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Morel-Lavallée Lesion: A Case Report of a Large Post-Traumatic Subcutaneous Lumbar Hematoma and Literature Review

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Open Journal of Modern Neurosurgery 2016年第1期6卷 29-36页

作者： Dominique N’Dri Oka daouda sissoko Alban Slim Mbende Neurosurgery Unit Yopougon Teaching Hospital Abidjan Cote d’Ivoire

Morel-Lavallée Lesions (MLL), described in 1863 by French surgeon Victor-Auguste-Francois Morel-Lavallée, are rare posttraumatic closed degloving injuries, occurring as a result of tangential sheer forces, in which the skin and subcutaneous tissue separate abruptly from the underlying deep fascia, causing fluid collection with liquefied fat. A 31-year-old policeman involved in a road traffic accident, presented with a gradually expanding lumbar swelling, which was soft, fluctuant and painful with contused skinon examination. Computed Tomography (CT) scan of the lumbar spine revealed a large subcutaneous hematoma on axial view, extending from the 12th thoracic vertebra down to the first sacral vertebra. There was no skeletal lesion. The treatment consisted of surgical excision/drainage of the collection followed by continuous suction with drainage tubes for two days. The collection is completely resolved;the patient made a full recovery and has been asymptomatic. Since there was a history of blunt trauma and given the nature and the location of the collection over osseous prominences, we report this rare case of a large posttraumatic lumbar hematoma diagnosed on clinical and CT scanning grounds as a Morel-Lavallée lesion. The patient was informed that non-identifying information from the case would be submitted for publication, and he provided consent.

关键词： Morel-Lavallée Lesions (MLL) Subcutaneous Hematoma Lumbar Trauma

Spinal Cord Compression Caused by Multifocal Histoplasmosis Treated Conservatively: Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2016年第1期6卷 20-24页

作者： Dominique N’Dri Oka Alban Slim Mbende daouda sissoko Neurosurgery Unit Yopougon Teaching Hospital Abidjan Cote d’Ivoire

We present the case of a 39-year-old patient admitted for a slow thoracic spinal cord compression syndrome associated with lumbar rachialgia. CT scan and MRI of the thoracic spine showed lysis of T4, T5, T6 and T7 vertebrae, an epiduritis and paravertebral abscesses. CT scan of the lumbar spine demonstrated osteolysis of the left iliac wing with skin invasion. This lesion infiltrated the sacrum and the body of L5. The iliac lesion was biopsied and the analysis revealed a granulomatous osteitis caused by Histoplasma duboisii. The treatment consisted of ketoconazole 400 mg daily for six months. Spinal decompressive surgery was not performed. Following antifungal treatment the patient had satisfying clinical and radiological outcome. After three years’ follow-up, the clinical course was uneventful. The patient had neither symptoms of spinal cord compression nor signs of further localizations.

关键词： Histoplasma duboisii Bone Multiple Localization Spinal Cord Compression

Pericallosal Artery Aneurysms: Twenty-Six Years of Microneurosurgical Endeavor in Three Major Neurosurgical Centers in Abidjan

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Open Journal of Modern Neurosurgery 2017年第4期7卷 129-141页

作者： Médard Kakou Alban Slim Mbende daouda sissoko Fulbert Kouakou Neurosurgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast

We present our experience of microsurgical treatment of pericallosal artery aneurysms (PCAA) in three neurosurgical centers in Abidjan (Ivory Coast) from 1990 to 2016. This present study aimed to evaluate characteristics of 6 patients with PCAA treated during a 26-year period and to establish the rate, clinical nuances, anatomical variations and respective microsurgical approaches of PCAA in Abidjan. We analyzed medical files of all 93 patients admitted for an intracranial aneurysm between 1990 and 2016 and focused on the 6 patients who were treated for a PCCA. The mean age of patients was 37 years, half of whom were less than 30 years old. They were 3 men and 3 women. The time from first symptom to admission was more than 3 days, but less than 16 days. Five out of six patients had ruptured aneurysms and the clinical condition on admission was WFNS grade 0 one patient (16.67%) and WFNS I-III five patients (83.33%). Analysis of radiological data revealed Fischer grade IV three patients and Fischer grade I-II three patients. A total of 7 PCCA were recorded and they accounted for 6.19% of all intracranial aneurysms and 9.72% of all anterior circulation aneurysms. Six out of seven aneurysms (85.71%) were either smaller (2 - 6 mm) or middle sized (6 - 15 mm). There was only one (14.29%) giant PCA aneurysm (>25 mm). According to the location, two aneurysms (28.57%) were located on the A2 segment of the pericallosal artery (PCA) and five (71.43%) on the A3 segment of the artery. We found 4 cases of saccular aneurysms (57.14%) and 3 cases of fusiform aneurysms (42.86%), two of which were located on A2 segments of the 2 PCA on the same patient (16.67%). We didn’t find any PCA anatomical variation associated with any of the 7 aneurysms. Two patients developed perioperative rebleeding and in 1 case a severe preoperative hydrocephalus was diagnosed. The median time from rupture to surgery was 59.5 days with a range of 14 to 180 days. Treatment techniques included 4 clipping (57

