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Cerebellar Syndrome Revealing a Giant Postero Inferior Cerebellar Artery Aneurysm: A Case Report and a Review of Literature

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Case Reports in Clinical Medicine 2021年第6期10卷 153-159页

作者： Oumar Diallo Maiga Abdoulaye Hima Beketi Katanga Anthony Thioub Mbaye Mahamadou Dama Oumar Coulibaly Daouda Sissoko Alpha Singuepire Drissa Kanikomo seydou boubakar badiane Hospital of Mali Bamako Mali Hospital of Niamey Niamey Niger University of Kara Kara Togo University Checkh Anta Diop Dakar Senegal Regional Hospital of Segou Ségou Mali Hospital Gabriel Touré Bamako Mali

Context: Cerebellar syndrome caused by disturbances of balance and coordination is not an uncommon neurological disorder. It has varied etiologies usually caused by tumor processes or suppurative collections. Vascular causes remain very rare, especially when it is a giant aneurysm of PICA representing 1% of intracranial aneurysms. Treating giant PICA aneurysms is a very difficult task for neurosurgeons because the surgical dissection can lead to severe damage due to the intimate relationship of PICA with the brainstem or nerve structures. We report a case of giant PICA aneurysm responsible for cerebellar syndrome successfully treated with surgery. The objective of this work is to draw the attention of practitioners to this unusual cause which can lead to diagnosis wandering and a lack of planning at the time of management. Case report: A 65 years old hypertensive patient was seen for a progressive disturbance of balance and walking disorder, but worsened in the last three months with no notion of fever. On admission, the patient was lucid, oriented in time and space and presented with static and kinetic cerebellar syndrome. Brain CT-scan without and with contrast revealed a tissular mass in the posterior fossa suggesting a tumor process, however, CT angiography showed a giant aneurysm of the PICA after reconstruction. A careful microdissection by a sub-occipital approach was decided. Opening the large cistern made it possible to visualize the aneurysm sack surrounded by a yellowish gliosis. The reclining and microdissection revealed the neck of the aneurysm, which was clipped to exclude the giant aneurysm in block. Postoperative follow-up was simple with progressive improvement in the cerebellar syndrome and walking over three months. Conclusion: Giant aneurysm of the PICA is rare. The localization in the posterior cerebral fossa can be confusing. Microsurgery gives a good result.

关键词： Giant Aneurysm PICA Cerebellar Syndrome CT Angiography

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

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

Late Discovery of a Vein of Galen Aneurysmal Malformation Complicated with Hydrocephalus: A Case Report

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Open Journal of Modern Neurosurgery 2020年第2期10卷 254-259页

作者： Diop Abdoulaye Faye Mohameth Cissé Mohamed El Hassimi Thioub Mbaye Ba Momar Code badiane seydou boubakar Neurosurgery Department of CHNU Fann Dakar Senegal

The aneurysmal malformation of the vein of Galen is a rare condition, corresponding to less than 1% of intracranial vascular malformations. It is a disease affecting mainly newborns and small children. We are reporting the case of an 11-year-old teenager who presented consciousness disorders associated to generalized convulsive seizures. The cerebral CT scan supplemented by an angioscanner, revealed an important expansive process in the pineal region, confirming the diagnosis of an aneurysmal malformation of the Galen’s ampulla with upstream obstructive hydrocephalus. The child benefited from a ventriculo-peritoneal shunt with favorable immediate operative sequels. His death occurred at home two months after surgery over the course of a convulsive seizure with post critical coma.

关键词： Intracranial Vascular Malformation Arteriovenous Malformation Vein of Galen