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Epidemiological, Clinical and Therapeutic Aspects of Spinal Pathology in Military People in a Country at War

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Open Journal of Modern Neurosurgery 2022年第1期12卷 39-46页

作者： Mamadou Salia Diarra Mohamed El Hassimi Cissé Izoudine B. Koumaré Oumar Diallo drissa kanikomo Military Neurosurgery Unit Infirmerie H&#244 pital de Bamako (IHB) Bamako Mali Neurosurgery Department H&#244 pital Mère-Enfant-Bamako USTT-B (Université des Sciences des Techniques et des Technologies de Bamako) Bamako Mali Neurosurgery Department H&#244 pital du Mali USTT-B Bamako Mali Neurosurgery Department H&#244 pital Gabriel Touré USTT-B Bamako Mali

Introduction: Lumbar and sciatic pain are frequent motives of disability in military people in Mali. As spine surgery isn’t recognized enough, our study aims to analyze etiologies, epidemiology, clinical features and surgical standards in order to improve troop abilities. Methodology: Our descriptive and retrospective study has included 31 operated military patients who underwent medical or surgical procedures between 2010 and 2018 in the Military Neurology/Neurosurgery Unit and Mère-Enfant Hospital Neurosurgery department. Results: Among 553 seen in consultation, fifty percent were between 30 and 50 years old. Main motive was sciatic pain (65.5%). Seventy eight percent of our patients were field militaires and sub-officers, and 83.2% were males. All of them have benefited a CT scan or MRI with medical treatment in rheumatology or neurology. Thirty-one patients underwent spine surgery and were included in the study, so 6% (mean age: 43.52 years, 90.3% males). Lumbar spine surgery represented 54.8% of cases with lumbar canal stenosis in 64.5% of cases. It appeared that spondylolisthésis with isthmic fracture was frequent (12.9%), and traumatic cervical spine fractures were dominant in 2012. Instrumented arthrodesis was performed for 41.9% of patients, lumbar discectomy for 32.3% and laminectomies for 22.6%. Degenerative etiology was found in 77.4% of cases and we’ve noticed a good outcome in 93.5% of operated cases. Conclusion: Spinal pathology in military people in Mali is in relation with training, weight carrying and

关键词： Military Spine Spondylolisthesis Mali

Intracranial Calcified Extradural Hematoma about a Case

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Open Journal of Modern Neurosurgery 2023年第2期13卷 69-73页

作者： drissa kanikomo Moussa Diallo André Tokpa Youssouf Sogoba Izoudine Blaise Koumaré Mamadou Salia Diarra Boubacar Sogoba Oumar Diallo Mahamadou Dama Oumar Coulibaly Mamady Coulibaly Abdoulaye kanikomo Department of Neurosurgery Teaching Hospital Gabriel Toure Bamako Mali Department of Neurosurgery Teaching Hospital of Bouake Bouake Cote d’Ivoire Department of Neurosurgery Luxembourg Hospital of Bamako Bamako Mali Department of Neurosurgery Mali Hospital Bamako Mali

Introduction: Extradural hematoma is a common pathology in our department. The natural history of small-volume hematoma is usually towards resorption. In rare cases, the hematoma calcifies and compresses the brain. We report an extradural hematoma in a 15-year-old boy who had a road traffic accident on February 2011. The brain CT-scan performed the following day revealed a small right frontal extradural hematoma. During hospitalization, he had a fever of 40 degrees with convulsions and the blood culture isolated the coagulase-negative staphylococci and Group D streptococci. When his conscience was restored, hemiparesis and dysarthria were observed. The control brain CT-scan performed 2 weeks after the trauma showed early resorption of the hematoma. Two months after the trauma, the brain CT-scan showed calcification of the hematoma. He underwent surgery in April 2011 to remove the calcification. The sequels were hemiparesis and posttraumatic epilepsy. Conclusion: The evolution of a small non-operated extradural hematoma can be done towards calcification thus requiring surgery.

