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Surgical Treatment of Cervical Spine Trauma in Rural Area (Low Income Country): Our Experience and Results

Open Journal of Orthopedics 2022年第4期12卷 195-203页

作者： Daouda Wague Mouhamet Cisse Gaye maguette Ansoumane Donzo Yakhiya Cisse Mouhamet Faye maguette mbaye mbaye Thioub Neurosurgery at CHMFT Diourbel Senegal Neurosurgery at Fann Dakar Senegal Neurosurgery at HOGIP Dakar Senegal Neurosurgery at Fann Dakar Senegal Neurosuregery at CHR Thies Senegal Neurosurgery at HOGIP Dakar Senegal Neurosurgery at UCAD Dakar Senegal

Introduction: cervical spine trauma remains one of the most common causes of morbidity in the world with a significant financial burden on our society. It is a devastating event for the patient and family. The aim of this study is to share our experience in the surgery management of cervical spine injury in rural area. Methods: We did retrospective and single center study for one year from August 2020 to August 2021. We included all the patients who had undergone surgery for cervical spine injury in our hospital. Results: The study is based on 14 patients, 9 males and 5 females (sex ratio: 1.8). The average age was 34 years old and 08 (57%) were employed at time of injury. Road traffic accident was the most common cause, it was found in 11 (78%) cases followed by falls in 2 (14%) and interpersonal assault in 1 (7%). The Time admission ranged from 03 hours to 03 weeks. The most associated lesion was head trauma 7 (50%) followed by chest injury in 05 (35%) and 92% of our patient had motor deficit. Surgery was performed in all cases. Closed reduction was performed in 09 (64%) before surgery. Different types of complications that we had encountered were: infection 01 (07%) case, bed sores 02 (14%) cases, respiratory distress 02 (14%) cases and cervical kyphosis 01 (07%) case. After 06 months 71% of patients have progressed well with partial or complete recovery of their deficit. 14% of death in our series were noted and 28% of patients returned to work. Conclusion: cervical spine trauma remains a heavy socio-professional handicap. In rural areas, despite the lack of equipment and the difficulties of care, our results are satisfactory. However, it is necessary to insist on psychotherapy for these patients.

关键词： Cervical Spine Morbidity Trauma Surgery

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Vertebroplasty and Kyphoplasty: Indications and Results, a Preliminary Senegalese Experience from the Neurosurgery Department of the CHNU of Fann

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Open Journal of Modern Neurosurgery 2023年第4期13卷 156-165页

作者： El Hadj cheikh Ndiaye Sy Celebre Mualaba Amidou Adjamou maguette mbaye mbaye Thioub Momar Code Ba Neurosurgical Clinic CHNU Fann Dakar Senegal

Introduction: Vertebroplasty and kyphoplasty are percutaneous techniques that consist in injecting an acrylic cement into the body of a pathological vertebra. This work aims to report the experience the of Fann’s neurosurgery department in treating certain spinal pathologies by vertebroplasty and kyphoplasty. Methods: During a 3-year period from July 1, 2019 to July 31, 2022, we conducted a retrospective, descriptive and analytical study, including patients who underwent vertebroplasty or kyphoplasty for dorsolumbar spinal pathology. Results: The mean age of the 13 patients in our study was 51.61 years. Female gender was predominant in 62% (n = 8). The context of spontaneous onset was found in six patients. Nine patients had a VAS (visual analogue scale) ≥ 8 (69.23%). On clinical examination, all patients had a syndrome without neurological deficits. 84.61% of patients had a CT scan (n = 11). The dorsolumbar hinge was most affected with 53.85% of cases. Seven patients had a vertebral compression of between 25% and. The average degree of kyphosis was 8˚ and seven patients had a degree of kyphosis ≥ 10˚. Tumour aetiology accounted for 46.15% of cases. Kyphoplasty was performed in 61.53% (n = 9) of the cases and vertebroplasty was performed in 38.47% (n = 4) of the patients. Kyphoplasty was associated with biopsy in two cases and with osteosynthesis in one patient. Vertebroplasty was always associated with a biopsy. The evolution was favourable with a significant reduction in pain and vertebral kyphosis. The mean VAS decreased from 8.15 to 0.69 three months after treatment and the mean kyphosis decreased from 8˚ to 2˚. Conclusion: Kyphoplasty and vertebroplasty as percutaneous techniques allow consolidation of the vertebral body and pain relief. Kyphoplasty alone not only reduces pain but also restores the height of the compacted vertebral body.

