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Cervical Spondylodiscitis Revealed by Tracheostomy Infected: A Rare Case Report Management and Outcome

Open Journal of Modern Neurosurgery 2023年第1期13卷 18-24页

作者： José Dimbimakoso Djimrabeye Alngar moune michèle yolande Mustapha Hamama Nizaireel Fatemi Rachid El Maaquil Faculty of Medicine and Pharmacy Université Mohamed V Rabat Morocco Department of Neurosurgery CHU ibnSina Rabat Morocco

Background: Spondylodiscitis is a spinal infection rare affecting primarily the intervertebral disk and the adjacent vertebral bodies. His diagnosis is difficult and often delayed or missed due to the rarity of the disease. Cervical spondylodiscitis has quite rare findings regarding the common location of spinal abscesses in the lumbar and thoracic regions. To obtain the best patient outcomes, these spinal infections require prompt diagnosis and appropriate treatment. Case description: A 44-year-old boy was admitted to the neurosurgery department of our hospital for heaviness in 4 limbs without gait disorders in context infected tracheostomy after staying in intensive care. MRI spine showed a spine deformity with lyse C4C5 epiduritis and spinal cord compressed. Antibiotics intravenous were started for 1 month the patient benefited from a corpectomy with an iliac graft and anterior cervical plate. The anatomopathological examination revealed an inflammation not specific. He was therefore put on antibiotics for 6 weeks. Three months later the neck pain and limb pain resolved after treatment and a complete return of lower extremity strength. Conclusion: Cervical spondylodiscitis has increased and become more aggressive. While radical surgical debridement, stable reconstruction together with antibiotic therapy remained a reliable approach to achieve complete healing of the inflammation, anterior alone surgery became more applicable.

关键词： Cervical Spondylodiscitis Spinal Tracheostomy Infection

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Risk Factors of Reoperation and Outcome of Patients Operated for Chronic Subdural Hematoma in a Teaching Hospital in Rabat

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Open Journal of Modern Neurosurgery 2023年第2期13卷 60-68页

作者： yolande michèle moune Jose Dimbi Makosso Mustapha Hemama Alngar Djimrabeye Dognon Kossi François de Paul Adjiou Saad Elmi Moussa Nourou Dine Adeniran Bankole Nizar El Fatemi Rachid El Maaqili Neurosurgery Department Ibn Sina Hospital Rabat Morocco

Background: chronic subdural hematoma is a common pathology, especially in the elderly. Although it has a good prognosis, it poses the problem of recurrence after surgical evacuation. Objective: To analyze the risk factors of reoperation in patients surgically treated for chronic subdural hematoma (cSDH) and evaluate the outcome of patients who benefited from a reoperation. Materials and Methods: A retrospective review was conducted in a single University Hospital Center in Rabat (Morocco) on 49 patients operated on from January 2020 to June 2021 for cSDH. Possible risk factors described in the literature were analyzed and the outcome of post-operative course was evaluated. Statistical significance was defined by p-value Results: 49 patients underwent surgical evacuation of cSDH. The sex ratio of male/female was 3.08. The mean age was 70.6 years. Concerning the medical history, 8.2% were diabetics, 10.2% had heart disease, 18.4% had hypertension, 16.3% associated of comorbidities, 2% had pulmonary embolism, and 2% had neoplasm. 18.4% were on anticoagulation therapy, no patients were on new oral anticoagulants. The clinical findings upon admission were motor deficit at 57.1%, signs of intracranial hypertension at 20.4%, altered consciousness at 16.9% and impaired behavior at 6.1%. 28.6% of patients had a past history of head trauma. The pre-operative CT scan showed unilateral cSDH at 81.6%, midline shifts at 77.6%, and false membranes at 34.7%. Blood appeared chronic at 40.8%, subacute at 24.5%, and mixed densities at 34.7%. The post-operative course was uneventful in 73.5%. According to Ibanez grading 8 patients had mild complications (grade I) and 5 moderate complications (grade II) after the first surgery. We recorded 10.2% of patients who needed a second surgery because of the deterioration of neurologic status or motor deficit associated with an abnormal CT scan. According to the GOS, 85.7% of patients had a good recovery while 10.2% died. None of the factors as

关键词： Chronic Subdural Hematoma Risk Factors of Reoperation Outcome

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Dermoid Cysts of the Conus Medullaris Associated with Sacral Meningocele. A Case Report

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Open Journal of Modern Neurosurgery 2022年第3期12卷 153-159页

作者： Mustapha Hemama Dimbi Makoso José Dognon Kossi François de Paul Adjiou moune yolande Nizare El Fatemi Moulay Rachid El Maaqili Department of Neurosurgery Ibn Sina University Hospital Rabat Morocco Faculty of Medicine and Pharmacy University of Mohammed V Rabat Morocco

Spinal dermoid cysts are gradually progressive benign tumors that may be congenital or acquired. They account for 0.8% to 1.1% of all primary spinal tumors. MRI is the gold standard for the radiological assessment. Management is difficult for tumors involving highly eloquent areas such as the conus medullaris. In this report, we present a rare case of an adult woman with dermoid cysts in the conus medullaris associated with a sacral meningocele which was treated with a midline myelotomy that drained yellowish keratinous fluid and decompressed the cyst. No aggressive attempt at complete resection of the cyst wall was undertaken. The patient fully recovered, and her condition considerably improved after surgery and remains good at a 6-month follow-up.

关键词： Dermoid Cysts Intramedullary Meningocele

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