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Management of Penetrating Cranioencephalic Trauma Caused by Sharp Metal Objects—Therapeutic and Evolutionary Aspects: 12 Cases at the Renaissance University Hospital in N’Djamena

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Open Journal of Modern neurosurgery 2024年第2期14卷 170-178页

作者： Goumantar Félicien Toudjingar Li-Iyane Olivier Ouambi Yannick Canton Kessely Donal Djasdé Mahouli Fata Vounki Momar Codé Ba neurosurgery Unit of Center Hospitalier Universitaire la Renaissance N&#8217Djamena Chad neurosurgery Unit of CHU la Ré f&#233rence Nationale N&#8217Djamena Chad neurosurgery Department of Centre Hospitalier National Universitaire de fann Dakar Senegal

Introduction: Cranioencephalic trauma caused by bladed weapons is rare, and that caused by sharp objects is exceptional. The aim of our study was to describe the clinical, therapeutic and evolutionary aspects. Materials and method: This was a descriptive and analytical study over a 48-month period at CHU la Renaissance from January 1, 2018 to December 31, 2021, concerning patients admitted for penetrating cranioencephalic trauma by pointed object. Results: Twelve cases, all male, of penetrating cranioencephalic sharp-force trauma were identified. The mean age was 34 ± 7 years, with extremes of 11 and 60 years. Farmers and herders accounted for 31% and 25% of cases respectively. The average admission time was 47 hours. Brawls were the circumstances of occurrence in 81.2% of cases. Knives (33%), arrows (25%) and iron bars (16.6%) were the objects used. Altered consciousness was present in 43.8% of cases, and focal deficit in 50%. Scannographic lesions were fracture and/or embarrhment (12 cases), intra-parenchymal haematomas (6 cases) and presence of object in place (4 cases). Surgery was performed in 11 patients. Postoperative outcome was favorable in 9 patients. After 12 months, 2 patients were declared unfit. Conclusion: Penetrating head injuries caused by sharp objects are common in Chad. Urgent surgery can prevent disabling after-effects.

关键词： Penetrating Trauma Skull Encephalon Sharp Object Surgery Patient Outcome

Giant Cerebriform Nevus Cell Nevus of the Scalp: A Case Report

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Open Journal of Modern neurosurgery 2024年第1期14卷 8-13页

作者： Mohamed El Hassimi Cissé N’daraw Ndoye Anne Aurore Sankale Pauline Diousse Abdoulaye Diop Alvine Nah Doe Sagar Diop Momar Codé Ba Seydou Boubakar Badiane neurosurgery Department of CHU Mère-Enfant “Le Luxembourg” Bamako Mali neurosurgery Department of CHNU de fann Dakar Sénégal Plastic and Cosmetic Surgery Department of CHU Le Dantec Dakar Sénégal Dermatology Department of Thiès Regional Hospital Thiès Sénégal

Giant cerebriform nevus cell nevus of the scalp is an extremely rare form of congenital melanocytic nevus. Giant cerebriform nevus of the scalp has a major psychosocial impact because of its unsightly appearance with fetid maceration. We report the case of a 35-year-old woman who had a painless, malodorous swelling of the cerebriform scalp measuring 20 × 17 cm in diameter with a wide base of insertion at the occipital level adhering to the deep planes. The excision associated with a skin plasty was carried out. Histology concluded that there was a giant cerebriform naevo-cellular nevus of the scalp.

关键词： Giant Nevus Tumor of the Scalp Resection

resident immune responses to spinal cord injury:role of astrocytes and microglia

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Neural Regeneration Research 2024年第8期19卷 1678-1685页

作者： Sydney Brockie Cindy Zhou Michael G.Fehlings Division of Genetics and Development Krembil Research InstituteUniversity Health NetworkTorontoONCanada Institute of Medical Science University of TorontoTorontoONCanada Division of neurosurgery and Spine Program Department of SurgeryUniversity of TorontoTorontoONCanada