关键词： Extradural Hematoma Calcification

Angiographic Features of Intracranial Aneurisms in Mali: A Preliminary Study of 105 Patients

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World Journal of Neuroscience 2023年第1期13卷 1-11页

作者： Mahamadou Dama Oumar Coulibaly Oumar Diallo Daouda Sissoko Hawa Diarra Kalba Tembine Mamadou Salia Diarra Madani Ouologem drissa kanikomo Neurosurgery Department University Hospital of Mali Bamako Mali Radiology Department University Hospital of Mali Bamako Mali Anesthesiology Department University Hospital of Mali Bamako Mali Neurosurgery Department Hospital of Luxembourg Bamako Mali Unite of Neurology Infirmery of the Armies Bamako Mali Department of Neurosurgery Gabriel Touré Hospital Bamako Mali

Introduction: Rupture of intracranial aneurisms leads to severe morbidity and mortality. There are two modalities of treatment surgery and endovascular treatment. The diagnosis is made by angiography (DSA, CTA, RMA). The angiographic features used to assess the risk of the complications and choose the treatment modality are size, location and aneurism morphology. Materials and Methods: We reviewed and analyzed the computed tomographic angiography and magnetic resonance angiography of all patients admitted to the hospital of Mali with IAs from 2015 to 2021 either 7 years. Patients who were less than 18 years old, those with non-aneurysmal SAH, patients who request a discharge and those with an incomplete angiographic description of the IAs were excluded from the analysis. Results: We have collected 105 patients with 109 aneurysms. The sex ratio was 2/1 in favor of females. The mean age was 44.51 years with the range from 18 to 70 years. The presentation mode was subarachnoid hemorrhage (SAH) in 97% of cases. 76.19% had confirmed high blood pressure before the bleeding. 19.04% were diabetics. 98% of our patients have made a CT angiography and 2% have made MR angiography for the aneurysm diagnosis. 97.24% of aneurisms were located in the anterior part of the Willis circle. 39.44% of these aneurisms were the anterior communicating complex aneurysm. 27.52% of aneurysm had a small size, 42.20% had a medium size, 20.18% large size against 5.50% of the giant (Figure 3) and the middle cerebral artery was the most involved in the least. 95.41% of cases were saccular aneurysms against 4.59% fusiform. Conclusion: The angiographic feature of an intracranial aneurism in the Malian population may differ from other populations of the sub-region. The anterior communicating complex aneurysm is more common and the aneurism of the posterior part of the Willis circle is less common. We found the aneurism size ≥ 6 mm, ACA, MCA and Pcom more frequent.

关键词： Subarachnoid Hemorrhage Aneurism CT Angiography RMA

A Case Report of 3C Syndrome and Literature Review

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Case Reports in Clinical Medicine 2022年第1期11卷 8-12页

作者： drissa kanikomo Youssouf Sogoba Moussa Diallo Mamadou Salia Diarra Oumar Coulibaly Boubacar Sogoba Mahamadou Dama Mamady Coulibaly Mamadou Diallo Department of Neurosurgery Gabriel Touré Teaching Hospital Bamako Mali Department of Neurosurgery Luxembourg Hospital Bamako Mali Department of Neurosurgery H&ocirc pital du Mali Bamako Mali

Ritscher-Schinzel syndrome, or 3C (cranio-cerebello-cardiac) syndrome is a developmental disorder characterized by cranio-facial, cerebellar and cardiac anomalies. It is a rare disease with an incidence of 1/1,000,000 inhabitants, and was first described by Ritscher-Schinzel in 1987. 3C syndrome is an autosomal recessive disease caused by a mutation on the long arm of chromosome 8 to 8q24.13, the KIAA0196 locus, the strumpellin protein gene. The cardiac and cerebral anomalies are most often leading cause of death at an early age and people with 3C syndrome rarely exceed 40 years. In this paper, we report a case of Ritscher-Schinzel in 3-month-old boy who was admitted to our neurosurgical department in September 2020. Clinical examination revealed a macrocrania with head circumference at 47 cm. There was a prominence of forehead and occiput, the root of the nose which was flat, hypertelorism and micrognatism. The CT scan revealed Dandy WALKER malformation with cystic dilation of the 4th ventricle, an aplasia of the cerebellar vermis associated with a tretraventricular hydrocephalus.

