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Management of Penetrating Cranioencephalic Trauma Caused by Sharp Metal Objects—Therapeutic and Evolutionary Aspects: 12 Cases at the Renaissance University Hospital in N’Djamena

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Open Journal of Modern Neurosurgery 2024年第2期14卷 170-178页

作者： Goumantar Félicien Toudjingar Li-Iyane Olivier Ouambi Yannick Canton Kessely Donal Djasdé Mahouli Fata Vounki momar codé ba Neurosurgery Unit of Center Hospitalier Universitaire la Renaissance N&#8217Djamena Chad Neurosurgery Unit of CHU la Ré f&#233rence Nationale N&#8217Djamena Chad Neurosurgery Department of Centre Hospitalier National Universitaire de Fann Dakar Senegal

Introduction: Cranioencephalic trauma caused by bladed weapons is rare, and that caused by sharp objects is exceptional. The aim of our study was to describe the clinical, therapeutic and evolutionary aspects. Materials and method: This was a descriptive and analytical study over a 48-month period at CHU la Renaissance from January 1, 2018 to December 31, 2021, concerning patients admitted for penetrating cranioencephalic trauma by pointed object. Results: Twelve cases, all male, of penetrating cranioencephalic sharp-force trauma were identified. The mean age was 34 ± 7 years, with extremes of 11 and 60 years. Farmers and herders accounted for 31% and 25% of cases respectively. The average admission time was 47 hours. Brawls were the circumstances of occurrence in 81.2% of cases. Knives (33%), arrows (25%) and iron bars (16.6%) were the objects used. Altered consciousness was present in 43.8% of cases, and focal deficit in 50%. Scannographic lesions were fracture and/or embarrhment (12 cases), intra-parenchymal haematomas (6 cases) and presence of object in place (4 cases). Surgery was performed in 11 patients. Postoperative outcome was favorable in 9 patients. After 12 months, 2 patients were declared unfit. Conclusion: Penetrating head injuries caused by sharp objects are common in Chad. Urgent surgery can prevent disabling after-effects.

关键词： Penetrating Trauma Skull Encephalon Sharp Object Surgery Patient Outcome

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Giant Cerebriform Nevus Cell Nevus of the Scalp: A Case Report

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Open Journal of Modern Neurosurgery 2024年第1期14卷 8-13页

作者： Mohamed El Hassimi Cissé N’daraw Ndoye Anne Aurore Sankale Pauline Diousse Abdoulaye Diop Alvine Nah Doe Sagar Diop momar codé ba Seydou Boubakar badiane Neurosurgery Department of CHU Mère-Enfant “Le Luxembourg” Bamako Mali Neurosurgery Department of CHNU de Fann Dakar Sénégal Plastic and Cosmetic Surgery Department of CHU Le Dantec Dakar Sénégal Dermatology Department of Thiès Regional Hospital Thiès Sénégal

Giant cerebriform nevus cell nevus of the scalp is an extremely rare form of congenital melanocytic nevus. Giant cerebriform nevus of the scalp has a major psychosocial impact because of its unsightly appearance with fetid maceration. We report the case of a 35-year-old woman who had a painless, malodorous swelling of the cerebriform scalp measuring 20 × 17 cm in diameter with a wide base of insertion at the occipital level adhering to the deep planes. The excision associated with a skin plasty was carried out. Histology concluded that there was a giant cerebriform naevo-cellular nevus of the scalp.

关键词： Giant Nevus Tumor of the Scalp Resection

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Management of Penetrating Cranioencephalic Trauma Caused by Sharp Metal Objects—Therapeutic and Evolutionary Aspects: 12 Cases at the Renaissance University Hospital in N’Djamena

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Open Journal of Modern Neurosurgery（现代神经外科学进展） 2024年第2期 170页

作者： Goumantar Félicien Toudjingar Li-Iyane Olivier Ouambi Yannick Canton Kessely Donal Djasdé Mahouli Fata Vounki momar codé ba

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Giant Cerebriform Nevus Cell Nevus of the Scalp: A Case Report

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Open Journal of Modern Neurosurgery（现代神经外科学进展） 2024年第1期

作者： Mohamed El Hassimi Cissé N’daraw Ndoye Anne Aurore Sankale Pauline Diousse Abdoulaye Diop Alvine Nah Doe Sagar Diop momar codé ba Seydou Boubakar badiane

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Thoracolumbar Spine Fracture-Dislocation without Neurological Deficit: A Case Report and Review of the Literature

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Open Journal of Orthopedics 2021年第5期11卷 153-163页