Spinal cord injury can be traumatic or non-traumatic in origin,with the latter rising in incidence and prevalence with the aging demographics of our *** r,as the global population ages,individuals with co-existent degenerative spinal pathology comprise a growing number of traumatic spinal cord injury cases,especially involving the cervical spinal *** makes recovery and treatment approaches particula rly challenging as age and comorbidities may limit regenerative *** these reasons,it is critical to better understand the complex milieu of spinal cord injury lesion pathobiology and the ensuing inflammatory *** review discusses microglia-specific purinergic and cytokine signaling pathways,as well as microglial modulation of synaptic stability and plasticity after ***,we evaluate the role of astrocytes in neurotransmission and calcium signaling,as well as their border-forming response to neural *** the inflammatory and reparative roles of these cells have eluded our complete understanding and remain key therapeutic targets due to their extensive structural and functional roles in the nervous *** advances have shed light on the roles of glia in neurotransmission and reparative injury responses that will change how interventions are *** key processes and existing knowledge gaps will allow future research to effectively target these cells and harness their regenerative potential.

关键词： astrocytes glial signaling microglia spinal cord injury synaptic transmission

Surgical Treatment of Cervical Spine Trauma in Rural Area (Low Income Country): Our Experience and Results

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Open Journal of Orthopedics 2022年第4期12卷 195-203页

作者： Daouda Wague Mouhamet Cisse Gaye Maguette Ansoumane Donzo Yakhiya Cisse Mouhamet Faye Maguette Mbaye Mbaye Thioub neurosurgery at CHMFT Diourbel Senegal neurosurgery at fann Dakar Senegal neurosurgery at HOGIP Dakar Senegal neurosurgery at fann Dakar Senegal Neurosuregery at CHR Thies Senegal neurosurgery at HOGIP Dakar Senegal neurosurgery at UCAD Dakar Senegal

Introduction: cervical spine trauma remains one of the most common causes of morbidity in the world with a significant financial burden on our society. It is a devastating event for the patient and family. The aim of this study is to share our experience in the surgery management of cervical spine injury in rural area. Methods: We did retrospective and single center study for one year from August 2020 to August 2021. We included all the patients who had undergone surgery for cervical spine injury in our hospital. Results: The study is based on 14 patients, 9 males and 5 females (sex ratio: 1.8). The average age was 34 years old and 08 (57%) were employed at time of injury. Road traffic accident was the most common cause, it was found in 11 (78%) cases followed by falls in 2 (14%) and interpersonal assault in 1 (7%). The Time admission ranged from 03 hours to 03 weeks. The most associated lesion was head trauma 7 (50%) followed by chest injury in 05 (35%) and 92% of our patient had motor deficit. Surgery was performed in all cases. Closed reduction was performed in 09 (64%) before surgery. Different types of complications that we had encountered were: infection 01 (07%) case, bed sores 02 (14%) cases, respiratory distress 02 (14%) cases and cervical kyphosis 01 (07%) case. After 06 months 71% of patients have progressed well with partial or complete recovery of their deficit. 14% of death in our series were noted and 28% of patients returned to work. Conclusion: cervical spine trauma remains a heavy socio-professional handicap. In rural areas, despite the lack of equipment and the difficulties of care, our results are satisfactory. However, it is necessary to insist on psychotherapy for these patients.

关键词： Cervical Spine Morbidity Trauma Surgery

The genomic and immunogenomic landscape of mechanics pathway informs clinical prognosis and response to mechanotherapy

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Science China(Life Sciences) 2024年第8期67卷 1549-1562页

作者： Peidong Zhang Peiwei Li Muya Tang Ryan CGimple Liang Huang Jing Yue Qiuhong Shen Yiwei Du Qian Zhang Zhengnan Yang Haihuai He Kailin Yang Linjie Zhao Shengtao Zhou Department of Obstetrics and Gynecology Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOEState Key Laboratory of BiotherapyWest China Second HospitalSichuan University and Collaborative Innovation CenterChengdu 610041China Physician Scientist Training Program Department of MedicineWashington University School of MedicineSt.Louis 63110USA Department of neurosurgery State Key Laboratory of BiotherapyWest China HospitalSichuan University and Collaborative Innovation CenterChengdu 610041China Department of Radiation Oncology Taussig Cancer CenterCleveland ClinicCleveland 44106USA

