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Short, Medium, and Long-Term Stroke Mortality in Libreville and Associated Factors

Neuroscience & Medicine 2024年第1期15卷 39-50页

作者： Grass Aurelle Mambila Matsalou jennifer Nyangui mapaga Pupchen M. Gnigone Minka’a Pagbe Michael Chermine Mboumba Mboumba Christian Allognon Mahutondji Aissata Ibrahima Camara Annick A. Nsounda Nelly Diouf Mbourou Michel-Arnaud Saphou-Damon Elsa Ayo Bivigou Philomene Kouna Ndouongo Neurology Department University Hospital of Libreville Libreville Gabon Cardiology Department University Hospitalof Libreville Libreville Gabon

Strokes are common around the world and especially in sub-Saharan Africa. They are responsible for severe sequelae and the majority of deaths. In Gabon, no study on stroke mortality has been conducted. Objective: To determine short, medium, long-term mortality and factors associated with long-term stroke mortality. Method: Our study took place in the Neurology Department of the University Hospital Center of Libreville (UHCL). It was a historical cohort study with descriptive and analytical purposes covering the period from June 1 to August 31, 2018 and taking into account hospitalized patients from January 1, 2013 to December 31, 2017. We conducted a comprehensive systematic recruitment of patients with stroke, 18 years old and more, and had been agreed to give information. We included all patients meeting the inclusion criteria. The data was gathered using Epi-Info 7 software. The CHI-2 test was used for the comparison of frequencies and the Student’s test, for comparison of means. Multivariate analysis with logistic regression allowed us to look for factors associated with long-term mortality. A result was statistically significant for a p 0.05 value. Results: At 3 months, 28 patients (18.1%) died, at 6 months thirty-one patients or 20.1% died. At 5 years old, fifty-three patients or 34.4% had died. The factors associated with long-term mortality, if the lost of sight were all alive were tobacco (p = 0.01) and stroke (p = 0.008). If all those who were lost to sight had died, no factor was associated with 5-year mortality. Conclusion: Stroke mortality must not be taken for granted, it can be underestimated because of the large number of lost sight. Measures must be put in place to strengthen post-stroke monitoring. .

关键词： Stroke Mortality Associated Factors Libreville

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Post-Stroke Epilepsy within a Teaching Hospital in Cotonou, Benin

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Neuroscience & Medicine 2017年第4期8卷 47-52页

作者： Dieu Donné Gnonlonfoun Constant Adjien Mendinatou Agbetou Thierry Adoukonou jennifer mapaga Gérard Goudjinou Dismand Houinato Department of Neurology National University Hospital Centre Cotonou Bénin Department of Neurology National University Hospital Centre Parakou Bénin

Seizures occurring after stroke are risk factors for the onset of ensuing epilepsy. However, the incidence of vascular epilepsy is low. The purpose of this study was to study vascular epilepsy features in a teaching university. It was a retrospective, descriptive and analytical study, conducted from 1st January 2015 to 31st December 2016 in Cotonou Teaching Hospital (CNHU-HKM), Benin. It involved 35 patients brought together through comprehensive sampling. Vascular epilepsy hospital attendance rate was 2%. There were simple partial seizures in 74.28% of cases while cerebral ischemia was recorded in 44.44% of patients. Neurological consultation after stroke occurrence was a protective factor against the occurrence of vascular epilepsy with significant p at 0.001.

