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Moyamoya Disease Associated with Hyperhomocysteinemia: A Rare Cause of Stroke in Sub-Saharan Africa

World Journal of Neuroscience 2022年第1期12卷 22-28页

作者： raphael marie kabore Habib A. K. Ouiminga Jean kabore Jean-Michel Vallat Department of Neurology Tengandogo Teaching Hospital Ouagadougou Burkina Faso Department of Neurosurgery Tengandogo Teaching Hospital Ouagadougou Burkina Faso Department of Neurology Yalgado Teaching Hospital Ouagadougou Burkina Faso Department of Neurology Dupuytren Teaching Hospital Limoges France

Introduction: Moyamoya disease (MMD) is a chronic cerebrovascular disorder characterized by progressive bilateral occlusion of the supraclinoid internal carotid artery (ICA) and its main branches, associated with the development of fine collateral networks, especially adjacent to the site of occlusion in the deep areas of the brain. MMD frequently occurs in East Asian populations, including pediatric and adult patients, and may lead to ischemic or hemorrhagic stroke, headache, epilepsy or transient ischemic attack. The majority is presumed to be of genetic origin and few cases of thrombophilia have been reported in MMD. We report a case of MMD in a young sub-Saharan African woman associated with Hyperhomocysteninemia (HHCys). Observation: A 33-year-old female was seen for aphasia, which had suddenly appeared fourteen days before, and was associated with memory impairment. She mentioned chronic headaches during the 10 previous years, of frontal seat, without migraine criteria. She had no history of hypertension, no obesity, no known dyslipidemia, and there was no family history of stroke. Neurological examination noted Wernicke’s aphasia, with discreet right central facial palsy, associated with memory impairment. The brain MRI revealed semi recent infarct in the left parietal lobe, sequelae in the left temporo-occipital and right frontal with lacunar ischemic lesions, associated with several foci of sub- cortical demyelination. MRA showed stenosis of the supraclinoid carotid arteries and their division branches. In addition, there was a stenosis of the posterior cerebral arteries, with a network of anastomosis at the level of the base of the skull. An investigation of thrombophilia showed hyperhomocysteinemia (HHCys). The diagnosis of moyamoya disease associated with hyperhomocysteinemia was mentioned. She was treated by Aspirin combined to folic acid. After a 3-year setback the patient was asymptomatic. Conclusion: MMD is a rare cause of stroke in sub-Saharan Afric

关键词： Moyamoya Headache Silent Infarcts Hyperhomocysteinemia Diagnosis Treatment

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Spinal Cord Compression, a Rare Neurofibromatosis Complication

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World Journal of Neuroscience 2019年第3期9卷 191-198页

作者： Habib Abdoul Karim Ouiminga Sylvain D. Zabsonré Aminath Kélani Souleymane Ouattara Assane Dravé raphael marie kabore Désiré Harouna Sankara Magatte Gaye Department of Neurosurgery CHU Tengandogo Ouagadougou Burkina Faso Department of Neurosurgery CHU Yalgado Ouédraogo Ouagadougou Burkina Faso Department of Neurosurgery Hopital National de Niamey Niger Department of Pathology CHU Tengandogo Ouagadougou Burkina Faso Department of Neurology CHU Ouahigouya Ouahigouya Burkina Faso Department of Neurology CHU Tengandogo Ouagadougou Burkina Faso Department of Imagery CHU Tengandogo Ouagadougou Burkina Faso Department of Neurosurgery H&ocirc pital Général Grand Yoff Dakar Senegal

Objective: The objective of this study is to report a case of spinal cord compression, which is a rare complication of neurofibromatosis type 1. Observation: We report the case of a 45-year-old man, which presented a syndrome of thoracic spinal cord compression at the stage of spastic paraparesis. Its installation was gradually over 6 months associated with the inaugural back pain. He had a clinical history of neurofibromatosis type 1 with “Café-au-lait” spots. There were multiple painless nodules under the skin of different size on the chest, forearms and legs. A large isolated nodule, purplish was observed on the chest. The neuro-imaging showed a para-spinal anterior mass expansion inside the spinal canal causing spinal compression at the level of the second and third thoracic vertebra. It extends into the intervertebral foramen of the third and fourth thoracic vertebra leading to a scalloping. A second large heterogeneous left intra-abdominal mass containing cyst areas and calcifications was discovered in imaging. After a spinal decompression with laminectomy of the second and third thoracic vertebra, the reduction of pain and motor recovery was gradual. The large nodule excision was performed. Histology found a plexiform neurofibroma. Excision of the left intra-abdominal mass could not be performed because the patient’s consent had not been obtained. Conclusion: The spinal cord compression is a rare complication of neurofibromatosis type 1. However, it is essential to think about it in front of any spinal cord symptoms or any atypical long term spinal pain.

