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Cervical Myelopathy: Diagnostic Aspects, Surgical Treatment and Evolution of Patients Operated upon in Yaounde

Open Journal of Modern Neurosurgery 2024年第1期14卷 72-82页

作者： bello figuim Djoubairou Ben Ousmanou Oumarou Haman Nassourou Ndome Toto Orlande Amadou Tidjani Djientcheu Vincent de Paul Yaounde Central Hospital Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1 Yaounde Cameroon Yaounde Military Hospital Faculty of Medicine and Pharmaceutical Sciences of the University of Douala Douala Cameroon Douala General Hospital Faculty of Medicine and Pharmaceutical Sciences of the University of Douala Douala Cameroon Higher Institute of Health Sciences Université des Montagnes Bangangté Cameroon

Introduction: Although cervical myelopathy is the most common degenerative cervical spine pathology in adults, the indications and approaches of surgical treatment have not yet been clearly defined in the literature. Very few studies exist regarding these aspects in our setting, and they are mostly outdated. This study aimed to describe the diagnostic aspects, current surgical treatment with technical improvements, and progression in patients. Patients and Methods: We conducted a multicentre retrospective descriptive study over a 10-year period between January 2011 and January 2020 in three referral centres in Yaoundé. All patients who underwent surgery for cervical myelopathy were included. Results: Fifty-two patients were recruited. The rate of operated cervical myelopathies among all degenerative spinal pathologies was 14.05%. The M/F sex ratio was 3/1, and the average age was 52 ± 10 years. All included patients had gait problems, 90.38% demonstrated motor deficiency, and 67.30% experienced at least three levels of compression. Surgery was decided based on the Nurick grade;a posterior approach was applied to 86.54% of patients. Postoperative progression showed a neurological improvement of 82% with an average follow-up of 4 years. Conclusion: In this study, the patients who underwent surgery were relatively young, their clinical presentations were mostly advanced, and surgical management showed good results in well-selected cases.

关键词： Cervical Myelopathy Diagnosis Treatment Evolution Cameroon

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Current Epidemiology of Intracranial Metastases in Two University Teaching Reference Hospitals of the Town of Yaounde, Cameroon: Analysis of 35 Cases Recorded in the Neurosurgery Departments

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Open Journal of Modern Neurosurgery 2024年第2期14卷 124-136页

作者： Nassourou Oumarou Haman Ronaldo Fonju Anu Orlane Ndome Toto bello figuim Indira Baboke Marguerite Gwladys Nzedzou Vincent de Paul Djientcheu Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of Neurosurgery Yaounde General Hospital Yaounde Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Neurosurgery Douala General Hospital Douala Cameroon Department of Neurosurgery Garoua General Hospital Garoua Cameroon

Background: The incidence of intracranial metastases (ICMET) has been steadily rising, and its frequency with respect to primary brain tumours is relatively high. Objective: The objectives of this study were to elucidate the current epidemiology and describe the clinical, diagnostic and therapeutic features of ICMET in Yaounde. Method and findings: A descriptive cross-sectional study was done in the neurosurgery departments of the General and Central Hospitals of Yaounde during the period from January 2016 to December 2022. We included all medical booklets of patients admitted for a tumoral intracranial expansive process with our target population being patients with histological evidence of ICMET, and did a retrospective inclusion of data using a pre-established technical form aimed at collecting sociodemographic data, clinical data, paraclinical data, and the treatment procedures. Analysis was done using the SPSS statistical software. A total of 614 cases of intracranial tumors were included among whom 35 presented histological evidence of ICMET. This gives a frequency of 5.7%. The sex ratio was 0.94, the mean age was 55.68 +/- 14.4 years, extremes 28 and 86 years and the age range 50 - 59 was affected in 28.57% of cases. The clinical presentation included signs of raised intracranial pressure (headache, blurred vision, vomiting) in 26 cases (74.3%), motor deficit 48.6%, seizures 17.1%. The mode of onset was metachronous in 71.4% and synchronous in 28.6%. The imaging techniques were cerebral CT scan in 82.9%, cerebral MRI in 40%, TAP scan in 22.9%. The metastatic lesions were supratentorial in 94.3% and single in 62.9%. The primary cancers found were breast cancer (31.4%), lung cancer (25.7%), prostate cancer (17.1%), thyroid cancer (5.7%), colon cancer (2.9%), and melanoma (2.9%). The therapeutic modalities were total resection (68.6%), radiotherapy (37.1%). Conclusion: Intracranial metastases are relatively frequent. There is a female sex predominance and the ag