Mechanics shape cell and tissue plasticity and maintain their *** cancers,mechanical signals regulate cancer hallmarks via mechanotransduction pathways,such as proliferation,metastasis and metabolic ***,comprehensive characterization of mechanotransduction pathway genes and their clinical relevance across different cancer types remains ***,we systematically portrayed the alterations of mechanotransduction pathway genes across 31 cancer types using The Cancer Genome Atlas(TCGA)*** the cancer types could be categorized into 6 subtypes based upon the transcriptional pattern of mechanics pathway *** subtype has its own unique molecular expression pattern,mutation landscapes,immune infiltrates,and patient clinical *** further found that the responses of two subtypes of cancers,one with the optimal outcome and the other with the worst prognosis,to a classical mechanotherapeutic agent(Fasudil,RhoA/ROCK inhibitor)were totally different,indicating that our cancer stratification system based upon mechanotransduction pathway genes could inform clinical responses of patients to mechanotherapeutic ***,our study provides a novel pan-cancer landscape of the mechanotransduction pathways and underscores its potential clinical significance in the prediction of clinical prognosis and therapeutic responses to mechanotherapy among cancer patients.

关键词： pan-cancer cancer mechanics multi-omics immunology

Allogenic microglia replacement:A novel therapeutic strategy for neurological disorders

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Fundamental Research 2024年第2期4卷 237-245页

作者： Yanxia Rao Bo Peng Department of Laboratory Animal Science MOE Frontiers Center for Brain ScienceFudan UniversityShanghai 200032China Department of neurosurgery Huashan HospitalInstitute for Translational Brain ResearchState Key Laboratory of Medical NeurobiologyMOE Frontiers Center for Brain ScienceMOE Innovative Center for New Drug Development of Immune Inflammatory DiseasesFudan UniversityShanghai 200000China Co-Innovation Center of Neuroregeneration Nantong UniversityNantongJiangsu 226001China

Microglia are resident immune cells in the central nervous system(CNS)that play vital roles in CNS development,homeostasis and disease *** defects in microglia lead to microglial dysfunction,which in turn leads to neurological *** correction of the specific genetic defects in microglia in these disorders can lead to therapeutic *** genetic defect correction approaches are dependent on viral vectorbased genetic defect ***,the viruses used in these approaches,including adeno-associated viruses,lentiviruses and retroviruses,do not primarily target microglia;therefore,viral vector-based genetic defect corrections are ineffective in *** replacement is a novel approach to correct microglial genetic defects via replacing microglia of genetic defects with allogenic healthy *** this paper,we systematically review the history,rationale and therapeutic perspectives of microglia replacement,which would be a novel strategy for treating CNS disorders.

关键词： Microglia Replacement Microglia replacement Microglia depletion Microglia-free niche CSF1R

The Management of Lumbosciatic Disc Related Disease at Renaissance University Teaching Hospital of N’Djamena-Chad: About 156 Cases

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Open Journal of Modern neurosurgery 2023年第1期13卷 25-32页

作者： Goumantar Felicien Toudjingar Yannick Canton Kessely Ngaoussandjim Ndom-Assal Olivier Ouambi Donald Djasde Mahouli Fata Vounki Alio Hamit Mahamat Momar Code Ba Department of neurosurgery La Renaissance University Hospital N’Djamena Chad Department of neurosurgery Reference Nationale University Hospital Center N’Djamena Chad Department of neurosurgery Fann University Hospital Center Dakar Senegal

Introduction: Low back disc disease (LSD) is a neurosurgical condition with significant socioeconomic repercussions. The objective of this study was to determine the frequency and report the modalities of management. Methodology: This study on lumbosciatic disc disease was carried out in the neurosurgery department of the University Hospital Center (CHU), la Renaissance in N’Djamena. It covered a period of 12 months (from September 2019 to August 2020). A descriptive and an analytical approach were used. The variables studied were epidemiology, clinic, radiology and therapy. Results: the results showed that LSD represented 14.7% of the reasons for consultation in neurosurgery. The average age was 45.8, and to some extent, it ranges between 18 and 76. Lifting was the main reason behind lumbosciatic disc disease with 35.9% of cases, followed by a sedentary life style which represents 30.8%. Lumbosciatica L5 was noted in 49.4%. Obesity and overweight were significant risk factors (P = 0.02) reported in 59% of cases. Motor and sensory deficits were observed in 14.8% and 17.3% of cases, respectively. CT of the lumbar spine was performed in 91% and MRI in 28.9%. The L4-L5 disc herniation represented 74.3% of cases, with a lateral location in 44.2% and L5 radicular impingement in 30.8%. Conservative treatment was instituted in 87.2% and surgical treatment in 12.8% of cases. Conclusion: LSD is caused by a sedentary lifestyle, physical work and overweight. Surgery deals with complicated cases and cases not responding to conservative treatment.

