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Surgical Repair of Growing Skull Fracture: A Case Report

Case Reports in Clinical Medicine 2022年第3期11卷 79-83页

作者： Youssouf Sogoba Seybou Hassane Diallo Moussa diallo Drissa Kanikomo Boubacar Sogoba Oumar Coulibaly Mahamadou Dama Mamadou Salia Diarra Oumar diallo Youssoufa Maiga Department of Neurosurgery Gabriel Touré Teaching Hospital Bamako Mali Department of Neurology Gabriel Touré Teaching Hospital Bamako Mali Department of Neurosurgery H&ocirc pital du Mali Bamako Mali Department of Neurosurgery H&ocirc pital Luxambourg Bamako Mali

Background: Growing skull fractures (GSF) are a rare complication of pediatric head trauma that comprises post-traumatic skull defect associated with an underlying dural tear and an intact arachnoid membrane. They are often misdiagnosed, and delay in management can lead to progression of the disease with neurological sequelae. GSF are rare and their incidence has been estimated as 0.05% - 1% of all pediatric skull fractures. This low incidence and the subtlety of its presentation often make diagnosis challenging with consequent delay in management. Surgery is recommended to treat GSF and involved dural repair with or without cranioplasty. In this paper, we report a case of a patient with GSF in whom the surgical repair was successful with good cosmetic and functional outcome. Case Report: A 12 months old girl was admitted to our neurosurgical department with right parietal swelling that had been gradually enlarging over 3 months. The history of the disease began when the girl was 1 month old with a fall with cranial impact resulting in head trauma with initial loss of consciousness. At presentation the girl was alert with normal consciousness. Clinical examination revealed the deformed skull with large pulsatile and painless swelling lesion in the right parietal region and hemiparesis on the left side. The CT scan revealed type 3 GSF including parietal bone diastasis with hypodense fluid collection that mimicked the leptomeningeal and porencephalic cyst. Surgical repair was performed. The post-operative course was uneventful and the child was discharged home five days after surgical intervention. Conclusion: GSF can lead to serious neurologic complications. Therefore educating parents on this potential outcome and close follow-up with clinical and imaging screening is recommended to screen children at risk for the development of the disease.

关键词： Growing Skull Fracture Head Trauma Dural Tear

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A Case Report of an Invasive Scalp Actinomycosis

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Case Reports in Clinical Medicine 2021年第2期10卷 34-38页

作者： Youssouf Sogoba Jean Paul Dembele Boubacar Sogoba Moussa diallo Seybou Hassane Diallo Oumar Coulibaly Quenum Kisito Oumar diallo Drissa Kanikomo Youssoufa Maiga Department of Neurosurgery H&ocirc pital Gabriel Touré Bamako Mali Department of Infectious Diseases H&ocirc pital du Point G Bamako Mali Department of Neurologie H&ocirc pital Gabriel Touré Bamako Mali Department of Neurosurgery H&ocirc pital du Mali Bamako Mali Department of Neurosurgery University Hospital of Parakou Parakou Benin

Background: Actinomycosis is a bacterial infection characterized by a chronic, suppurative and granulomatous process. The causative organism was identified in 1891 as Actinomycosis israelii. The disease is usually caused by the introduction of the bacteria through minor wound. Actinomycosis was classified by Cope into 3 different forms: cervicofacial (50%), pulmonothoracic (30%) and abdominopelvic (20%). Actinomycosis is an insidious disease but occasionally the clinical course can be more aggressive, involving underline tissue and organs. Involvement of scalp by actinomycosis is rare causing diagnostic dilemma and could be mistaken for different pathologies, such as tuberculosis or carcinoma. The most common clinical findings are local tumefaction with abscesses and sinuses draining pus that contains the granule of the causative organism. CT scan and MRI are aspecific for diagnosis, but they can help in defining the localization and the extension of the lesion. The certain diagnostic is based on cytology and/or biopsy. Case: A 24 year-old-man was admitted to our neurosurgical department with a 16-month history of multiple scalp ulcerated lesions and swelling of the head. He was complaining of headache. Physical examination revealed multiple scalp subcutaneous nodules and ulcerated lesions with swelling of the head. Our examination of the oral cavity revealed a poor oral hygiene condition with multiple caries. The CT scan revealed multiple scalp subcutaneous masses with chronic inflammatory changes of the skull. Routine laboratory test was normal. Surgical biopsy was performed and the histological result was compatible with actinomycosis. After histological confirmation, parenteral Penicillin 20 million units daily were given for 4 weeks. Clinical improvement was observed after completing a 4-week regimen of intravenous antibiotics. Conclusion: Involvement of scalp by actinomycosis could be mistaken for different pathologies, such as tuberculosis or carc