关键词： Cardiac Anomalies Ritscher-Schinzel Syndrome 3C

Surgical Repair of Growing Skull Fracture: A Case Report

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Case Reports in Clinical Medicine 2022年第3期11卷 79-83页

作者： Youssouf Sogoba Seybou Hassane Diallo Moussa Diallo drissa kanikomo Boubacar Sogoba Oumar Coulibaly Mahamadou Dama Mamadou Salia Diarra Oumar Diallo Youssoufa Maiga Department of Neurosurgery Gabriel Touré Teaching Hospital Bamako Mali Department of Neurology Gabriel Touré Teaching Hospital Bamako Mali Department of Neurosurgery H&ocirc pital du Mali Bamako Mali Department of Neurosurgery H&ocirc pital Luxambourg Bamako Mali

Background: Growing skull fractures (GSF) are a rare complication of pediatric head trauma that comprises post-traumatic skull defect associated with an underlying dural tear and an intact arachnoid membrane. They are often misdiagnosed, and delay in management can lead to progression of the disease with neurological sequelae. GSF are rare and their incidence has been estimated as 0.05% - 1% of all pediatric skull fractures. This low incidence and the subtlety of its presentation often make diagnosis challenging with consequent delay in management. Surgery is recommended to treat GSF and involved dural repair with or without cranioplasty. In this paper, we report a case of a patient with GSF in whom the surgical repair was successful with good cosmetic and functional outcome. Case Report: A 12 months old girl was admitted to our neurosurgical department with right parietal swelling that had been gradually enlarging over 3 months. The history of the disease began when the girl was 1 month old with a fall with cranial impact resulting in head trauma with initial loss of consciousness. At presentation the girl was alert with normal consciousness. Clinical examination revealed the deformed skull with large pulsatile and painless swelling lesion in the right parietal region and hemiparesis on the left side. The CT scan revealed type 3 GSF including parietal bone diastasis with hypodense fluid collection that mimicked the leptomeningeal and porencephalic cyst. Surgical repair was performed. The post-operative course was uneventful and the child was discharged home five days after surgical intervention. Conclusion: GSF can lead to serious neurologic complications. Therefore educating parents on this potential outcome and close follow-up with clinical and imaging screening is recommended to screen children at risk for the development of the disease.

关键词： Growing Skull Fracture Head Trauma Dural Tear

Bilateral Chronic Subdural Hematoma after Endoscopic Third Ventriculostomy in a Child: A Case Report and Review of the Literature

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World Journal of Neuroscience 2018年第1期8卷 44-49页

作者： Oumar Coulibaly Oumar Diallo Mahamadou Dama Bourama Kané Feng Zhou Youssouf Sogoba drissa kanikomo Department of Neurosurgery Hopital du Mali U.S.T.T.B Bamako Mali Department of Pediatrics Hopital du Mali U.S.T.T.B Bamako Mali The First Affiliated Hospital of Medical School of Zhejiang University Zhejiang China Department of Neurosurgery Hopital Gabriel Touré U.S.T.T.B Bamako Mali

Hydrocephalus had been managed by ventriculoperitoneal shunt (VPS) or endoscopic third ventriculostomy (ETV) since several years. But these two different technics had some complications that must be managed promptly to avoid eventual fatal evolution. Chronic subdural hematomas after ETV is among these complications and is a very rarely situation observed in our department. This rare event associated with malaria in a child is considered to have a high mortality. Here we report a rare case of bilateral chronic subdural hematoma occurring in a 4-month-old boy after ETV and we discuss the likely pathogenesis and the difficulties of management.

关键词： Hydrocephalus ETV Chronic Subdural Hematoma Malaria

Traumatic Spinal Cord Injuries in Gold Miners in Mali: Preliminary Study on 76 Cases

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World Journal of Neuroscience 2019年第3期9卷 208-215页

作者： Oumar Coulibaly Mahamadou Dama Oumar Diallo Daouda Sissoko Boubacar Sogoba Singuepiré Alpha Youssouf Sogoba drissa kanikomo Hô pital du Mali Bamako Mali Hô pital Gabriel Touré University of Sciences Technics and Technologies of Bamako (USTTB) Bamako Mali