关键词： Lumbosciatica Herniated Disc Surgical Treatment Conservative Treatment Chad

Dorsal Psammomatous Meningioma Revealed by Sciatica Case Report

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Open Journal of Orthopedics 2021年第5期11卷 164-169页

作者： Daouda Wague Maguatte Gaye Cheikh Ndiaye Sy Mouhamet Cisse Souleymane Diallo Youssouf Sakho Neurosurgeon at CHMFT Touba Senegal Professor of neurosurgery (UCAD) and Head of neurosurgery Unit at HOGIP Dakar Senegal Neurosurgeon and Senior Researcher at UCAD Dakar Senegal resident in neurosurgery at fann Touba Senegal resident in neurosurgery at HOGIP Dakar Senegal Professor of neurosurgery at UCAD Dakar Senegal

Introduction: Meningiomas are benign tumors most localized in brain. Intraspinal meningiomas are rare and may have an intra or extradural topography. We report the case of a dorsal psammomatous meningioma revealed by sciatica. Case description: We present a 58-year-old female hospitalized for bilateral painful and disabling L5 sciatica rebellious to medical treatment and physiotherapy. At physical examination, she presented a lumbar spinal syndrome without root deficit. MRI (Magnetic Resonance Imaging) showed a borderline lumbar canal with a paramedian L4-L5 herniated disc. She undergone a first surgery a L4 decompressive laminectomy and there was no postoperative complications. The follow-up was marked by partial pain regression. Three months later, after a fall she presented low back pain and progressive worsening gait troubles. A MRI was realized and shown L3-L4, L4-L5 duct narrowing. A second surgery a L3 and L5 decompressive laminectomy was performed. The postoperative follow up was characterized

关键词： Meningioma Dorsal Sciatica Psammomatous

Vertebroplasty and Kyphoplasty: Indications and Results, a Preliminary Senegalese Experience from the neurosurgery Department of the CHNU of fann

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Open Journal of Modern neurosurgery 2023年第4期13卷 156-165页

作者： El Hadj cheikh Ndiaye Sy Celebre Mualaba Amidou Adjamou Maguette Mbaye Mbaye Thioub Momar Code Ba Neurosurgical Clinic CHNU Fann Dakar Senegal

Introduction: Vertebroplasty and kyphoplasty are percutaneous techniques that consist in injecting an acrylic cement into the body of a pathological vertebra. This work aims to report the experience the of fann’s neurosurgery department in treating certain spinal pathologies by vertebroplasty and kyphoplasty. Methods: During a 3-year period from July 1, 2019 to July 31, 2022, we conducted a retrospective, descriptive and analytical study, including patients who underwent vertebroplasty or kyphoplasty for dorsolumbar spinal pathology. Results: The mean age of the 13 patients in our study was 51.61 years. Female gender was predominant in 62% (n = 8). The context of spontaneous onset was found in six patients. Nine patients had a VAS (visual analogue scale) ≥ 8 (69.23%). On clinical examination, all patients had a syndrome without neurological deficits. 84.61% of patients had a CT scan (n = 11). The dorsolumbar hinge was most affected with 53.85% of cases. Seven patients had a vertebral compression of between 25% and. The average degree of kyphosis was 8˚ and seven patients had a degree of kyphosis ≥ 10˚. Tumour aetiology accounted for 46.15% of cases. Kyphoplasty was performed in 61.53% (n = 9) of the cases and vertebroplasty was performed in 38.47% (n = 4) of the patients. Kyphoplasty was associated with biopsy in two cases and with osteosynthesis in one patient. Vertebroplasty was always associated with a biopsy. The evolution was favourable with a significant reduction in pain and vertebral kyphosis. The mean VAS decreased from 8.15 to 0.69 three months after treatment and the mean kyphosis decreased from 8˚ to 2˚. Conclusion: Kyphoplasty and vertebroplasty as percutaneous techniques allow consolidation of the vertebral body and pain relief. Kyphoplasty alone not only reduces pain but also restores the height of the compacted vertebral body.

关键词： Vertebroplasty and Kyphoplasty Indications and Results Preliminary Senegalese Experience