关键词： Vertebroplasty and Kyphoplasty Indications and Results Preliminary Senegalese Experience

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Acute Paraplegia Due to <i>Salmonella brandenburg</i>Spondylodiscitis: Case Report

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Open Journal of Modern Neurosurgery 2019年第3期9卷 327-337页

作者： Claudiu Popa maguette mbaye mbaye Thioub Tanguy Riem Benjamin Daumas-Duport Nathalie Asseray Roger Robert Department of Neurosurgery CHU Saint Etienne Saint Etienne France Department of Neurosurgery CHNU Fann Dakar Sénégal Department of Neurosurgery CHU Nantes Nantes France Department of Neuroradiology CHU Nantes Nantes France Department of Infectious Diseases CHU Nantes Nantes France

The authors present the case of a 48-year-old man admitted for acute onset of paraplegia in a patient suffering from backaches for 1 week. The rapidly progressive motor disturbances had been evolving for approximately 12 hours. The entire spinal MRI showed an epidural mass at T4-T6 associated with extensive lesions of spondylodiscitis and a T7-T8 vertebral body loss of height. A large six-level laminectomy was performed. A tumoral etiology couldn’t be entirely excluded intraoperatively so that no fusion has been done at that time. The pathological exam revealed acute inflammatory lesions with no argument in favor of a tumoral process. Bacteriological exam of the pathological specimen and stools cultures were positive for Salmonella brandenburg. An episode of gastroenteritis after the ingestion of a pizza has been evoked. The antibiotic medication was prescribed for 12 weeks. Postoperative evolution was favorable with a possible march between bars 6 weeks after. The authors emphasize the pseudo-tumoral presentation in an immunocompetent patient, the lack of complications and the post-ingestion mechanism.

关键词： Spondylodiscitis Spinal Epidural Abscess Paraplegia Salmonella brandenburg Post-Ingestion Immunocompetent

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The Outcome of Endoscopic Third Ventriculostomy in a Mixed Population of Adult and Pediatric Patients

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Open Journal of Modern Neurosurgery 2020年第3期10卷 325-333页

作者： maguette mbaye Lebrun Gahito Alioune Badara Thiam mbaye Thioub Elcheikh Ndiaye Sy Mohameth Faye Sagar Diop Moustapha Ndongo Ndaraw Ndoye Momar Code Ba Seydou Boubakar Badiane Neurosurgical Department of Fann Teaching Hospital Cheikh Anta Diop University Dakar Senegal

Background: Endoscopic third ventriculocisternostomy (ETV) is the most common neuroendoscopic technique in the treatment of noncommunicating hydrocephalus. Since its introduction, ETV has been a safe alternative to ventriculoperitoneal shunt (VP shunt), which has a high complication rate with significant socio-economic consequences. The authors report the results of ETV performed in the neurosurgical department of FANN teaching hospital in Dakar. Methods: This retrospective study presents the results of ETV performed in 513 patients with hydrocephalus of various etiologies, ranging from February 2010 to February 2018. We have included in our series from 2010 to 2016, all patients with clinically revealed non-communicating hydrocephalus followed by a brain computed tomography (CT) scan or brain magnetic resonance imaging (MRI) and who have benefited from an ETV, in which the ETV Success Score was evaluated. Results: The mean age of our patients was 14.10 years, with 298 (58%) males. The clinical symptomatology varied in both children and adults and manifested in children as macrocrania in 67.8% of the patients, while in adults, it manifested as raised intracranial pressure (ICP) in 87.5% of patients. A brain CT scan was performed in 461 (89.86%) of patients. The causes of hydrocephalus were dominated in 49% of patients by malformative pathologies, followed by tumors in 41% of patients, infections in 2.33% of patients, and normal-pressure hydrocephalus in 3.8% of patients. During the postoperative period, we found 21.41% of various complications. Conclusions: The findings in our series were compared to those in the literature and were satisfactory, thus proving the effectiveness and safety of ventriculocisternostomy in our department. In resource-limited countries, ETV can be performed with good results and less mortality and morbidity.