关键词： Actinomycosis Bacterial Infection Computed Tomography

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Surgical Management of 4 Cases of Craniofacial Fibrous Dysplasia

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World Journal of Neuroscience 2021年第4期11卷 279-286页

作者： Youssouf Sogoba Moussa diallo Boubacar Sogoba Djènè Kourouma Izoudine Blaise Koumaré Mamadou diallo Oumar Coulibaly Mahamadou Dama Mamadou Salia Diarra Seybou Hassane Diallo Salimata diallo Oumar diallo Youssoufa Maiga Drissa Kanikomo Depatment of Neurosurgery H&#244pital Gabriel Touré Bamako Mali Department of Neurosurgery Hopital du Mali Bamako Mali Department of Neurosurgery Hopital Mère-enfant Bamako Mali Depatment of Neurology H&#244pital Gabriel Touré Bamako Mali

Background: Fibrous dysplasia is an uncommon skeletal disorder in which normal bone and marrow are replaced with fibro-osseous tissue. The disease comprises 2.5% of all bone tumors and 7.5% of all benign bone neoplasm. It is the progressive, slowly developing disease and the optimum treatment remains unclear in many cases. Aim: In this study, the authors report their experience in the surgical treatment of four cases of craniofacial fibrous dysplasia. Cases presentation: The study involved 4 patients with craniofacial fibrous dysplasia. There were 3 men and a woman. The patients were 10, 17, 20 and 8 years old. No patient had a focal neurological deficit. The CT scan appearance was compatible with Fibrous dysplasia in all patients. The site of disease was frontal in one case and parietal in the other 3 cases. Cosmetic surgical treatment was performed in all patients. Cranioplasty was performed in one patient and planned for the other three. Conclusion: Fibrous Dysplasia is a benign slow growing disease that may cause as well as clinical symptom and aesthetical discomfort. Radical resection, if possible, is the only technique to obtain resolution of the disease.

关键词： Fibrous Dysplasia Surgical Treatment Bone Tumor

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Demographic and Clinical Characteristics of 63 Children with Myelomeningoceles

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Open Journal of Modern Neurosurgery 2021年第2期11卷 59-64页

作者： Youssouf Sogoba Seybou Hassane Diallo Issa Amadou Boubacar Sogoba Moussa diallo Benoi Kamaté Daouda Mariko Coulibaly Oumar Quenum Kisito Hawa Diall Leonie Diakité Salimata diallo Belco Maiga Fousseyni Traoré Karamoko Sacko Oumar diallo Drissa Kanikomo Youssoufa Maiga Department of Neurosurgery H&#244 pital Gabriel Touré Bamako Mali Department of Neurology H&#244 pital Gabriel Touré Bamako Mali Department of Pediatric Surgery H&#244 pital Gabriel Touré Bamako Mali Department of Neurosurgery H&#244 pital du Mali Bamako Mali Department of Neurosurgery University Hospital of Parakou Parakou Benin Department of Pediatrics H&#244 pital Gabriel Touré Bamako Mali