作者： Roger Mulumba Ilunga Abdoulaye Diop Mohameth Faye Vital Nacoulma Nicaise Akodjetin Mahougnon Sodjinou momar codé ba Department of Neurosurgery Regional Hospital Center of Thiès Thiès Senegal Department of Neurosurgery Regional Hospital of Ziguinchor Ziguinchor Senegal Department of Neurosurgery National Teaching Hospital of Fann Dakar Senegal

background: Thoracolumbar spine fracture-dislocations are very unstable and usually secondary to high energy trauma. Due to disruption of the entire vertebrae columns, the absence of neurological deficit is exceptiona... 详细信息

Background: Thoracolumbar spine fracture-dislocations are very unstable and usually secondary to high energy trauma. Due to disruption of the entire vertebrae columns, the absence of neurological deficit is exceptional. Aim: The purpose of this work is to report our experience in the management of this entity in a context of limited resources and to make a review of the literature. Case presentation: A 30-year-old man was admitted with a severe low back pain after a traffic accident. Neurological functions were intact after examination. Radiological assessments revealed a complete L3-L4 fracture-dislocation. The patient underwent an open posterior reduction and internal long segment fixation. The post-operative was marked by a surgical site infection treated with surgical debridement and targeted antibiotic therapy. The neurological functions were preserved. Conclusion: Fracture-dislocations of the thoracolumbar spine are caused by high energy trauma and are remarkably unstable lesions. When they are associated with intact neurorological functions, reduction and stabilization of these fractures are a challenge.

关键词： Spine Fracture-Dislocation Thoracolumbar Spine Spine Surgery Trauma

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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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From Fostering to Delusional Disorder of Filiation

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Open Journal of Psychiatry 2024年第4期14卷 283-286页

作者： momar Camara Wissem Masmoudi El Hadji Makhtar ba Sokhna Seck Maïmouna Dieye Aïda Sylla Department of Psychiatry and Medical Psychology Cheikh Anta Diop University Dakar Senegal Thiaroye National Psychiatric Hospital Center Dakar Senegal Fann National University Hospital Center Dakar Senegal Albert Royer Childrens Hospital Dakar Senegal

Introduction: Fostering is a widespread practice in West Africa. It played an essential role in the circulation of children. The failure of its community regulation, not compensated by a legal framework, has made its practice precarious. Observation: A case study was conducted on Dior, who was hospitalised in a psychiatric ward for a delusional disorder of filiation. Dior was entrusted to her maternal grandmother and aunt at ages 2 and 9. During these fosterings, the place of the symbolic father was not substituted, causing a void that challenged her imagination. The outcome was an inscription in a genealogy where she had found herself with prestigious parents. Discussion: Fostering has strongly disrupted the family dynamics in Dior’s case. One of her options was to assume the paternal function, the use of which was perceived as a defiance or even a transgression. This same function would be a starting point of a psychosis whose filial character would only be an attempt at rectification where reality and imagination collide. Conclusion: Our study reveals the importance of stable parental figures at stake in fostering contexts, which constitute a risk factor for the development of a subsequent psychosis.

关键词： Delusional Disorder of Filiation Psychopathology Interactions Fostering Family

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Results of the First 10 Cases of Coronary Bypass Surgery in Senegal

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World Journal of Cardiovascular Surgery 2024年第4期14卷 45-60页

作者： Papa Amath Diagne Jean Claude Ndiogou Dione Papa Ousmane ba momar Sokhna Diop El Hadji Boubacar ba momar Dioum Marième Soda Mbaye Moussa Seck Diop Mory Camara Abdou Lahad Mbengue Abdou Aziz Thiaw Abdoul Khoudoss Diallo Moussa Mareme Samba Dialtabé Ibrahima Guéssé ba Anta Mbaye Sall Papa Salmaneba Amadou Gabriel Ciss Department of Cardiovascular and Thoracic Surgery FANN National University Hospital Dakar Senegal

This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.

关键词： Coronary Bypass Surgery Coronary Lesions Cardiac Surgery Senegal

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Early Prosthetic Valve Endocarditis with Mycobacterium Tuberculosis after Mitral Valve Replacement: A Case Report

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World Journal of Cardiovascular Surgery 2024年第3期14卷 33-40页

