作者： André Tokpa louis derou Konan Serge Yao Dominique Oka N’dri Department of Neurosurgery Teaching Hospital of Bouaké Bouaké C&#244 te d’Ivoire Department of Neurosurgery Teaching Hospital of Yopougon Abidjan C&#244 te d’Ivoire

The spontaneous disappearance of a ruptured intracranial aneurysm is unusual and its mechanism remains incompletely understood. However, several hypotheses are put forward and are mostly found in Virchow’s triad. We report the case of a man who suffered subarachnoid hemorrhage by rupture of a blister aneurysm of the P1 segment of the left posterior cerebral artery. A control arteriography performed one week after the rupture showed a disappearance of the aneurysm and a significant vasospasm of the carrier artery. Angiograms performed at 3 weeks and 3 months confirmed this disappearance of the aneurysm and a return to normal artery size. Clinically the patient was doing well. Therefore his aneurysm was spontaneously declared cured. Several studies are needed to clarify the natural history of spontaneously thrombosed aneurysms and elucidate their occurrence mechanism in order to improve the management of intracranial aneurysmal pathology.

关键词： Intracranial Aneurysm Subarachnoid Hemorrhage Cerebral Angiography Spontaneous Thrombosis

Congenital Depressed Skull Fracture Lifting with Suction Cup: A Therapeutic Alternative to Surgery

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Open Journal of Modern Neurosurgery 2019年第2期9卷 115-122页

作者： André Tokpa louis derou Konan Serge Yao Oka Dominique N’dri Department of Neurosurgery Teaching Hospital of Bouaké Bouaké Cote d’Ivoire Department of Neurosurgery Teaching Hospital of Yopougon Abidjan Cote d’Ivoire

Congenital skull fractures of newborn are rare and create medico-legal problems. Their management is controversial. Between surgery considered too aggressive and uncertain conservative attitude, reduction by suction cup or breast pump is an alternative. The authors report their experience through a case of successful resolution of a congenital depressed skull fracture using a suction cup in a newborn at 13 day of life followed by a literature review. This technique avoids the usual complications of surgery and reduces the anxiety of parents related to surgery. It also avoids the anxiety of having a newborn with a recessed skull and a conservative attitude with uncertain outcome.

关键词： Congenital Skull Fracture Depressed Skull Fracture Suction Cup

Microsurgical Management of Intracranial Aneurysms in Côte d’Ivoire: A Series of 128 Cases

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Open Journal of Modern Neurosurgery 2020年第1期10卷 105-113页

作者： Andre Tokpa Aderehime Haidara louis derou Soress Dongo Medard Kakou Guy Varlet Neurosurgery Department Bouake Teaching HospitalBouakeCote d’Ivoire Neurosurgery Department Yopougon Teaching HospitalAbidjanCote d’Ivoire

Introduction: The management of intracranial aneurysms in sub-Saharan Africa is essentially surgical. In this retrospective study, the authors report their experience in surgical management of intracranial aneurysm in Côte d’Ivoire. Methods: We carried out a retrospective study on patients operated for a ruptured or unruptured intracranial aneurysm between January 1st, 2012 and December 31st, 2018. Data on epidemiological characteristics of patients and aneurysms, treatments and patient outcomes were analyzed. Results: One hundred twenty eight aneurysms were operated. Sixty-six percent of the patients were female. According to the World Federation of Neurosurgical Societies (WFNS) scale, 58, 5% of patients were in grade I. Fisher scale showed 29% of Fisher 2 and 49% of Fisher 4. The aneurysms were mainly located on the internal carotid artery in 38% and anterior complex in 36%. The average size of aneurysms was 6.5 mm. In 81.4% the size of the aneurysms was less than 10 mm. Most aneurysms (90%) were treated at late stage. According to the modified Rankin Scale, 92 patients (83%) had good outcome, 7 patients (6%) had poor outcome, and the mortality rate was 11%. Conclusions: This study shows encouraging results if we refer to the overall postoperative results. However, there is a sub-diagnosis and low treatment rate of ruptured intracranial aneurysms. The improvement of intracranial aneurysms management requires improving the standard of health in the country.

关键词： Intracranial Aneurysm Microsurgery Cote d’Ivoire Subarachnoid Haemorrhage

Anterior Cervical Spine Osteosynthesis Complicated by Pharyngoesophageal Perforation

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Open Journal of Modern Neurosurgery 2018年第4期8卷 383-388页

作者： André Tokpa louis derou Ml Konan Guy Varlet Dominique N’dri-Oka Department of Neurosurgery CHU de Yopougon Abidjan Cote d’Ivoire

Anterior cervical spine surgery for traumatic or degenerative disease is a well-established procedure. However, complications such as pharyngoesophageal perforation can occur. In this study, we report a series of 6 pharyngoesophageal perforations after surgery. Based on the literature review, we analyzed pathogenesis, diagnosis and discussed therapeutic strategies. Three cases occurred after surgeries of traumatic cervical spine whereas the remaining were after surgeries for degenerative cervical myelopathy. The mean duration of surgery was 210 minutes. The symptoms, appearing 48 hours after surgery, were commonly hyperthermia, dysphagia, sore throat and swelling of the incision site. The diagnostic was confirmed after contrast-enhanced esophagography. The treatment strategies consisted of insertion of nasogastric feeding tube, oral intake restriction, intravenous antibiotics administration, wound drainage. Reoperation was necessary in 4 cases with removal of the hardware in three of them. One death occurred by pulmonary embolism in a tetraplegic patient. The occurrence of pharyngoesophageal perforation after cervical spine surgery can be disastrous. It can be avoided by increasing surgeon awareness during the surgical procedure. Early detection, immediate and multidisciplinary therapy are recommended to achieve the best outcomes.