Introduction: Gold panning is the research and artisanal exploitation of gold in the auriferous areas (rivers or others). Traumatisms arising from these activities are due to severe spinal cord injury and generally affect young people in full activity. They constitute a real social handicap in Mali and even in Africa. The aim of our study is to share our expertise in the management of these vertebro-medullary traumasin these miners who currently escape to all controls in Mali. Material and Methods: From 2013 to 2016, 76 Traumatic Spine Cord Injuries (TSCI) were treated in the department of Neurosurgery of “Hôpital du Mali”. There were 73 males (96.05%) versus 03 Females (3.95%), aged between 21 - 43 years old. Results: All of our patients were admitted with deficit differing from paraparesis to tetraplegia. According to Frankel scale, we found 59 patients with complete deficits (A grade, 77.63%), and incomplete deficits in 17 cases (12 grade B, 04 grade C, 01 grade D). The X-ray standard radiographies were done in 24 cases (31.58%) from which 02 patients had been operated with these data. CT scan centered on the injured spinal segment was performed in 74 cases (97.37%). The lumbar spine was affected in 39 cases, followed by thoracolumbar junction in 19 cases and thoracic spine in 16 cases. The cervical spine was only interested in two cases. Fractures dislocations are the most frequently lesions encountered in our series. The surgical approach was performed in 74 patients and 02 patients received conservative treatment. Conclusion: Traumatic Spinal Cord Injuries (TSCI) among miners are a real disaster in Mali and continue to plague thousands of families or increase the number of disabled people in our society. It is the only work, where the person concerned is making of his own grave. And according to witnesses, several miners remained at the bottom of the wells. Their prevention must first involve users by raising the awareness of local residents and traditional therapists, but also the country that must p

关键词： Spinal Cord Injury Gold Mali

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

A Case Report of an Invasive Scalp Actinomycosis

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Case Reports in Clinical Medicine 2021年第2期10卷 34-38页

作者： Youssouf Sogoba Jean Paul Dembele Boubacar Sogoba Moussa Diallo Seybou Hassane Diallo Oumar Coulibaly Quenum Kisito Oumar Diallo drissa kanikomo Youssoufa Maiga Department of Neurosurgery H&ocirc pital Gabriel Touré Bamako Mali Department of Infectious Diseases H&ocirc pital du Point G Bamako Mali Department of Neurologie H&ocirc pital Gabriel Touré Bamako Mali Department of Neurosurgery H&ocirc pital du Mali Bamako Mali Department of Neurosurgery University Hospital of Parakou Parakou Benin

Background: Actinomycosis is a bacterial infection characterized by a chronic, suppurative and granulomatous process. The causative organism was identified in 1891 as Actinomycosis israelii. The disease is usually caused by the introduction of the bacteria through minor wound. Actinomycosis was classified by Cope into 3 different forms: cervicofacial (50%), pulmonothoracic (30%) and abdominopelvic (20%). Actinomycosis is an insidious disease but occasionally the clinical course can be more aggressive, involving underline tissue and organs. Involvement of scalp by actinomycosis is rare causing diagnostic dilemma and could be mistaken for different pathologies, such as tuberculosis or carcinoma. The most common clinical findings are local tumefaction with abscesses and sinuses draining pus that contains the granule of the causative organism. CT scan and MRI are aspecific for diagnosis, but they can help in defining the localization and the extension of the lesion. The certain diagnostic is based on cytology and/or biopsy. Case: A 24 year-old-man was admitted to our neurosurgical department with a 16-month history of multiple scalp ulcerated lesions and swelling of the head. He was complaining of headache. Physical examination revealed multiple scalp subcutaneous nodules and ulcerated lesions with swelling of the head. Our examination of the oral cavity revealed a poor oral hygiene condition with multiple caries. The CT scan revealed multiple scalp subcutaneous masses with chronic inflammatory changes of the skull. Routine laboratory test was normal. Surgical biopsy was performed and the histological result was compatible with actinomycosis. After histological confirmation, parenteral Penicillin 20 million units daily were given for 4 weeks. Clinical improvement was observed after completing a 4-week regimen of intravenous antibiotics. Conclusion: Involvement of scalp by actinomycosis could be mistaken for different pathologies, such as tuberculosis or carc

关键词： Actinomycosis Bacterial Infection Computed Tomography