Spontaneous extradural hematoma is rare in patients with sickle cell disease. We report a clinical case of a 19-year-old young man with sickle cell anemia who presented a sickle cell crisis complicated by the development of multiple acute extradural and subgaleal hematomas that had not been treated surgically. We discuss the physiopathology of this event. Although it is rare, clinicians should be aware of this phenomenon as part of a spectrum of neurologic complications in these patients.
The localization of the tuberculoma at the third ventricle is rare. The authors report a case of third ventricle solitary Tuberculoma which has occurred in a 10 year old patient and revealed by a syndrome of intracranial hypertension without tuberculosis stigma. This lesion appears clinically and radiologically as a primary brain tumor. A total removal using a subchoroidal approach to the third ventricle has been performed. Histological examination showed a tuberculous like granuloma. An adjuvant antituberculous chemotherapy practiced for 6 months brought the complete cure. The authors insist on the diagnostic and therapeutic difficulties in front of a third ventricle solitary tuberculoma.
Introduction: The management of intracranial aneurysms in sub-Saharan Africa is essentially surgical. In this retrospective study, the authors report their experience in surgical management of intracranial aneurysm in Côte d'Ivoire. Methods: We carried out a retrospective study on patients operated for a ruptured or unruptured intracranial aneurysm between January 1st, 2012 and December 31st, 2018. Data on epidemiological characteristics of patients and aneurysms, treatments and patient outcomes were analyzed. Results: One hundred twenty eight aneurysms were operated. Sixty-six percent of the patients were female. According to the World Federation of Neurosurgical Societies (WFNS) scale, 58, 5% of patients were in grade I. Fisher scale showed 29% of Fisher 2 and 49% of Fisher 4. The aneurysms were mainly located on the internal carotid artery in 38% and anterior complex in 36%. The average size of aneurysms was 6.5 mm. In 81.4% the size of the aneurysms was less than 10 mm. Most aneurysms (90%) were treated at late stage. According to the modified Rankin Scale, 92 patients (83%) had good outcome, 7 patients (6%) had poor outcome, and the mortality rate was 11%. Conclusions: This study shows encouraging results if we refer to the overall postoperative results. However, there is a sub-diagnosis and low treatment rate of ruptured intracranial aneurysms. The improvement of intracranial aneurysms management requires improving the standard of health in the country.
Congenital skull fractures of newborn are rare and create medico-legal problems. Their management is controversial. Between surgery considered too aggressive and uncertain conservative attitude, reduction by suction cup or breast pump is an alternative. The authors report their experience through a case of successful resolution of a congenital depressed skull fracture using a suction cup in a newborn at 13 day of life followed by a literature review. This technique avoids the usual complications of surgery and reduces the anxiety of parents related to surgery. It also avoids the anxiety of having a newborn with a recessed skull and a conservative attitude with uncertain outcome.
Epidural localization of myeloid leukaemia is rarely reported. Spinal cord compression as an initial presentation of acute myeloid leukaemia is extremely rare. This is a report of a 17-year-old black boy who presented to emergency department with neurological symptoms of spinal cord compression. Imaging modalities showed multiple soft tissue masses in the epidural space. After surgical treatment, histopathological examination of the epidural mass showed myeloid leukaemia cells infiltration. Literature review on Medline and "scholar Google" database was done.The characteristics and management of extra-medullary leukaemia are discussed. Granulocytic sarcoma, myeloid sarcoma or chloroma with acute myeloid leukaemia should be considered as part of epidural spinal cord compression. Therefore surgery is indicated on an emergent basis.
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