关键词： Endoscopic Third Ventriculostomy Hydrocephalus Minimally Invasive Neurosurgery

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Brain Metastases: Epidemiological, Clinical, Diagnosis, Treatment and Outcome Features in Dakar

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Open Journal of Modern Neurosurgery 2019年第4期9卷 410-418页

作者： Alioune Badara Thiam maguette mbaye mbaye Thioub Rel Gerald Boukaka Kala El Hadji Cheikh Ndiaye Sy Mohameth Faye Kafia Doualeh Ali Momar Codé Ba Seydou Boubakar Badiane Neurosurgery Department Fann Teaching Hospital Dakar Senegal

Brain metastases (BM) are the most frequent brain cancer. There are few studies on BM in Senegal. The aim of this study was to describe epidemiological, clinical, diagnosis, treatment and outcome features of patients diagnosed with BM. We conducted a retrospective and descriptive study of patients diagnosed with brain tumors and regularly followed at the neurosurgery department of the “Fann Teaching Hospital (CHNU-Fann)” of Dakar (Senegal) between from January 2010 to December 2017. The medical records of all the patients with evidence histologically diagnosed with BM were reviewed. In our study, 682 medical records of patients with brain tumors were reviewed, and only 20 showed histological evidence of BM (2.9%). The mean age was 45.45 years. The sex-ratio was 0.43. Brain CT scan was performed in all the patients (100%) and brain MRI in 3 patients. The brain lesions were multiple in 70% of the patients and single in 30%. The histological type of BM was adenocarcinoma (55%) and squamous cell carcinoma (45%). Five types of primary cancers were found: lung cancer (50%), breast cancer (30%), colorectal cancer (10%), melanoma (5%) and one undetermined cancer. All the patients had extirpation surgery;50% of the patients died 7 days after the surgery;25% had a survival of 3 months after the surgery and 25% of the patients were lost of sight. Conclusion: The improvement of the screening and diagnosis tests, and the use of the radiation treatment and chemotherapy could allow early management and decrease the death’s frequency of the patients with BM in Senegal.

关键词： Brain Metastases Surgical Extirpation Dakar

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The Practice of Neurosurgery in Edward Francis Small Teaching Hospital of Banjul, the Gambia

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Journal of Health Science 2018年第1期6卷 11-23页

作者： John Nute Jabang Alioune B. Thiam Papa I. Ndiaye maguette Gaye-Sakho mbaye Thioub maguette mbaye Charles A. Roberts Ousman Sanyang Alhagie Manneh Chemo S. Jallow Abdoulie Bah Baboucarr Sowe Baboucarr Daffeh Ammandou Correa Ousman Nyan Ulric Jones Ahmadou Samateh Seydou B.Badiane Youssoupha Sakho Edward Francis Small Teaching Hospital Independence Drive Banju11515 the Gambia Centre Hospitalier Universitaire de Fann Cheikh Anta Diop Avanue Dakar 5035 Senegal Hopital General de Grand Yoff Dakar Grand Yoff-Dakar 3270 Senegal

