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A Rare Cause of Hemiparesis: Intracranial Mycotic Aneurysm—A Case Report, and Review of the Literature

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Open Journal of Modern Neurosurgery 2021年第3期11卷 171-179页

作者： yao christian hugues dokponou Mehdi Hakkou Olivier Ouambi Nourou Dine Adeniran Bankole Abdessamad El Ouahabi Service de Neurochirurgie de l’Hô pital Des Spécialités Rabat Morocco Faculté de Médecine et de Pharmacie Université Mohammed V Rabat Rabat Morocco

Background: The intracranial mycotic aneurysm is known to be a rare complication of infective endocarditis and it is more clinically challenging to get this diagnosis right when it happened to be in a patient without a past medical history of heart diseases. We report a documented case of mycotic aneurysm revealed by isolated left hemiparesis and our management with the collaboration of the cardiology department. Case Description: A 48-year-old male patient with a history of teeth loss, a chronic smoker presented with sudden heaviness in the left upper and lower limbs. No fever. Physical examination revealed a left hemiparesis of 3/5 on the muscle tone scale without the stiffness of the neck. The CT-Scan and the MRI conclude of subarachnoid and cerebral hemorrhage with right temporal hematoma being most probably a vascular malformation. The cerebral arteriography concluded of a right Sylvian mycotic distal aneurysm in the M4 segment. Transesophageal echocardiography was performed and concluded of infectious endocarditis with mitral and aortic valvular disease grade II. Positive blood culture for staphylococcus coagulase-negative. The patient was managed with antibiotic therapy and clinically stable after 28 days. He was then transferred to the cardiology department for follow-up. Six (6) months later a CT-angiography was done for a check-up and shows no further changes in the aneurysm. The patient underwent surgery, two (2) months later, for clipping the aneurysm because the aneurysm did not regress in size. The aneurysm was then excluded with an eventless post-operative per

关键词： Mycotic Aneurysm Endocarditis Endovascular Case Report

Severe Traumatic Brain Injury with Sphenopalatine Artery Ruptured: Case Report and Review of the Literature

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Open Journal of Modern Neurosurgery 2021年第3期11卷 204-209页

作者： Adil Belhachmi yao christian hugues dokponou Fernand Nathan Imoumby Napoléon Imbunhe Sofia El Akroud Miloudi Gazzaz Mohammed V University Rabat Morocco Service de Neurochirurgie Hô pital Militaire d’Instruction Mohammed V Rabat Maroc

Emergency endovascular procedure for external carotid exclusion is required to save patients with life-threatening massive epistaxis from a ruptured sphenopalatine artery secondary to severe traumatic brain injury. We report a case of a 20-year-old pedestrian admitted with a severe traumatic brain injury (TBI) secondary to an automobile (a lorry) road accident at high velocity. He presented to the emergency room in a coma with a Glasgow coma scale of 6/15 and massive epistaxis. He underwent emergency stabilization by sedation and was intubated. Body CT-Scan shows fracture of the palatine and pterygoid plate and multiple fractures of the skull with intracranial right frontal lobe hematoma. CT-Angiography was done immediately and confirmed a rupture of the sphenopalatine artery. The patient died of massive epistaxis while waiting for the endovascular procedure. This is a rare clinical case that needs unusual emergency endovascular management. Arterial embolization in emergency settings should be thought in front of any patient with persistent post-traumatic nose bleeding and be carried out as soon as possible to save the patient’s life.

关键词： Traumatic Brain Injury Sphenopalatine Artery Endovascular

Brain Metastasis of Uterine Leiomyosarcoma: A Case Report and Review of the Literature

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Open Journal of Modern Neurosurgery 2021年第2期11卷 107-113页

作者： Fernand Nathan Imoumby yao christian hugues dokponou Franck Kouakou Hajar El Agouri Abad Cherif El Asri Miloud Gazzaz Department of Neurosurgery Mohammed V Military Teaching Hospital Rabat Morocco Faculty of Medicine and Pharmacy Mohammed V University Rabat Morocco Department of Anatomy Pathology Mohammed V Military Teaching Hospital Rabat Morocco

The metastases of uterine leiomyosarcoma to the brain are exceptional and such cases are seldomly reported in the literature. The diagnosis is based on CT and brains MRI findings, in association with a gynecological history of cancer. Their management still stays without guidelines, and the surgical total resection is known to be the only way to influence positively the prognosis and save patient lives. We report a rare case of a 46 years old woman who underwent a hysterectomy and bilateral salpingo-oophorectomy 5 years earlier and presented with the right hemiparesis and whose CT scan and MRI of the brain showed cerebral lesions related to brain location of uterine leiomyosarcoma. The patient underwent surgery for gross total tumor resection, followed by adjuvant radiotherapy, and was doing well after surgery. Three months later she was admitted for recurrences and died after two months of palliative care.

