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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

Surgical Treatment of Traumatic Brain Injuries of Children in Abidjan: Difficulties, Results and Prospects

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Open Journal of Modern Neurosurgery 2019年第3期9卷 369-378页

作者： Romuald Kouitcheu Moumouni Abd El Kader Christian Padonou Aicha Pape guy varlet Neurosurgery Department CHU YopougonAbidjanIvory Coast Departement of Neurosurgery CHU Sylvanus OlympioLomeTogo

Introduction: Traumatic brain injury (TBI) in children is a common cause of emergency department admission to our institution. TBI constitutes a real public health problem in developed countries and marked increase in underdeveloped countries. The aim of this study was to evaluate the results of neurosurgical treatment of TBI in children at the neurosurgery department of Yopougon Teaching Hospital, while underlining the difficulties of the adequate management of this affection in Abidjan. Patients and Methods: It was a retrospective, descriptive monocentric study performed in the neurosurgery department, of Yopougon Teaching Hospital-Abidjan (Ivory Coast) from January 2000 to December 2017. We included all patients less than 16 years old admitted to the emergency department and all admitted in neurosurgery department for a TBI with a cerebral tomodensitometry and/or a magnetic resonance imaging having undergone a neurosurgical treatment. Results: During the study period 2825 cases of TBI in children aged less than 16 years old admitted to pediatric emergencies of our institution;among them 1020 (36%) presented clinical abnormalities and/or imaging. 292 (10.34%) children were hospitalized in neurosurgery department. 108 (36.9%) had surgical treatment. The mean age of patients was 7.8 ± 0.80 years with a male predominance (64%). Of the 108 children who had been operated on, 41 had acute extra-dural hematoma evacuation, 22 had a cranio-cerebral wound healing, 36 had a lift from a fracture depressing the skull and 9 had an acute subdural hematoma evacuation with a decompressive flap. The mean delay between diagnosis and surgical care was 104 ± 67.25 hours. The postoperative evolution at the last follow-up was favorable in 96 (88.8%) children with sequelae in 12 children (6 language disorders, 2 epileptic seizures and 4 motor deficits). The postoperative mortality rate was 11.2%. Conclusion: Ivory Coast Health System does not provide optimal care management of patients w

关键词： Child Neurosurgery Traumatic Brain Injury Sub-Saharan Ivory Coast

Late Post-Traumatic Cerebrospinal Rhinorrhoea

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Open Journal of Modern Neurosurgery 2017年第3期7卷 103-111页

作者： Fulbert Kouakou Romuald Kouitcheu Alban Slim Mbende Dominique N’Dri Oka guy varlet Neurosurgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast

Cerebrospinal fluid (CSF) rhinorrhoea results from anatomical breach between the subarachnoid space and air sinus cavities of the skull base and traumatic CSF rhinorrhoea accounts for 80% - 90% of all cases of CSF leaks. We sought to report the case of a 16-year-old patient with a history of head injury following a fall from a tree, who developed a post-traumatic CSF rhinorrhoea after an onset of meningitis. The patient sustained a fall from a 6-meter tree in 2008, and was reviewed by our neurosurgical team in February 2016 for a 1-month history of progressive headaches associated with fever, asthenia and left CSF rhinorrhoea. Clinical examination revealed frank meningism and abundant CSF leak from the left nostril. CT scanning showed fractures of the left frontal bone and sinus wall associated with a massive pneumocephalus. The patient benefited from surgical repair of the tear and post-operative lumbar punctures at day 15. The patient’s guardian was informed that non-identifiable information from the case would be submitted for publication and he provided consent.

关键词： Post-Traumatic Cerebrospinal Rhinorrhoea Meningitis Surgical Repair

Surgical Treatment of Traumatic Brain Injuries of Children in Abidjan: Difficulties, Results and Prospects

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