作者： Papa Amath Diagne Mory Camara Papa Ousmane ba momar Sokhna Diop Moussa Samba Abdou Lahad Mbengue Jean Claude Ndiogou Dione Myriam Bizrane Marième Soda Mbaye Moussa Seck Diop Toudiani Malam Kaka Papa Salmane ba Papa Adama Dieng Amadou Gabriel Ciss Assane Ndiaye Cardiovascular and Thoracic Surgery Department FANN National University Hospital Dakar Senegal

background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mitral valve replacement, with a favorable clinical course following anti-tuberculosis treatment. Case Presentation: We report a 24-year-old male patient, admitted to the cardiac surgery department of the Fann Hospital (Dakar, Senegal), for the management of severe mixed (rheumatic and endocarditic) mitral insufficiency with associated tricuspid insufficiency. He had a history of recurrent angina and polyarthralgia in childhood, was hospitalized several times for refractory global cardiac decompensation, and for a suspected infective endocarditis a month before his admission. On admission, the clinical examination revealed signs suggestive of mitral and tricuspid insufficiency. Transthoracic echocardiography revealed severe post-endocarditic mitral insufficiency with A3 amputation, highly mobile 15 mm vegetations on the free edge of the large valve, moderate tricuspid insufficiency, and severe pulmonary artery hypertension. Mechanical mitral valve replacement and tricuspid valve annuloplasty using autologous pericardial strip were performed via median sternotomy. After ten days, the patient presented with global cardiac decompensation associated with a clinico-biological infectious syndrome, and tans-oesophageal echography revealed an abscess at the sinotubular junction, communicating with the aorta. A thoraco-abdomino-pelvic CT scan was done, which revealed a bilateral alveolar-interstitial syndrome with mediastinal lymphadenopathy. Anti-tuberculosis treatment with RHZE was initiated for 06 months. The clinical course was favorable. Conclusion: Tuberculous endocarditis in prostheses is a serious complication of heart valve replacement surgery, which may evolve favorably under medical treatment.

关键词： Tuberculous Endocarditis Prosthetic Valve Endocarditis Mycobacterium Tuberculosis

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Screening of Myocardial Cardiotoxicity Induced by Anticancer Chemotherapy and the Importance of Global Longitudinal Strain

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World Journal of Cardiovascular Diseases 2024年第6期14卷 381-391页

作者： Marguerite Téning Diouf Fatou Aw Hussein Khadra Sophie ba Doudou Diouf Michel Ngonar Sarr Joseph Salvador Mingou Malick Ndiaye Simon Antoine Sarr momar Dioum Aliou Alassane Ngaide Serigne Mor Beye Simon Manga Alain Affangla Youssou Diouf Khadimu Rassoul Diop Malick Bodian Mohamed Leye Mouhamadou bamba Ndiaye Alassane Mbaye Adama Kane Maboury Diao Abdoul Kane Cardiology Department of the Dalal Jamm Hospital Dakar Senegal Cardiology Department Hospital Aristide Le Dantec Dakar Senegal Cardiology Department Hospital Fann Dakar Senegal UFR2S Saint Louis Saint Louis Senegal UFR Ziguinchor Ziguinchor Senegal Training and Research in Health Sciences Unit University of Thies Thies Senegal Cardiology Department Hospital General Idrissa Pouye Dakar Senegal

Introduction: The improvement of survival in patients with cancer and the expansion of therapeutic options have led to the emergence of a new profile of cardiotoxicity, specifically associated with antimitotic agents. Our study aimed to assess the incidence of chemotherapy-induced myocardial toxicity in patients with cancer. Patients and Methods: We conducted a looking-forward longitudinal cohort study including all patients admitted to the Cardiology departments of Aristide le Dantec Hospital and Dalal Jamm National Hospital Centre for apre-chemotherapy check-up. The included patients did not undergo any pre-existing cardiopathy. Results: Over a period of two years ranging from January 2019 to December 2021, a total of 37 patients were included in the study. Notably, there was a female predominance (92%) with an average age of 49.7 years ± 13.69. Breast cancer accounted for 70% of the neoplasms. Laboratory findings revealed moderate anemia in 19 patients (51%). At inclusion, the left ventricle (LV) was of normal size (LV diastole at 44.46 ± 4.97 mm). The systolic function of the left ventricle was normal in all patients, with an average ejection fraction (EF) of 63.1% ± 5.80 and a mean global longitudinal strain (GLS) of −20.4% ± 2.58. The most commonly used agents were anthracyclines. During follow-up, 3 patients (8.1%) developed clinical symptoms of left heart failure, and LV dysfunction on echocardiography was observed in 5 (13.5%) patients, with a significant decrease in EF Conclusion: The incidence of cardiac toxicity is not negligible, hence the importance of early screening. Strain imaging is an essential tool that should be performed as part of the assessment before chemotherapy and re-evaluated during treatment.

关键词： Cancer Chemotherapy Global Longitudinal Strain Cardiotoxicity

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