关键词： Uterine Leiomyosarcoma Brain Metastasis Case Report

Arachnoiditis Ossificans Mimicking Spinal Intradural Extramedullary Tumor: A Case Report and Review of the Literature

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Open Journal of Modern Neurosurgery 2021年第3期11卷 157-163页

作者： yao christian hugues dokponou Inas El Kacemi Fernand Nathan Imoumby Franck Loukou Kouakou Sofia El Akroud Miloud Gazzaz Mohammed V Military Teaching Hospital Rabat Morocco Faculty of Medicine and Pharmacy Mohammed V University Rabat Morocco

Arachnoiditis ossificans is an intradural extramedullary lesion resulting from an unusual chronic meningeal inflammatory process and it is thought to be the sequela of end-stage adhesive arachnoiditis secondary to surgery, trauma, arachnoid hemorrhage, meningeal irritation, myelography (particularly oil-based contrast agents), and spinal anesthesia. The spinal arachnoiditis ossificans may be silent or cause a variety of symptoms depending on its location and uncommonly happen to cause spinal cord compression. Very little attention has been paid to the management and outcome of this rare condition in the neurosurgical reem. We report the case of a 45 years old man admitted with L1 - L2 arachnoiditis ossificans revealed by polyradiculopathy on incomplete cauda equina syndrome mimicking spinal canal tumors. The patient underwent surgery and we performed the laminectomy of L1 - L2, total resection of the lesion, followed by a complete remission of the hemiparesis after three months of kinesitherapy nursing.

关键词： Management Outcome Arachnoiditis Ossificans Spinal Tumor Case Report

Massive Rhinorrhea as a Complication of COVID-19 Nasopharyngeal Swab

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Open Journal of Modern Neurosurgery 2023年第3期13卷 145-148页

作者： Inas El Kacemi yao christian hugues dokponou Fresnel Lutèce Ontsi Obame Moussa Elmi Saad Napoleao Imbunhe Salami Mohcine Abad Cherif El Asri Miloud Gazzaz Department of Neurosurgery Military Teaching Hospital Mohammed V University Rabat Morocco

The nasopharyngeal swab for COVID-19 testing is generally considered safe;however, it is primarily performed by staff that may not completely understand the anatomy of the nasal cavity and nasopharynx. We report the treatment of a 48-year-old man who developed unilateral left rhinorrhea after a nasopharyngeal swab sample. It is aimed to draw attention to this complication that can be prevented with the appropriate technique during nasopharyngeal swab sampling.

关键词： COVID-19 Testing Nasopharyngeal Swab Rhinorrhea

Least Square Finite Element Model for Analysis of Multilayered Composite Plates under Arbitrary Boundary Conditions

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World Journal of Engineering and Technology 2024年第1期12卷 40-64页

作者： christian Mathew yao Fu Department of Engineering Mechanics Virginia Polytechnic Institute and State University Blacksburg Virginia USA Department of Aerospace and Ocean Engineering Virginia Polytechnic Institute and State University Blacksburg Virginia USA

Laminated composites are widely used in many engineering industries such as aircraft, spacecraft, boat hulls, racing car bodies, and storage tanks. We analyze the 3D deformations of a multilayered, linear elastic, anisotropic rectangular plate subjected to arbitrary boundary conditions on one edge and simply supported on other edge. The rectangular laminate consists of anisotropic and homogeneous laminae of arbitrary thicknesses. This study presents the elastic analysis of laminated composite plates subjected to sinusoidal mechanical loading under arbitrary boundary conditions. Least square finite element solutions for displacements and stresses are investigated using a mathematical model, called a state-space model, which allows us to simultaneously solve for these field variables in the composite structure’s domain and ensure that continuity conditions are satisfied at layer interfaces. The governing equations are derived from this model using a numerical technique called the least-squares finite element method (LSFEM). These LSFEMs seek to minimize the squares of the governing equations and the associated side conditions residuals over the computational domain. The model is comprised of layerwise variables such as displacements, out-of-plane stresses, and in- plane strains, treated as independent variables. Numerical results are presented to demonstrate the response of the laminated composite plates under various arbitrary boundary conditions using LSFEM and compared with the 3D elasticity solution available in the literature.