The management of neurosurgical pathologies has become a priority in our regions. Over the years the number of patients consulting in neurosurgical clinics continues to rise. Publications and studies of neurosurgical activities are rare in sub-Saharan Africa and almost inexistent in the Gambia in particular hence the impetus for this study： The Practice of Neurosurgery in EFSTH （Edward Francis Small Teaching Hospital） of Banjul, the Gambia. The objective of this study was to report on all the neurosurgical activities of the Neurosurgery unit of EFSTH of Banjul over an 18-month period. A retrospective study of all the neurosurgical activities of the EFSTH over a period of 18-month was carried out. Data were obtained from the medical records of the hospital categorized according to age groups. Consultation, admission, surgery, morbidity and mortality were evaluated. We included all patients managed in the Neurosurgery unit and excluded patients with insufficient data or missing folders. The Neurosurgery unit had a total of 2,038 patients giving an average of 113 patients seen per month of whom 399 （19.57%） were hospitalized and 127 （6.23%） benefitted from neurosurgical intervention. Morbidities and mortalities of 19 and 47 are respectively. Pediatric population with ages ranging from 0-9 years dominated in our admissions. Male： Female ratio was 2：1. The clinical features in our studies varied according to the diverse pathologies encountered in the study. Imaging was dominated by CT scan 168 cases （61%）, X-Rays 102 cases （37%）. Pathologies seen in the Outpatient consultations were mainly degenerative pathology 938 （46%）, Trauma 391 （21%）, Hydrocephalus and other CNS （Central nervous system） Malformations 325 （16%）. Hospitalizations were mostly dominated by Trauma 300 （75.18%）, Hydrocephalus and other CNS Malformations 41 （9.77%）, degenerative disease 26 （6.52%）. Neurosurgical interventions were mainly trauma 47 （37%）, Hydrocephalus and other CNS Malformations 39 （31%）,

关键词： Traumatic degenerative CNS malformation hydrocephalus.

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Profile of Pituitary Adenomas in Senegal: Epidemiological, Clinical and Therapeutic Aspects about 241 Collected Cases

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Open Journal of Internal Medicine 2023年第3期13卷 144-154页

作者： Diédhiou Demba Diallo Ibrahima Mané mbaye maguette Sow Djiby Ndiaye Fama Mody Ndour Michel Assane Dieng Mouhamed Gadji Fatou Kiné Thioye Elhadj Mamadou Halim Charles Ndao Cheikh Matar Ndiaye Boun Khatab Diouf Sarr Anna Ndour mbaye Maimouna Medical Clinic II AbassNdao Hospital Center Cheikh Anta Diop University Dakar Senegal Department of Neurosurgery Fann Hospital Center Cheikh Anta Diop University Dakar Senegal

Introduction: in adults, adenomas are the most frequent causes of pituitary tumours. The objective was to characterize its epidemiological and clinical aspects, as well as its therapeutic modalities in Senegal. Methodology: this was a multicenter, retrospective, descriptive and analytical study carried out from the Senegalese register of pituitary adenomas (2008-2022). Results: 242 patients were collected with an average age of 42.4 ± 13 years and a sex ratio (M/F) of 0.91. The mean consultation time was 19.7 ± 23 months. The circumstances of discovery were pituitary apoplexy (11 cases, 4.54%), tumor syndrome (176 cases, 72.72%), gonadal manifestations (103 cases, 42.56%), dysmorphic syndrome (21 cases, 8.68%), hypercorticism (15 cases, 6.19%). Morphologically, it was a macroadenoma (197 cases, 81.40%), an extensive adenoma (22 cases, 9.10%). The hormonal profile was lactotropic hypersecretion (80 cases, 33.05%), somatotropic (13 cases, 5.39%), corticotropic (14 cases, 5.78%), mixed (9 cases, 3.71%). The factors significantly associated with prolactinoma were young age (p = 0.000), female sex (p = 0.000), long consultation delay (p = 0.000) and microadenoma (p = 0.001). Only arterial hypertension was associated with acromegaly (p = 0.000). We found a significant correlation between Cushing’s disease and microadenomas (p = 0.000). Non-secreting adenomas were significantly associated with advanced age (p = 0.000), long delay in consultation (p = 0.000), male gender (p = 0.000), tumor syndrome (p = 0.001) and macroadenomas (p = 0.000). Pituitary surgery was effective in 173 patients (71.49%) including 166 cases (68.59%) by transphenoidal approach. Postoperative incidents were transient diabetes insipidus in 82 cases (47.39%), cerebrospinal fluid leak (20 cases, 11.56%). Death was observed in 18 patients in the entire series (7.44%). The latter had a tumor syndrome (88.88%), a macroadenoma (83.33%) and had undergone pituitary surgery (72.22%). Conclusion: pituitary path