Background: Myelomeningocele (MMC) is the most common neural tube defect (NTD) characterized by the extrusion of the spinal cord into a sac filled with cerebrospinal fluid, resulting in lifelong disability. In the general population, the incidence of MMC ranges from 0.3 to 4.5/10,000 births. Live born infants with myelomeningocele have a death rate of approximately 10%. Many factors may play a role in the development of MMC such as environmental and genetic factors. In this study, we present our experience with a group of 63 children afflicted with MMC. Methods: This study was a retrospective analysis of 63 patients with MMC admitted to the neurosurgical department of Gabriel Touré Hospital from September 2017 to August 2018. A detailed history was obtained from the family at presentation. The family history and medical information before and during the pregnancy were compiled. Patients underwent complete physical and neurological examinations. Forty-seven (74.60%) patients underwent repair of the MMC and a ventriculoperitoneal shunt was placed in 12 (19%) patients with accompanying hydrocephalus. The risk factors, neurological status, and surgical results have been analyzed. Results: Of 63 children with MMC admitted to our neurosurgical department, 34 (54%) were boys and 29 (46%) were girls. Forty (63.49%) patients were the children of marriages of second cousins or closer. The mean age of the fathers was 34 years (16 - 65), while that of mothers was 26 years (16 - 38). The pregnancy was unplanned in all cases. Fourteen (22.22%) mothers had genitourinary infections, 9 (14.3%) had malaria and 57 (90.47%) mothers used analgesics and antibiotics during the pregnancy. Fifty-nine (93.65%) children were born at term, 58 (92%) were delivered via normal spontaneous vaginal delivery, and 5 (8%) via cesarean section. Lumbosacral lesions were the most frequent in 27 (42.86%) patients. Forty-seven (74.60%) patients underwent repair of the MMC and a ventriculoperitoneal shun

关键词： Myelomeningocele Neural Tube Defects Hydrocephalus

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Serious Myasthenia at the Department of Internal Medicine of Point G University Teaching Hospital: A Clinical Case

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Neuroscience & Medicine 2019年第3期10卷 207-212页

作者： Assétou Kaya Soukho Djenebou Traoré Adramé Keita Djibril Sy Guida Landouré Seybou Hassane Diallo Youssouf Fofana Kaly Keita Mamadou Mallé Ibrahima Amadou Dembélé Drissa Sangaré Mamadou Cissoko Barry Boubacar Sangaré Mamadou Dembélé Abdel Kader Traoré Hamar Alassane Traoré Department of Internal Medicine Point G University Teaching Hospital Bamako Mali Department of Neurology Point G University Teaching Hospital Bamako Mali Department of Neurology GABRIEL TOURE University Teaching Hospital Bamako Mali Department of Internal Medicine Mother-Child Hospital “Luxembourg” Bamako Mali

Introduction: Myasthenia is a rare and disabling autoimmune disease. Few studies were devoted to this pathology. We report a clinical case of myasthenia in the Department of Internal Medicine at the Point G University Teaching Hospital. Observation: This is a 41-year-old patient of Malian origin, a trader with a history of hemorrhoidectomy in 2011 and familial hypertension, was admitted on August 19, 2014, for muscle weakness, dysphonia, and dysphagia. The disease started 1 year before admission at the department with progressive muscle weakness of the upper limbs aggravated by repetitive movements and spreading to the head “drooping head” and inferior limbs, associated with general fatigue, dysphonia and selective dysphagia for solid foods. The diagnosis of myasthenia was maintained based on the clinical signs such as ptosis, bilateral diplopia, and weakness with lower limbs muscle strength rated at 3/5, and confirmed with confirmatory exams;a positive anti-acetylcholine receptor antibody (RIA), the post-synaptic neuromuscular conduction block at ENMG and the positive neostigmine pharmacological test. The patient received Neostigmine (prostagmine) 0.5 mg one ampoule in IM/day and Prednisone at a dosage of 1 mg/kg/day. The evolution was marked by a moderate improvement of the symptomatology afterward the patient was evacuated to Tunisia on family request where he received a course of immunoglobulin 2 g/kg in 2 days. The evolution in Tunisia was favorable. The patient returned in Mali and death occurred after 2 months in a context of respiratory distress. Conclusion: Myasthenia is a rare but serious disease requiring careful management and monitoring to reduce respiratory complications.