关键词： Multilayered Composite and Sandwich Plate Transverse Stress Continuity Condition Arbitrary Boundary Condition Layerwise Theory Least-Squares Formulation

Epidemiological, Diagnostic, Therapeutic and Progressive Aspects of Arterial Hypertension in Children at the University Hospital Center of Bouaké (Côte d’Ivoire)

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Open Journal of Pediatrics 2024年第2期14卷 379-390页

作者： Richard Azagoh-Kouadio yao Kossonou Roland Yeboua Kouassi christian yao John Patrick Yenan Iburaima Alamun Akanji Kouadio Vincent Assé Pediatric Department of Angré University Hospital Abidjan Ivory Coast Pediatric Department of Bouaké University Hospital Bouaké Ivory Coast

Introduction: Arterial hypertension (AH) in children is under-diagnosed and often has a poor prognosis. The aim of this study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of hypertension in children at the University Hospital of Bouaké, with a view to improving the prognosis. Methods: This was a cross-sectional, analytical study carried out in the paediatrics department of Bouaké University Hospital. It concerned the medical records of children aged 4 to 15 hospitalised from 1 January 2017 to 31 December 2020 for hypertension. Diagnosis was based on the simplified blood pressure guidelines of the Expert Consensus of the French Society of Hypertension. The variables studied were epidemiological, diagnostic, therapeutic and evolutionary. Quantitative variables were compared at the significance level p ≤ 0.05. Results: The hospital incidence of hypertension was 0.32% (69/21,642). The sex ratio was 0.72. 97.1% of the children were over five years of age. Oedema (49.3%) and breathing difficulties (20.2%) were the main reasons for consultation. Hypertension was classified as threatening (56.5%), confirmed (31.9%) and borderline (11.6%). The cause was renal in 66.7%, dominated by impure nephrotic syndrome (24.6%). Treatment for hypertension consisted mainly of a diuretic (79.7%) and a calcium channel blocker (47.8%). Outcome was favourable in 50.7% of cases. Mortality was 20.3%. No factor was significantly associated with death. Conclusion: Hypertension in children at Bouaké University Hospital is serious. The aetiology is mainly renal. Early diagnosis and management are key to improving prognosis.

关键词： Hypertension Children Renal Pathologies Prognosis Côte d’Ivoire

Assessment of the Vaccination Status of Children Aged 6 to 30 Months in a Tertiary Level Health Care Center in Côte d’Ivoire

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Open Journal of Pediatrics 2024年第3期14卷 536-546页

作者： Yenan John Patrick Kpangni Jean Bertrand yao Kouassi christian Yeboua yao Kossonou Roland Aka-Tanoh Koko Aude Hélène Avi-Siallou Christelle Honorine Asse Kouadio Vincent Department of Pediatrics University Teaching Hospital of Bouake Bouake Ivory Coast Unit Pediatric Surgery University Teaching Hospital of Bouake Bouake Ivory Coast

Introduction: Vaccination coverage in Côte d’Ivoire over the period 2011 to 2015 was below the target of 95% for all antigens. The objective of this study was to analyze the vaccination status of children aged 6 to 30 months with a view to improving vaccination coverage. Patients and Methods: This was a descriptive cross-sectional study which took place from June to September 2018 in a tertiary health center, focusing on children aged 6 to 30 months with a correctly completed health record. The parameters studied were sex, age, educational level of mothers, dates of vaccine administration and reason for missed vaccination opportunities. Results: We retained 212 children. The sex ratio was 1.21 and 93% had received the BCG vaccine before the age of 1 month. The average ages of combined and co-administered vaccines for the 1st and 2nd doses were 7.66 ± 3.81 and 12.88 ± 3.95 weeks, respectively. The median was 16.57 weeks for the 3rd dose. The proportion of vaccinated subjects was greater than 90% for the BCG vaccine and the 3 doses of combined vaccines, and 77% for the yellow fever and measles vaccines. The reasons for non-vaccination were attributable to the children’s parents and health facilities. Conclusion: Improving vaccination coverage requires regular supply of vaccines to centers, and the involvement of all health professionals, community and religious leaders in the vaccination awareness process.

关键词： Children Vaccination Coverage Missed Opportunities

Epidemiological, Diagnostic, Therapeutic, and Prognostic Profile of Non-Tuberculous Community-Acquired Purulent Pleurisy in Children at the Bouaké University Hospital Center, 2017-2021

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Advances in Infectious Diseases 2024年第1期14卷 220-232页

作者： Yapo Thomas Aba christian yao Pacôme Monemo Richard Azagoh-Kouadio Iburaima Akandji Noelle Gonné Jean-Marie Karidioula Vincent Achi Vincent Kouadio Asse Department of Infectious and Tropical Diseases University Hospital of Bouaké Bouaké Ivory Coast University Alassane Ouattara of Bouake Bouake Ivory Coast Department of Pediatrics University Hospital of Bouaké Bouaké Ivory Coast Department of Bacteriology & Virology University Hospital of Bouake Bouaké Ivory Coast Department of Pediatrics University Hospital of Angré Abidjan Ivory Coast Department of Pneumology University Hospital of Bouake Bouaké Ivory Coast

Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.

关键词： Community-Acquired Purulent Pleurisies Children Mortality Bouaké