关键词： Pituitary Adenoma Prognosis Management Senegal

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Characteristics, Management, and Outcomes of Tetanus Cases in a Referral Center in Senegal, between 2010 and 2017

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Advances in Infectious Diseases 2023年第3期13卷 375-388页

作者： Daouda Thioub Ndeye Aissatou Lakhe Khardiata Diallo mbaye Papa Latyr Junior Diouf Catherine Sarr Ndeye Amy Sarr Aboubakar Sidikh Badiane Mamadou Seck Ndeye maguette Fall Viviane Marie Pierre Cisse-Diallo Daye Ka Moussa Seydi Louise Fortes Department of Infectious and Tropical Diseases Fann National University Hospital Dakar Senegal Department of Infectious and Tropical Diseases Dalal Jamm National Hospital Guediawaye Senegal

Tetanus is an infection caused by Clostridium tetani. The disease has been described from the earliest medical literature. Despite this old knowledge, the existence of a vaccine, and the progress made in pathophysiology and treatment, tetanus remains a real public health problem, particularly in developing countries. Tetanus in children and adults is still a frequent cause of hospitalization in the Infectious and Tropical Diseases Department (SMIT) of the Fann National University Hospital (CHNU). We conducted this study with the main objective of carrying out a situational analysis of tetanus at SMIT from 2010 to 2017. We recorded 706 cases of tetanus in a total of 8123 hospitalized patients. The median age of the patients was 23 years [1 - 90 years]. The sex ratio (M/F) was 4/1. More than half (58.78%) came from suburban areas. The population was most frequently made up of students (24%) or manual workers (22.1%). At least one comorbidity was present in 107 patients (15.15%). The absence of a vaccination record was found in 99.56%. The main portal of entry was integumentary (83.3%), post-circumcision (5.7%) and otogenous (4%). Tetanus was generalized in 93.9% of cases. The main signs of tetanus found were trismus and dysphagia. Patients were most frequently classified as stage II (78.7%). Antibiotic therapy was based on metronidazole (51.41%). Anti-tetanus serotherapy was carried out by sub-occipital administration in 97.6%. Tracheostomy was performed in 48 patients. Complications occurred in 226 patients (32.01%). The main complications were respiratory (53.98%), infectious (45.13%) and cardiovascular (41.59%). The average delay in hospitalization was 3.6 ± 3.4 days. The mean length of hospital stay was 11.9 ± 8.2 days. The hospital case-lethality rate was 18.98%. Despite the decline in cases over the years in our country, tetanus remains a public health problem because of its prevalence, severity, and lethality.

关键词： Tetanus Management Outcomes Senegal

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Neuro-meningeal Tuberculosis in Adult Senegalese Patients: Profile and Outcome of Cases Diagnosed at a Referral Service, from 2015 to 2020

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Case Reports in Clinical Medicine 2023年第8期12卷 270-278页

作者： Daouda Thioub Viviane Marie Pierre Cisse-Diallo Papa Latyr Junior Diouf Ndeye Aissatou Lakhe Agbogbenkou TeviDéla-dem Lawson Aboubakar Sidikh Badiane Ndeye maguette Fall Khardiata Diallo-mbaye Daye Ka Sylvie Audrey Diop Moussa Seydi Infectious and Tropical Diseases Department of Fann National University Hospital Dakar Senegal Health Sciences Training and Research Unit Iba Der Thiam University Thiès Senegal