关键词： Post-Stroke Epilepsy Vascular Epilepsy Cotonou Benin

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The Short-Term and Medium-Term Prognosis of a Stroke and the Factors of Poor Prognosis in Liberville

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Neuroscience & Medicine 2022年第4期13卷 135-144页

作者： Nyangui mapaga jennifer Gningone Pupchen Marylise Mambila Grass Aurelle Diouf Mbourou Nelly Saphou-Damon Michel-Arnaud Nsounda Annick Andréa Camara Aissata Ibrahima Kouna Ndouongo Philomène Department of Neurology Centre Hospitalier Universitaire Libreville Libreville Gabon

Objectives: was to determine the factors influencing stroke prognosis in Libreville. Methods: This was a multicenter study prospective with a descriptive and analytical focus carried out from March 1st to July 31, 2014. Recruitment was systematic and exhaustive. The data collected was processed and analyzed using Epi-Info 3.3.5 software. Results: This study involved 66 patients including 27 male (40.9%) and 39 female (59.1%). Mean age was 55.1 +/? 15.3 years, mostly female. There were 57.5% ischemic stroke, 42.5% hemorrhagic stroke. The mean NIHSS was 7.8 +/? 6.6 at admission. Intra- hospital stroke mortality rates at 1 and 3 months were 7.6% and 9.1% respectively, ranging from 18.2% to 31.8%. The following factors were identified as associated with death at 1 month: age, high NIHSS at admission, high blood pressure, leukocytosis, hyperthermia and delay in admission. As for functional outcome, patients were relatively autonomous at discharge and factors associated with poor functional outcome (Rankin Conclusion: This study highlights many factors influencing prognosis of stroke. The poor prognostic factors were age, high NIHSS at admission, high blood pressure, hyperthermia, blood glucose, leukocytosis, delay in admission and length of hospital stay. Addressing these factors in the acute phase management strategies may improve the prognosis of stroke patients in Gabon.

关键词： Prognosis Stroke Libreville

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High-Field MRI Contribution in Tolosa-Hunt Syndrome (THS). Report of Two Cases and Review of Literature

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Open Journal of Radiology 2018年第3期8卷 141-149页

作者： Chérif Mohamadou Aidara Philomène Kouna jennifer Nyangui mapaga Nfally Badji Hamidou Deme Abdoulaye Dione Diop Abdoulaye Ndoye Diop Sokhna Ba El Hadj Niang Radiology Department Fann University Hospital Dakar Sénégal Neurology Department El Rapha Polyclinic Trois Quartiers BP 256 Libreville Gabon

Background: Tolosa Hunt Syndrome is an inflammatory condition of unknown etiology of the cavernous sinus and superior orbital fissure. Because of the difficulty in establishing histological evidence, his diagnosis is based on a set of arguments established by the International Headache Society. MRI allows indirect visualization of the granuloma and plays a key role in diagnosis and follow-up. Aim: To illustrate High-field MRI contribution in Tolosa-Hunt Syndrome (THS). Cases Presentation: Two patients, a 25-year-old female and a 40-year-old male were recruited in this retrospective case report study at the Radiology service of Fann University Hospital (Dakar Senegal). The first patient has been suffering from a right retro-orbital pain and diplopia for 2 months and the second from a painful oculomotor nerve palsy for 3 months. Blood tests, lumbar puncture, thyroid hormone levels and an infectious screen were done. Screening for converting enzymes, and serum antibodies were also done. They underwent a high field MRI (Siemens 1.5T) with T1, T2, FLAIR, T2*, diffusion B1000, TOF polygon, CISS 3D and T1 gadolinium sequences in the 3 planes space. No significant abnormality was detected in blood tests or CSF analysis. Screening for converting enzymes and serum antibodies screen were also negative. For each patient, MRI examinations showed a non tumoral thickening of the right cavernous sinus, suggesting a granulomatous involvement. Tolosa Hunt Syndrome was evoked firstly. They were put on corticotherapy at high doses with a spectacular regression of symptoms. The Criteria of the International Headache Society of THS were met in both patients. Conclusion: High-field MRI is a significant diagnostic tool in the assessment of painful ophthalmoplegia. It allows a direct visualization of the granuloma of the cavernous sinus and assesses its course throughout the disease.

关键词： Painful Ophthalmoplegia Tolosa-Hunt Syndrome Criterias of International Headache Society High-Field MRI

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