关键词： Neurofibromatosis Von Recklinghausen’s Disease Spinal Cord Compression

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Symptomatic Extra-Dural Arachnoid Cyst

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World Journal of Neuroscience 2018年第2期8卷 185-189页

作者： Habib Abdoul Karim Ouiminga Magatte Gaye Cheik Tidiane Hafiz Bougouma raphael marie kabore Dé siré Harouna Sankara Oumar Salia Souleymane Ouattara Yannick Canton Kessely Department of Neurosurgery CHU-Blaise Compaore Ouagadougou Burkina Faso Department of Neurosurgery Hopital General Grand Yoff Dakar Senegal Department of Intensive Care Unit CHU-Blaise Compaore Ouagadougou Burkina Faso Department of Neurology CHU-Blaise Compaore Ouagadougou Burkina Faso Department of Imagery CHU-Blaise Compaore Ouagadougou Burkina Faso Department of Orthopedics and Traumatology CHU-Blaise Compaore Ouagadougou Burkina Faso Department of Pathology CHU-Blaise Compaore Ouagadougou Burkina Faso

Objective: The aim of this study is to report a case of arachnoid cyst due to mass effect on the thoracic marrow. Observation: A 15-year-old patient was admitted to our institution and complaining of high back pain. Three months before he developed progressive and occasional back pain with thoracic irradiation in hemi-belt, increased by the dorsal decubitus. Neurological examination revealed a spasmodic paraplegia. The muscular strength was quoted as 2 to the left and 3 to the right on a scale of 5. Magnetic resonance imaging (MRI) revealed and extradural cyst located to the dorsal spinal cord. The ablation of a voluminous translucent cyst was achieved after a vast decompressive laminectomy from the sixth to the eighth thoracic vertebra. The dural communication with the cyst was stitched. After surgery, the pain has disappeared and the neurological recovery was progressive over a period of 21 days. The diagnosis of arachnoid cyst was confirmed by histological examination. Conclusion: The extradural thoracic arachnoid cyst is a rare affection of good forecast. In the symptomatic form, the surgery as soon as possible remains the solution. The MRI keeps all its interest for the diagnostic orientation and the therapeutic strategy.

关键词： Arachnoid Cyst Extradural Marrow Surgery

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Spinal Cord Compression, a Rare Neurofibromatosis Complication

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World Journal of Neuroscience（神经科学国际期刊） 2019年第3期

作者： Habib Abdoul Karim Ouiminga Sylvain D. Zabsonr Aminath Kélani Souleymane Ouattara Assane Drav raphael marie kabore Désiré Harouna Sankara Magatte Gaye

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A formal approach using SysML for capturing functional requirements in avionics domain

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Chinese Journal of Aeronautics 2019年第12期32卷 2717-2726页

作者： Shaofan ZHU Jian TANG Jean-marie GAUTHIER raphael FAUDOU Beijing Aeronautical Science and Technology Research Institute COMACBeijing 102211China Samares-Engineering Blagnac 31700France

In this work,a Model-Based Systems Engineering approach based on Sys ML is *** approach is used for the capture and the definition of functional requirements in avionics *** motivation of this work is triple:guide the capture of functional requirements,validate these functional requirements through functional simulation,and verify efficiently the consistency of these functional *** proposed approach is decomposed into several steps that are detailed to go from conceptual model of avionics domain to a formal functional model that can be simulated in its operating *** achieve this work,a subset of Sys ML has been used as an intermediate modelling language to ensure progressive transformation that can be understood and agreed by system *** concepts are introduced to ensure theoretical consistency of the *** addition,transformation rules are defined and the mappings between concepts of ARP4754 A civil aircraft guidelines and Sys ML are formalized through *** resulting formalization enables engineers to perform functional simulation of the top-level functional architecture extracted from operational ***,the approach has been tested on an industrial avionics system called the Onboard Maintenance System.