关键词： Intracranial Metastases Epidemiology Yaounde

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Metastatic Spinal Tumors: Diagnostic Methods, Management and Prognosis at the Yaounde Central Hospital and Yaounde General Hospital

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Open Journal of Modern Neurosurgery 2024年第2期14卷 158-169页

作者： Nassourou Oumarou Haman figuim.bello Orlane Ndome Toto Roland Ndouh Nchufor Nya Durand Bakop Ronaldo Foalou Anu Vincent de Paul Djientcheu Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Neurosurgery Department Yaounde General Hospital Yaounde Cameroon Cameroon Academy of Young Scientists Yaounde Cameroon Department of Neurosurgery Garoua General Hospital Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Neurosurgery Douala General Hospital Douala Cameroon Facuty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Metastatic spinal tumors (MST) refer to secondary involvement of the vertebral column by hematogenously-disseminated metastatic cells. They could affect either the bony structures or the spinal cords. Mechanical instability and neurologic deficits resulting from spinal cord compression are the most common manifestations. Surgical intervention remains the most effective treatment for about 20% of patients who present with spinal cord compression. The prognosis is relatively poor. This work has as objectives to describe: the diagnostic tools, the different modalities of management and the prognostic elements of spine metastasis. Methodology: We conducted an ambispective cross-sectional descriptive study;with retrospective data collection from January 2015 to December 2021 and prospective collection from January to April 2022 in the “Neurosurgery” unit of the Yaounde Central Hospital and the “Oncology and Neurosurgery” units of Yaounde General Hospital. Result: We included 101 patients. The M/F sex ratio was 1.66. The average age of the participants was 56.44 years (±14.19 SD) with a median of 58 years. Metastatic spinal tumors were discovered in 61.39% of patients with a previously known primary tumor and 21.78% of patients had newly discovered tumors. The neurologic examination revealed a vertebral syndrome in 79.21% of cases, radicular syndrome in 60.40% and sub-lesional syndrome in 59.89%. Sensory disorders accounted for 39.60% and sphincter disorders accounted for 34.65%. According to the degree of severity, the lesions were classified as Frankel E (37.62%) followed by Frankel D (21.78%). Metastatic lesions were mostly found at the thoracic vertebrae (68.25%) and lumbar vertebrae (22.22%). The most represented primary tumors were: prostate tumors (41.58%) and breast tumors (23.76%);followed by malignant hemopathies (15.84%). Computed-tomography scan (CT-scan) was the most frequent diagnostic imaging technique used (71.28%). Analgesic treatment mostly

关键词： Metastases Spinal Tumors Diagnosis Prognosis Spinal Cord Compression

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Prognostic Value of the Brain CT-Scan in Head Trauma in Yaounde Central Hospital

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Open Journal of Clinical Diagnostics 2023年第3期13卷 80-87页

作者： Freddy Mertens Bombah Ebogo Messina figuim.bello Doulanni Bouba Pierre Ongolo Zogo Department of Surgery and Specialty Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Oral and Maxillofcaila Surgery Faculty of Medicine Pharmacy and Odontology Cheikh Anta Diop University of Dakar Dakar Senegal Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon Department of Medical Imaging and Radiation Therapy Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon

Introduction: Cranial trauma is a serious medico-surgical pathology that hinders the vital and functional prognosis. The Rotterdam computed tomography (CT) score refined features of the Marshall score. This score was designed to categorize traumatic brain injury (TBI) type and severity in adults. The aim of our research was to evaluate the association between the Rotterdam CT scores of patients after a cranial traumatism in terms of survival. Material and methods: It was a cross-sectional and analytical study from January 2018 to March 2020, using medical records of patients suffering from cranial traumatism, received and taken in charge in the Yaounde central hospital. Results: 100 patients were retained out of 115 recruited patients. The average age was 35.20 with a sex ratio of 4.55. The Rotterdam score was between 1 and 5 with a median of 2. The overall mortality at 6 months and 1 year was 32%. With an equal score compared to European studies, we recorded significantly higher mortality. We found the sequelae in 24% of the patients. GOS ranged from 1 to 5, and survival without sequelae (GOS 1) was the most represented. There was a positive correlation between the Rotterdam score and the GOS with a Pearson correlation coefficient of +0.514. Conclusion: The death rate in Rotterdam score equals is greater in our context compared to European studies.

关键词： Cranial Traumatism Cerebral CT-Scan Prognosis Rotterdam Score

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Comparison of Transrectal Prostate Digital and Ultrasound-Guided Core Biopsies in 400 Men in a Low-and-Middle Income Country

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Open Journal of Urology 2023年第10期13卷 418-432页

作者： Junior Barthelemy Mekeme Mekeme Oriol Landry Mbouche figuim.bello Bright Che Awondo Aurele Achille Mbassi Cedrick Jean Fouda Tax Liendi Marcella Biyouma Guillaume Gayma Marcel Junior Yon Mekeme Junior Ngue Ngue Mabah Paul Adrien Atangana Pierre Ongolo Zogo Pierre Joseph Fouda Noel Coulibaly Angwafo III Fru Maurice Aurelien Sosso Faculty of Medecine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Department and Urology and Andrology Yaounde Central Hospital Yaounde Cameroon Higher Institute Medical Technology Yaounde Cameroun Anatomy and CytoPathology Laboratory “Centre Pasteur” Yaounde Cameroon Felix Houphouet Boigny University of Cocody Abidjan Ivory Coast

Background: The diagnosis of prostate cancer (PCa) relies on clinical assessment with digital rectal examination, serum PSA and histological examination. Limitations in our technical facilities, high financial cost of ultrasound-guided biopsy often prevent us from implementing the guidelines on the practice of prostate biopsy. Methods: We conducted a retrospective and cross-sectional descriptive study comparing digital-guided and ultrasound-guided transrectal prostate biopsy of 400 patients over a period of 12 years in the Yaounde Central Hospital. We reviewed files of patients who underwent digital and ultrasound guided biopsy procedures. Data was analyzed using EPI info 7.0. Parametric variables were reported as means and standard deviations and percentages and counts were used to report categorical variables. Results: Out of the 400 patients, 292 digital-guided transrectal biopsies (73%) and 108 ultrasound-guided transrectal biopsies (27%) were performed in patients who were suspected of having prostate cancer (PCa). Patients were aged between 39 to 90 years. Both procedures were effective in identifying prostate cancer. Gleason score between 2 to 10 detected prostate adenocarcinoma for 301 patients (75.2%). The complications included anal pain, rectal bleeding, hematuria and urinary tract infections, with an occurrence rate similar for both ultrasound-guided (2.25%) and digitally-guided techniques (2.5%). Seven patients (1.75%) required hospitalization for management of complications. The mortality rate was null. Conclusion: Both techniques are effective in detecting PCa with the similar complication rates. Digital-guided trans-rectal prostate biopsy still has its place in a resource-limited setting like ours.

关键词： Prostate Biopsy Digital Guided Ultrasound Guided Adenocarcinoma Gleason Score

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