L´arteria lusoria ou artère sous Clavière droite retro-œsophagienne constitue la malformation de l'arc aortique la plus fréquente avec une prévalence de 0,5-2,5 %. Elle peut être découverte face à des symptômes de compression des voies respiratoires et/ou de l’œsophage tels qu´une dyspnée ou une dysphagie voire infections respiratoires à répétition; mais la plupart des cas c´est une pathologie asymptomatique comme rapportée par plusieurs auteurs. Nous rapportons le cas d´une patiente de 44 ans qui a été prise en charge dans notre service de réanimation pour une détresse respiratoire liée à l´arteria lusoria. C´est une cause rare de dyspnée à laquelle il faudrait y penser devant une dyspnée ne répondant pas au traitement médical. Sa prise en charge reste médicale avec une simple surveillance, si elle est asymptomatique mais une intervention chirurgicale serait nécessaire si elle devient symptomatique ou quand elle est associée à un diverticule de Kommerell (DK).
Lumbosciatica is a frequent reason for consultation in general medicine and emergency medicine with an estimated incidence between 2% and 14%. There are several therapeutic modalities, including infiltrations, which are very controversial. Based on this observation, we conducted a prospective study in which 19 patients had undergone epidural and peri-radicular infiltration; the epidural was the most represented infiltration in 68.4% of the patients, the peri-radicular was in 21.1% of them and the combination of both was in 10.5% of the cases, with only 30.6% of the infiltrations carried out under radioscopy. The molecules used were Triamcinolone Acetonide-based Kenacort and Methylprednisolone Acetate-based Depo-Medrol. The evolution of post-infiltration pain decreased significantly in 94.7% of cases, with a statistically significant difference (p = 0.04). No complications were observed in our patients and none of them had resorted to surgery during the follow-up period except for a single case of recurrence of pain relieved by periodic spaced infiltrations. Despite the small size of our sample, we can conclude that infiltration techniques still have a place in the management of Lumbosciatica alongside the surgery.
Frontal sinus aspergillosis is a rare infection that can be usually associated with immunocompromised states and life-threatening with high mortality rate. The authors report in a developing country a case of immunocompetent patient with left unilateral frontal headache, associated with left eye ptosis. The Brain CT Scan revealed frontal sinus aspergillosis. She underwent surgery followed by itraconazole cure. The outcome is successful after a period of 14 months with resolution of symptomatology. Anatomopathological examination confirmed aspergillosis. They share their experience of management of this disease in a country where neurosurgery is very young specialty and where molecules against aspergillosis are not available.
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