关键词： Avionics systems Conceptual model Functional simulation Model-Based Systems Engineering

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Road map for pain management in pancreatic cancer: A review

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World Journal of Gastrointestinal Oncology 2016年第8期8卷 599-606页

作者： marie José Lahoud Hampig raphael Kourie Joelle Antoun Lana El Osta Marwan Ghosn Department of Anesthesiology and Critical Care Faculty of Medicine Saint Joseph University Department of Oncology Faculty of Medicine Saint Joseph University

Beside its poor prognosis and its late diagnosis, pancreatic cancer remains one of the most painful malignancies. Optimal management of pain in this cancer represents a real challenge for the oncologist whose objective is to ensure a better quality of life to his patients. We aimed in this paper to review all the treatment modalities incriminated in the management of pain in pancreatic cancer going from painkillers, chemotherapy, radiation therapy and interventional techniques to agents under investigation and alternative medicine. Although specific guidelines and recommendations for pain management in pancreatic cancer are still absent, we present all the possible pain treatments, with a progression from medical multimodal treatment to radiotherapy and chemotherapy then interventional techniques in case of resistance. In addition, alternative methods such as acupuncture and hypnosis can be added at any stage and seems to contribute to pain relief.

关键词： Pain management Interventional Medical Treatment Pancreatic cancer

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Knowledge and attitudes of driver license applicants and instructors about driving of patients with epilepsy in Burkina Faso

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Acta Epileptologica 2022年第1期5卷 29-35页

作者： Dabilgou Alfred Anselme Drave Alassane Kyelem Julie marie Adeline Eklou Lorrainda Emerance Napon Christian Millogo Athanase Karfo Kapouni kabore Jean Department of Neurology University Hospital Yalgado OuedraogoOuagadougouBurkina Faso Department of Neurology Regional University Hospital of OuahigouyaOuahigouyaBurkina Faso Department of Neurology University Hospital of BogodogoOuagadougouBurkina Faso Department of Neurology University Hospital of Sourou SanoBobo DioulassoBurkina Faso Department of Psychiatry University Hospital of BogodogoOuagadougouBurkina Faso

Background:Epilepsy is the most common neurological disease in the *** objective of the study was to determine the knowledge,attitude and practice of driver's license applicants and instructors in driving schools on epilepsy in Burkina ***:This cross-sectional study was carried out from January 7th to March 7th 2020 in 21 driving schools approved by the National Driver License Authority in the city of *** driver applicants and one instructor were selected in each driving school,resulting in a total of 315 driver applicants and 21 instructors in the ***:The mean age of participants was 29.91±7.63 *** of the driver applicants included in the study was once experienced a seizure *** respondents had heard of *** main source of epilepsy information was from family(42.5%).Two hundred and twenty-six respondents(673%)had witnessed an epileptic seizure.A majority of participants(55.9%)believed that persons with epilepsy be not permitted to drive a motor *** 44.0% of participants thought that people with epilepsy should be permitted to drive under certain *** hundred and four(30.9%)participants suggested that people with epilepsy be permitted to drive a light *** hundred and forty-one(42.0%)suggest to withdraw the driving license for lifetime if a driver had an epileptic seizure attack;while twenty-three(6.8%)participants recommended suspension of driver license for 12 ***:Efforts should be made to improve awareness and education among license applicants and instructors on the driving by people with epilepsy.

关键词： Knowledge Driving by people with epilepsy Driver license applicants Burkina Faso

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Gangrene of the External Genitalia at the Regional University Hospital Center of Ouahigouya: Epidemiological Profile and Therapeutic Aspects

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Open Journal of Urology 2020年第6期10卷 184-191页

作者： Tiéoulé Mamadou Traore Clô taire Alexis marie Kiemdiba Donega Yameogo Moussa kabore Souleymane Ouedraogo Service de chirurgie du CHU régional de Ouahigouya Ouahigouya Burkina Faso Service d’urologie du CHU Yalgado Ouédraogo Ouagadougou Ouaga Ouagadougou Burkina Faso

Introduction: Gangrene of extern genitary organs is a rapidly progressive necrotizing fasciitis of the perineum and external genitalia that results from a polymicrobial infection. Mortality remains high despite advances in resuscitation. We report the experience of the surgery department of the Regional University Hospital Center (CHUR) of Ouahigouya in order to describe the epidemiological profile and the therapeutic aspects of GOGE. Patients and methods: We carried out a descriptive and analytical retrospective study collecting 41 cases of Fournier’s gangrene treated over 63 months (from March 2013 to July 2018) in the surgical department of the Ouahigouya regional university hospital center. Ethical clearance was taken from the institutional ethics committee. Results: The mean age of the patients was 65.02 ± 17.92 years with extremes of 23 years and 95 years. All patients were male. Urologic causes were the most common with 36.58% of cases. The average consultation time was 15.44 ± 16.04 days with extremes of 1 day and 60 days. All patients received resuscitation, bi or triantibiotherapy and surgical debridement. The mortality rate was 24.39%. The mean duration of hospitalization was 10.83 ± 6.257 days with extremes of 1 day and 60 days. Conclusion: The Fournier’s gangrene always has a very high lethality. Improving the prognosis requires fast and effective management.