Background: Among patients treated for tuberculosis, 2% to 5% have a Central Nervous System (CNS) lesion, and its frequency rises to 10% in HIV-infected patients. Neuro-meningeal tuberculosis (NMT) is responsible for death and severe permanent neurological damage. This poor prognosis requires early diagnosis and rapid initiation of specific treatment. Unfortunately, the great clinical polymorphism and the lack of specificity of radiological and biological signs are frequently responsible for a delay in diagnosis and management. Senegal is one of the African countries where tuberculosis has remained a concern until now. And there are no studies carried out on this subject. Objective: The objective of this study was to describe the profile and outcome of Neuro-meningeal tuberculosis (NMT) cases diagnosed at the infectious diseases department (SMIT) of Fann University Hospital in Dakar, (referral service for management of tuberculosis). Methods: We carried out a retrospective, descriptive and analytical study, reviewing medical records of adults diagnosed with NMT at the SMIT of Fann Hospital from January 2015 to December 2020. Results: We collected 55 cases of NMT. The median age was 38 years [range 16 - 77 years]. The sex ratio (M/F) was 3.23. HIV patients represented 41.82% of cases. A history of tuberculosis was found in 25.5% of cases. The delay in consultation was greater than one month in 60% of patients. Headaches were the most constant reason for consultation (94.55%). Meningeal signs were present in 94.55% of patients, and consciousness disorders and intracranial hypertension were present in 63.64% and 56.36% respectively. Nerve palsy was found in 38.18%. CSF was clear in 81.64%. GeneXpert MTB/RIF in CSF was performed in 33 patients and was positive in 4 patients. Brain CT was abnormal in 72.09% of cases. Tuberculoma, hydrocephalus and meningeal contrast enhancement were the main lesions. The neuro-meningeal localization was associated with a pulmonary form i

关键词： Neuro-meningeal Outcome Profile Senegal Tuberculosis

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Factors Associated with Death among Tuberculosis Patients in Dakar

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Advances in Infectious Diseases 2021年第2期11卷 122-139页

作者： Moustapha Diop Papa Samba Ba Jean Augustin Diegane Tine Ndèye maguette Fall Tracie Youbong Mouhamadou Ndiaye Ndèye Mouminatou mbaye Mouhamed Bouye Nestor Diatta Alassane Sarr Sokhna Walo Ndiaye Ibrahima Cisse Louise Fortes Degenonvo Abdourahmane Niang Adama Faye Moussa Seydi Department of Infectious and Tropical Diseases Dakar Principal Hospital Dakar Senegal Health and Development Institute Cheikh Anta Diop University of Dakar Dakar Senegal Department of Infectious and Tropical Diseases FANN Teaching Hospital Dakar Senegal Department of Pulmonology Dakar Principal Hospital Dakar Senegal Faculty of Medicine and Odontology Cheikh Anta Diop University of Dakar Dakar Senegal Private Institute for Training and Research in Medicine Dakar Senegal

Introduction-Objective: Tuberculosis (TB) is the leading cause of death from a single infectious agent worldwide. The predictors of mortality due to TB are rarely evaluated in Senegal. The aim of our study was to identify factors associated with related TB death in two treatment centers in Dakar, Senegal. Method: We conducted a prospective descriptive-analytical study dealing with TB patients followed in the Department of Infectious and Tropical Diseases at FANN Teaching Hospital and Dakar Principal Hospital and in the Department of Pulmonology at Dakar Principal Hospital from March 1st, 2019 to February 29th, 2020. Univariate and multivariate logistic regressions were performed to identify the associated factors of death. Results: Two hundred eighty-two patients in the Department of Infectious and Tropical Diseases at FANN teaching hospital (57%), in the Department of Infectious and Tropical Diseases at Dakar Principal Hospital (31%), and in the Department of Pulmonology at Dakar Principal Hospital (12%) were included in the study. The mean age was 39 ± 16 years and the male to female ratio was 2.2. Isolated pulmonary TB, isolated extrapulmonary TB, and both pulmonary and extrapulmonary TB were present in 33.3%, 30.5% and 36.2% of cases, respectively. Twenty-two patients died, corresponding to a mortality rate of 7.8%. Factors independently associated with death were age ≥ 60 years (26.2 [3.6 - 191.2]) compared to 16 - 40 years’ age group, HIV infection (7.2 [1.4 - 36.9]), neurological localization of TB (13.19 [3.2 - 54.3]), and hemoglobin level Conclusion: Tuberculosis remains a fatal disease despite therapeutic advances. Better knowledge of associated factors of death from TB may help to reduce its mortality.

关键词： Tuberculosis Death Associated Factors Dakar

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