关键词： Pericallosal Artery Aneurysm Pericallosal Artery Microsurgery Treatment Abidjan

Infracallosal Aneurysm Rupture Revealed by Chronic Subdural Hematoma: A Case Report

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World Journal of Neuroscience 2022年第3期12卷 112-117页

作者： Mahamadou Dama Oumar Diallo Oumar Coulibaly daouda sissoko Theodore H. M. Coulibaly Aliou Maiga Youssouf Sogoba Neurosurgery Department University Hospital of Mali Bamako Mali Anesthesiology Department University Hospital of Mali Bamako Mali Siramana Medical-Surgical Clinic Bamako Mali Neurosurgery Department University Hospital Gabriel Touré Bamako Mali

Chronic subdural hematoma (CSDH) is one of the most common entities seen in neurosurgery. We report a case of infracallosal aneurysm revealed by CSDH in a 52 years old woman. She presented 3 days alteration of consciousness in 2019 and repeated in September 2020 a severe headache and dizziness. There was no history of others symptoms, nor head trauma. Routine blood examination and coagulation profile were normal. Emergency computed tomography (TC) showed a left temporoparietal-occipital CSDH. Cerebral Angio CT found a bilobated of A2 aneurysm. The precallosal interhemispheric approach was made and clipping the aneurysm after evacuation of CSDH without complication. CSDH is one of the revealed features of intracerebral aneurysm rupture.

关键词： CSDH Cerebral Hemorrhage Infracallosal Aneurysm SAH

Intraorbital Mature Teratoma in Infant

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Open Journal of Modern Neurosurgery 2022年第3期12卷 127-131页

作者： Oumar Diallo Abdoulaye Hima Maiga Bekety Katanga Anthony Mahamadou Dama Oumar Coulibaly daouda sissoko Alpha Singuepiré Hospital of Mali Bamako Mali Hospital of Niamey Nyamay Niger Hospital of Kara Kara Togo Hospital of Ségou Ségou Mali

Intraorbital mature teratoma is a rare congenital tumor of slow evolution that can compromise vision. Objectives: We describe the clinical and therapeutic aspects of a mature teratoma in childhood with a literature review. Clinical Case: It was a 12-year-old who had a progressive straight monocular exophthalmia with blindness. CT without and with contrast injection showed a double component intracolonic invasive tumor with partial contrast acquisition after injection. This tumor respected the bone walls of the orbit. The treatment was surgical by conjunctival dissection of the tumor and enucleation. This allowed the tumor to be fully excised under an operating microscope. The operating procedures were simple. Anatomopathology confirmed the nature of the tumor by visualizing the presence of a squamous epithelium by the high-magnification (X20) method of hematoxylin and eosin. Conclusion: Mature intraorbital teratoma is an embryonic tumor with early diagnosis the finding in an older child remains rare. Complete surgical excision allows healing.

关键词： Teratoma Mature Micro Surgery

Traumatic Spinal Cord Injuries in Gold Miners in Mali: Preliminary Study on 76 Cases

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World Journal of Neuroscience 2019年第3期9卷 208-215页

作者： Oumar Coulibaly Mahamadou Dama Oumar Diallo daouda sissoko Boubacar Sogoba Singuepiré Alpha Youssouf Sogoba Drissa Kanikomo Hô pital du Mali Bamako Mali Hô pital Gabriel Touré University of Sciences Technics and Technologies of Bamako (USTTB) Bamako Mali

Introduction: Gold panning is the research and artisanal exploitation of gold in the auriferous areas (rivers or others). Traumatisms arising from these activities are due to severe spinal cord injury and generally affect young people in full activity. They constitute a real social handicap in Mali and even in Africa. The aim of our study is to share our expertise in the management of these vertebro-medullary traumasin these miners who currently escape to all controls in Mali. Material and Methods: From 2013 to 2016, 76 Traumatic Spine Cord Injuries (TSCI) were treated in the department of Neurosurgery of “Hôpital du Mali”. There were 73 males (96.05%) versus 03 Females (3.95%), aged between 21 - 43 years old. Results: All of our patients were admitted with deficit differing from paraparesis to tetraplegia. According to Frankel scale, we found 59 patients with complete deficits (A grade, 77.63%), and incomplete deficits in 17 cases (12 grade B, 04 grade C, 01 grade D). The X-ray standard radiographies were done in 24 cases (31.58%) from which 02 patients had been operated with these data. CT scan centered on the injured spinal segment was performed in 74 cases (97.37%). The lumbar spine was affected in 39 cases, followed by thoracolumbar junction in 19 cases and thoracic spine in 16 cases. The cervical spine was only interested in two cases. Fractures dislocations are the most frequently lesions encountered in our series. The surgical approach was performed in 74 patients and 02 patients received conservative treatment. Conclusion: Traumatic Spinal Cord Injuries (TSCI) among miners are a real disaster in Mali and continue to plague thousands of families or increase the number of disabled people in our society. It is the only work, where the person concerned is making of his own grave. And according to witnesses, several miners remained at the bottom of the wells. Their prevention must first involve users by raising the awareness of local residents and traditio