关键词： Fournier’s Gangrene Epidemiology Emergency Mortality

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Epidemiology of Urological Emergencies at the Regional University Hospital Center of Ouahigouya, Burkina Faso

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Open Journal of Urology 2020年第6期10卷 177-183页

作者： Mamadou Tiéoulé Traore Clô taire Alexis marie Kiemdiba Donega Yameogo Moussa kabore Souleymane Ouedraogo Service de chirurgie du CHU régional de Ouahigouya Ouahigouya Burkina Faso Service d’urologie du CHU Yalgado Ouédraogo Ouagadougou Ouaga Ouagadougou Burkina Faso

Introduction: Urological emergencies are less frequent compared to other emergencies, particularly traumatological and digestive emergencies. The objective of this study was to determine the epidemiological profile of urological emergencies in a regional hospital in Burkina Faso. Patients and methods: This was a cross-sectional study of urological emergencies admitted to the Surgical Department of the Ouahigouya Regional University Hospital in Burkina Faso over a period of 41 months. The study covered a 41-month period from March 2015 to July 2018. Ethical clearance was taken from the institutional ethics committee. Results: Urological emergencies accounted for 3.7% of all emergencies. The mean age of the patients was 56.59 ± 25.93 years (range 1 year - 95 years). The sex ratio was 12.05. Bladder urinary retention was the main urological emergency in 48.28% of cases. Suprapubic cystostomy was the most performed surgical procedure (56.25%) followed by debridement of external genitalia gangrene (27.68%). Conclusion: Urological emergencies occupy a significant place in our work context. An increase in the number of urologists would improve their management.

关键词： Epidemiology Urological Emergencies Retention Cystostomy

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Cerebral Venous Thrombosis: A Rare Complication of Spinal Anesthesia

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World Journal of Neuroscience 2021年第1期11卷 1-7页

作者： raphael M. kabore Habib A. K. Ouiminga Labodi Lompo H. Desire Sankara Anselme Dabilgou Alassane Drave Svetlana Barro Cherban Christian Napon Athanase Millogo Jean kabore Department of Neurology CHU Tengandogo Ouagadougou Burkina Faso Department of Neurosurgery CHU Tengandogo Ouagadougou Burkina Faso Deparement of Imagery CHU Tengandogo Ouagadougou Burkina Faso Department of Neurology CHU Yalgado OUEDRAOGO Ouagadougou Burkina Faso Department of Neurology CHU Ouahigouya Ouahigouya Burkina Faso Department of Anesthesia-Reanimation CHU Tengandogo Ouagadougou Burkina Faso Department of Neurology CHU Bogodogo Ouagadougou Burkina Faso Department of Neurology CHU-Souro SANOU Bobo-Dioulasso Burkina Faso

Introduction: Cerebral venous thrombosis (CVT) is a rare complication of spinal anesthesia. The diagnosis is difficult when it occurs by isolated headache, following post spinal puncture headache (PSPH). We report a case of cerebral venous thrombosis complicating PSPH, following a spinal anesthesia. Observation: A 23-year-old man was admitted to the emergency room for PSPH appeared 6 hours after a spinal aesthesia for removal of osteosynthesis equipment from the right tibial plateau. The headache was fronto-occipital, relieved by lying down. Six days later, headache became permanent, not relieved by morphine, associated with vomiting. The neurological examination was normal. Brain magnetic resonance Magnetic venography showed superior sagittal sinus and right transverse sinus thrombosis. After administration of low molecular weight heparin at curative dose, and warfarin under INR control, the evolution was marked by a rapid regression of headaches on the same day. After a 1-year setback, the patient was asymptomatic. Conclusion: CVT is a rare complication of spinal anesthesia and potentially severe if diagnosed lately. Urgent brain imaging must be performed for any atypical headache or the onset of neurological disorders so as not to misunderstand cerebral vein thrombosis. Controlling the spine anesthesia would reduce the inadvertent perforation of the dura-mother that would lead to CVT complicating post spinal puncture headaches.

关键词： Spinal Anesthesia Post Spinal Puncture Headache Cerebral Venous Thrombosis

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