关键词： Myasthenia Immunoglobulin Internal Medicine Point G Hospital

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Management and Outcome of Acute Subdural Hematoma in Gabriel TouréHospital

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Open Journal of Emergency Medicine 2022年第1期10卷 48-53页

作者： Youssouf Sogoba Drissa Kanikomo Quenum Kouassi Jean Marie Kisito Moussa diallo Bakary Dembélé Boubacar Sogoba Djènè Kourouma Izoudine Blaise Koumaré Seybou Hassane Diallo Hamidou Almeimoune Moustapha Mangané Thierno Madane Diop Oumar Coulibaly Mamadou Salia Diarra Mahamadou Dama Oumar diallo Youssoufa Maiga Djibo Mahamane Diango Department of Neurosurgery Gabriel Touré Teaching Hospital Bamako Mali Neurosurgeon University of Parakou Parakou Benin Department of Neurology Gabriel Touré Teaching Hospital Bamako Mali Department of Emergency Care Gabriel Touré Teaching Hospital Bamako Mali Department of Neurosurgery H&#244 pital du Mali Bamako Mali Department of Neurosurgery H&#244 pital Luxambourg Bamako Mali

Background: Traumatic Brain Injury (TBI) is a major health problem worldwide. It is the main cause of trauma mortality. Acute subdural hematoma (ASDH) has a reputation for being the most serious of all posttraumatic head injuries. Its frequency is estimated to be 1% to 5% of all head injuries and 22% of severe head injuries. The aim of this study was to assess the epidemiological, clinical and prognosis aspects of ASDH in our department. Material and Methods: This prospective study, from January to December 2019, included 57 patients admitted to the Gabriel Touré Teaching Hospital for ASDH. Patients underwent detailed clinical and radiological evaluation and ASDH was diagnosed by non-contrast computed tomography (CT) scan. Functional outcome was evaluated 6 months after injury by Glasgow Outcome Scale. Results: During the study period, 662 patients were admitted for TBI including 57 (8.61%) cases of ASDH. The mean age was 34 years with extremes of 2 and 77 years. There was a male predominance with 52 (91.2%). The main cause of trauma was motor vehicle accidents in 38 (66.6%) patients. According to the Glasgow coma scale (GCS), 33 (57.9%) patients were classified mild (Table 2). The thickness of the hematoma was more than 1 cm in 13 (22.8%) patients and less than 1 cm in 44 (77%) patients. Surgical treatment was performed in 13 (22.8%) patients. The outcome was favorable in 30 (52.6%) patients and the mortality rate was 33.3%. Conclusion: ASDH remains a difficult challenge because of the high mortality. The mortality rate remains high particularly in patient with poor GCS score at admission.

关键词： Acute Subdural Hematoma Traumatic Brain Injury Outcome

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Conservative Treatment in Grisel’s Syndrome Following Tonsillectomy

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World Journal of Neuroscience 2018年第1期8卷 38-43页

作者： Youssouf Sogoba Abdoulaye Barry Issa Amadou Boubacar Sogoba Drissa Kanikomo Seybou Hassane Diallo Oumar Coulibaly Youssoufa Maiga Siaka Soumaoro Dianguina dit Noumou Soumaré Kadidiatou Singaré Mohamed Keita Department of Neurosurgery Hopital Gabriel Touré Bamako Mali Department of Pediatrics Hopital de Kati Bamako Mali Department of Pediatric Surgery Hopital Gabriel Touré Bamako Mali Department of Neurology Hopital Gabriel Touré Bamako Mali Department of ENT Hopital Gabriel Touré Bamako Mali Department of Pneumonology Hopital du Point G Bamako Mali

Grisel’s syndrome is a rare complication that is characterized by non-traumatic atlantoaxial subluxation. It is most commonly seen in children after an upper respiratory tract infection or neck surgery, such as an adenoidectomy, tonsillectomy and mastoidectomy. Grisel’s Syndrome is characterized by torticollis and a limited range of motion of the neck with pain. Here the authors report a case of a Malian 5-year-old girl with Grisel’s syndrome following tonsillectomy. The patient’s complaints were fully resolved after 2 weeks of conservative treatment.