关键词： Cervical Spinal Surgery Osteosynthesis Complications Pharyngo Oesophageal Perforation

Epidural spinal cord compression as initial clinical presentation of an acute myeloid leukaemia: case report and literature review

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Chinese Neurosurgical Journal 2016年第1期2卷 -页

作者： Dominique N'Dri Oka Alpha Boubacar Bah André Valentin Tokpa louis derou Department of Neurosurgery Teaching Hospital of Yopougon in Abidjan Ivory Coast 21 BP 632 Abidjan C(o)te d'lvoire Department of Neurosurgery Teaching Hospital of Conakry Conakry Guinea

Epidural localization of myeloid leukaemia is rarely *** cord compression as an initial presentation of acute myeloid leukaemia is extremely *** is a report of a 17-year-old black boy who presented to emergency department with neurological symptoms of spinal cord *** modalities showed multiple soft tissue masses in the epidural *** surgical treatment,histopathological examination of the epidural mass showed myeloid leukaemia cells *** review on Medline and 'scholar Google' database was *** characteristics and management of extra-medullary leukaemia are *** sarcoma,myeloid sarcoma or chloroma with acute myeloid leukaemia should be considered as part of epidural spinal cord *** surgery is indicated on an emergent basis.

关键词： Spinal cord compression Initial epidural localization Acute myeloid leukaemia

Clinical Factors Influencing the Neurological Recovery of Patients Operated for a Cervical Myelopathy at the Teaching Hospital of Bouake

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Open Journal of Modern Neurosurgery 2023年第2期13卷 51-59页

作者： derou louis Dongo Soress Yao Konan Serge Teti Landry Keke Jean-Baptiste Fionko Yao Bernard Tokpa André Broalet Espérance Haidara Aderehime Neurosurgery Department Bouaké Teaching Hospital Bouaké Ivory Coast Neurosurgery Department Yamoussoukro Saint Joseph Moscatti’s Hospital Yamoussoukro Ivory Coast

Introduction: Cervical myelopathy is the most common myelopathy among people over 50 of age. Cervicosteoarthritis is the main etiology. The purpose of this work was to identify clinical factors that may influence neurological recovery in patients undergoing surgery for cervical myelopathy in our work setting. Materials and Methods: We performed a retrospective analytical study on patients operated on for cervical myelopathy at the teaching hospital of Bouake. The logistic regression model was used to identify the factors influencing post-operative neurological recovery. Results: 50 patients’ records have been enrolled in this study. The mean age of our patients was 53 years with extremes ranging from 25 to 78 years and 39 of our patients (62%) were male. The mean modified pre-operative JOA score was 11.62 versus 12.94 after the surgery. Age, sex, the number of levels operated on and the duration of the evolution of the signs showed no significant link with neurological recovery. Preoperative mild myelopathy (P = 0.0491) and post-operative functional rehabilitation (P = 0.0459) were identified as factors favouring neurological recovery after cervical myelopathy surgery. Conclusion: The good conducts of functional rehabilitation sessions as well as a mild myelopathy were the factors favouring neurological recovery.

关键词： Spinal Spondylosis Medullary Compression Myelopathy

A rare case of giant solitary spinal B cell lymphoblastic lymphoma

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Chinese Neurosurgical Journal 2016年第4期2卷 245-248页

作者： Hermann Adonis N'da Kporou Landry Drogba louis derou Slim Alban Mbende Dominique N'dri Oka Vincent Ba Zézé Service de Neurochirurgie CHU de Yopougon Abidjan C(o)te d'lvoire 21 BP 632 Abidjan C(o)te d'lvoire

Background:Common B cell lymphoma locations are lymph nodes,skin,bone,mediastinum and it accounts for 2 ％ of *** solitary spinal B-LBL has not yet been *** presentation:A 15-years old boy was admitted for a painful swelling of the thoracolumbar spine and *** showed a voluminous mass of the thoracolumbar *** treatment consisted of surgical decompression and stabilization,followed by chemotherapy and *** examination showed a *** quality of life improved ***:To the best of our knowledge,this is the first case of giant solitary spinal B-LBL ever *** to choose a treatment method over another should weigh on individual *** should be considered as initial treatment option in this atypical lesion.

关键词： B Lymphoblastic lymphoma Spinal tumour Spine surgery