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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 Stroke as a Post-Operative Lethal Complication of a Bilateral Chronic Subdural Hematoma: A Case Report

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Open Journal of Modern Neurosurgery 2021年第2期11卷 122-127页

作者： fernand nathan imoumby Franck Kouakou Yao C. Hugues Dokponou Abad Cherif El Asri Miloud Gazzaz Mohammed V Military Teaching Hospital Rabat Morocco Faculty of Medicine and Pharmacy Mohammed V University Rabat Morocco

Chronic subdural hematoma (CSDH) is a common neurosurgical condition that is frequently encountered in neurosurgery practice. Its etiologies are dominated by traumatic head injury, and clinical presentations are various. The prognosis is generally good, but complications can be seen. Some of these complications can lead to the death of the patient. We report the rare case of a 70-year-old man admitted to the emergency room for the management of bilateral CSDH revealed by severe headache, vomiting, and loss of consciousness. He underwent a successful evacuation of both hematomas but had a stroke in both posterior cerebral artery territories, which was lethal 72 hours after surgery. We present and try to find an explanation for this exceptional post-operative complication of CSDH.

关键词： Brain Stroke Complication Subdural Hematoma 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

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