关键词： Atlantoaxial Subluxation Grisel’s Syndrome Torticollis

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Giant Intracranial Arachnoid Cyst Causing Acute Neurologic Symptoms

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World Journal of Neuroscience 2018年第3期8卷 363-369页

作者： Youssouf Sogoba Boubacar Sogoba Seybou Hassane Diallo Drissa Kanikomo Djenè Kourouma Oumar Coulibaly Issa Amadou Moustapha Mangané Hamidou Almeimoune Madani Thierno Diop Youssoufa Maiga Broulaye Samaké Djibo M. Diango Department of Neurosurgery Hopital Gabriel Touré Bamako Mali Department of Neurology Hopital Gabriel Touré Bamako Mali Department of Neurosurgery Hopital du Mali Bamako Mali Department of Pediatric Surgery Hopital Gabriel Touré Bamako Mali Department of Anesthesiology and ICU Hopital Gabriel Touré Bamako Mali

Intracranial arachnoid cysts (IAC) are benign lesions containing cerebrospinal fluid (CSF). Most of them are clinically silent and remain static in size. However some may present with mild and slow progressive symptoms caused by the cyst. The authors present the case of 54-year-old woman who presented with acute symptoms of severe headache, vomiting, and gait disturbance of 2 day’s duration. She had no history of head trauma. On admission, neurological examination revealed that the patient had a Glasgow Coma Scale score of 15, and a left side hemiplegia. A CT scan revealed a hypodense fluid collection in the right frontoparietal region that mimicked an arachnoid cyst. The symptoms were improved after an emergency marsupialisation via craniotomy.

关键词： Arachnoid Cyst Neuroendoscopy Microsurgical Fenestration

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Management of Spinal Schwannomas in Gabriel TouréHospital: Review of 11 Cases

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Surgical Science 2018年第8期9卷 256-261页

作者： Youssouf Sogoba Boubacar Sogoba Drissa Kanikomo Seybou Hassane Diallo Djenè Kourouma Oumar Coulibaly Issa Amadou Moustapha Mangané Hamidou Almeimoune Madani Thierno Diop Youssoufa Maiga Broulaye Samaké Djibo M. Diango Department of Neurosurgery H&#244 pital Gabriel Touré Bamako Mali Department of Neurology H&#244 pital Gabriel Touré Bamako Mali Department of Neurosurgery H&#244 pital du Mali Bamako Mali Department of Pediatric Surgery H&#244 pital Gabriel Touré Bamako Mali Department of Anesthesiology and ICU H&#244 pital Gabriel Touré Bamako Mali