关键词： Spinal Cord Injury Gold Mali

About an Observation of a Child Penetrating Brain Injury by Knife

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Open Journal of Modern Neurosurgery 2021年第4期11卷 267-271页

作者： Noukhoum Koné Issa Sarki Souleymane Badra Aliou Koné daouda sissoko Valentin Tokpa Ahmed Salem Kleib Outouma Soumaré Aderehime Haidara Department of Neurosurgery Kiffa Hospital Center Kiffa Mauritania Department of Neurosurgery Yopougon Hospital Center Abidjan Ivory Coast Department of Neurosurgery Ongwediva Medipark Hospital Ongwediva Namibia

Background: Reported cases of knife injuries to the head in children are rare. Here we describe a case of pediatric penetrating brain injury by knife (PPBIK) and review literature. The patient’s parents were informed that non-identifying information from the case would be submitted for publication, and they provided consent. Case Presentation: A 3-year-old boy presented to our emergency department with a knife penetrating the front of his head during play. Neurologic examination was normal. Radiograph in lateral view demonstrated a metallic knife entering frontal bone. Computed tomography (CT) scan showed small hemorrhage around the foreign body recognized, accompanied by small pneumocephalus. The knife was surgically removed and the dura was closed. He was discharged home after the surgery with normal neurological status. Conclusion: Only four cases of PPBIK have been reported in the literature. The adequate management of these types of injuries requires a correct neuroradiological evaluation.

关键词： Craniocerebral Trauma Penetrating Head Injury Traumatic Brain Injury Wound Stab

Angiographic Features of Intracranial Aneurisms in Mali: A Preliminary Study of 105 Patients

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World Journal of Neuroscience 2023年第1期13卷 1-11页

作者： Mahamadou Dama Oumar Coulibaly Oumar Diallo daouda sissoko Hawa Diarra Kalba Tembine Mamadou Salia Diarra Madani Ouologem Drissa Kanikomo Neurosurgery Department University Hospital of Mali Bamako Mali Radiology Department University Hospital of Mali Bamako Mali Anesthesiology Department University Hospital of Mali Bamako Mali Neurosurgery Department Hospital of Luxembourg Bamako Mali Unite of Neurology Infirmery of the Armies Bamako Mali Department of Neurosurgery Gabriel Touré Hospital Bamako Mali

Introduction: Rupture of intracranial aneurisms leads to severe morbidity and mortality. There are two modalities of treatment surgery and endovascular treatment. The diagnosis is made by angiography (DSA, CTA, RMA). The angiographic features used to assess the risk of the complications and choose the treatment modality are size, location and aneurism morphology. Materials and Methods: We reviewed and analyzed the computed tomographic angiography and magnetic resonance angiography of all patients admitted to the hospital of Mali with IAs from 2015 to 2021 either 7 years. Patients who were less than 18 years old, those with non-aneurysmal SAH, patients who request a discharge and those with an incomplete angiographic description of the IAs were excluded from the analysis. Results: We have collected 105 patients with 109 aneurysms. The sex ratio was 2/1 in favor of females. The mean age was 44.51 years with the range from 18 to 70 years. The presentation mode was subarachnoid hemorrhage (SAH) in 97% of cases. 76.19% had confirmed high blood pressure before the bleeding. 19.04% were diabetics. 98% of our patients have made a CT angiography and 2% have made MR angiography for the aneurysm diagnosis. 97.24% of aneurisms were located in the anterior part of the Willis circle. 39.44% of these aneurisms were the anterior communicating complex aneurysm. 27.52% of aneurysm had a small size, 42.20% had a medium size, 20.18% large size against 5.50% of the giant (Figure 3) and the middle cerebral artery was the most involved in the least. 95.41% of cases were saccular aneurysms against 4.59% fusiform. Conclusion: The angiographic feature of an intracranial aneurism in the Malian population may differ from other populations of the sub-region. The anterior communicating complex aneurysm is more common and the aneurism of the posterior part of the Willis circle is less common. We found the aneurism size ≥ 6 mm, ACA, MCA and Pcom more frequent.

关键词： Subarachnoid Hemorrhage Aneurism CT Angiography RMA

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