Background: Spinal schwannomas are common tumors of spinal neoplasm and account for about 25% of intradural spinal cord tumors in adults. They are generally benign and slow-growing. Advanced in radiologic and surgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. In this report, the authors present the incidence, clinical presentation, localization, and results of surgically treated spinal schwannomas. The results of a literature review are also presented. Methods: Eleven consecutive patients with histologically confirmed spinal schwannomas were treated from January 2013 to December 2016 in the neurosurgical department of Gabriel Touré Hospital, Bamako, Mali. Neuroradiological diagnosis was made, CT scan in 7 patients, and MRI in 4 patients. All patients were operated on via the posterior approach. All cases were surgically excised, and they were confirmed to be schwannomas by pathologists. The patients were followed for 6 to 38 months (mean 28 months). Functional outcome was assessed using the motor grade and sensory change. Results: There were 11 patients with 7 (63.6%) males and 4 (36.4%) females. The mean age was 40.3 years (range 23 - 62 years). The most common symptom at the time of diagnosis was radicular pain in 9 (81.8%) patients followed by motor weakness in 8 (72.7%) patients. The most frequent site of spinal schwannomas was the thoracic region in 5 (45.5%) patients. During surgery, Gross-total resec-tion was achieved in 8 patients (72.7%) and subtotal removal in 3 (27.3%) patients. Histological findings were benign schwannoma in all cases. Postoperative complications developed in two patients, including one with cerebrospinal fluid leakage and other one with wound infection. In the short-term follow-up period, most of the patients (90.9%) appeared to be improved in comparison with their preoperative neurological status. There was no operative mortality. Conclusion: In this study, the clinical manifestations and surgical resul

关键词： Spinal Schwannoma Spine Surgery Recurrence

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Surgical Repair of Encephaloceles in Gabriel TouréHospital: Review of 17 Cases

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Open Journal of Modern Neurosurgery 2018年第4期8卷 375-382页

作者： Youssouf Sogoba Drissa Kanikomo Boubacar Sogoba Djenè Kourouma Oumar Coulibaly Issa Amadou Seybou Hassane Diallo Moustapha Mangané Hamidou Almeimoune Maiga Madani Thierno Diop Belco Maiga Leonie Diakité Fousseyni Traoré Youssoufa Maiga Yacaria Coulibaly Broulaye Samaké Djibo M. Diango Department of Neurosurgery H&#244 pital Gabriel Touré Bamako Mali Department of Neurosurgery H&#244 pital du Mali Bamako Mali Department of Pediatric Surgery H&#244 pital Gabriel Touré Bamako Mali Department of Neurology H&#244 pital Gabriel Touré Bamako Mali Department of Anesthesiology and ICU H&#244 pital Gabriel Touré Bamako Mali Department of Pediatrics H&#244 pital Gabriel Touré Bamako Mali

Background: Encephaloceles are congenital neural tube defects characterized by the protrusion of meninges and/or brain tissue from a defect in the skull. The incidence of the disease is about 0.8 - 5.6/10,000 live births. They are classified based on the location and type of skull defect as occipital encephalocele, encephalocele of the cranial vault, frontoethmoidal encephalocele, and basal encephaloceles. Surgical reduction being the first line treatment and resection of herniated structures may be necessary when the encephalocele is large. In the present study, the authors present their experience in treating 17 patients with encephaloceles. Methods: This study is a retrospective analysis of 17 patients from January 2013 to December 2016 in Gabriel Touré Hospital, Bamako, Mali. A history was obtained from the family at presentation. Medical information before and during the pregnancy was compiled. All patients underwent CT scan as a routine preoperative imaging study, to evaluate the encephalocele and to plan the surgical procedure. The following data were recorded for analysis: age, sex, location of encephalocele, neurological status, operative method, postoperative complications and surgical results. Results: There were 10 (58.8%) female and 7 (41.2%) male patients. The patients ranged in age from 3 days to 36 months. The most common site of encephalocele sac was the occipital region in 14 (82.4%) cases followed by the frontal region in 2 (11.8%) cases and the vertex in 1 (5.9%) case. The sac size was less than 3 cm in 5 (17.6%) cases, 3 - 5 cm in 8 (47.1%) cases and more than 5 cm in 4 (23.5%) cases. Three (17.6%) children presented with CSF leakage. Hydrocephalus was present in the preoperative period in 6 (35.3%) cases;all of them required VP shunt procedure. None of the cases had a preoperative neurologic deficit. Surgical excision was performed in all cases. In the postoperative period, meningitis developed in 2 cases (11.8%), wound infection in 1 case (5.9%) and seizure in 1 case (5.9%). Three patients

关键词： Encephalocele Neural Tube Defect Hydrocephalus Congenital Malformation

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