Intracranial arachnoid cysts (AC) are believed to be congenital and chronic subdural hematomas tend to occur in elderly patients with a history of mild head injury. The association between these two entities sporadica...Intracranial arachnoid cysts (AC) are believed to be congenital and chronic subdural hematomas tend to occur in elderly patients with a history of mild head injury. The association between these two entities sporadically occur in relatively young patients but rare in elderly patients. We report a 65-year-old man who presented with headache and dizziness of 2 months’ duration with a history of head injury. Brain computed tomography (CT) a CSDH in right side and a hygroma in left side. After first operation with burr holes in both sides, the patient underwent an early recurrence of acute subdural hematoma in the right side. The evacuation of this hematoma by a craniotomy allowed seeing an AC that we resected partially with complete recovery of the patient. The association CSDH/AC is rare and possible in elderly patients and there is no consensus on treatment.展开更多
Objective: Intracranial suppurations are a cosmopolitan pathology whose prevalence depend of the region of the world. They are mostly caused by otolaryngological infections. Despite the progress, they remain serious d...Objective: Intracranial suppurations are a cosmopolitan pathology whose prevalence depend of the region of the world. They are mostly caused by otolaryngological infections. Despite the progress, they remain serious diseases in Africa. The objective of this study was to report the epidemiology, clinical and etiological aspects of intracranial suppurations in Togo. Method: This was a retrospective and descriptive study carried out from January 1, 2012 to December 31, 2020 including all cases of intracranial suppuration treated in the neurosurgery unit of Sylvanus Olympio university hospital in Lomé. The evolution was evaluated at discharge, at 3 and 6 months after. Results: We collected 185 cases of intracranial suppuration. The average age of the patients was 12.6 years with a male predominance (72.4%). The main clinical signs were the infectious syndrome (92.4%), intracranial high pressure (51.4%), focal deficit (38.4%) and seizures (20.5%). An otolaryngological infections history was noted within 3 months in 72.4%. The brain CT scan noted a predominance of empyema (63.8%) mostly subdural (64.4%). Radiological sinusitis was found in 57.3%. We identified etiology in 69.2% predominated by otolaryngological causes. Patients received medical and surgical treatment in 77.3%. The bacteriology was positive only in 7 cases. The mortality rate was 15.1%, mostly no operated cases (78.6%). At 6 months 84% recovered without sequelae. The predictive prognostic factors for mortality were: coma (p 0.001), absence of surgical treatment (p 0.02). Conclusion: Intracranial suppuration remains frequent in our country, mainly due to otolaryngological pathologies. The clinical presentation is not always specific and Bergman’s triad is rarely complete. The results of treatment are good if it is early.展开更多
<strong>Objective:</strong> To describe the pattern of intracranial tumors in Sylvanus Olympio teaching hospital of Lomé (Togo). <strong>Method:</strong> We conducted a retrospective and d...<strong>Objective:</strong> To describe the pattern of intracranial tumors in Sylvanus Olympio teaching hospital of Lomé (Togo). <strong>Method:</strong> We conducted a retrospective and descriptive study between November 2017 and December 2019. Data were obtained from the clinical records of patients with intracranial tumors treated in our neurosurgery unit, and histology obtained. Patients without a definitive histological diagnosis were excluded. <strong>Results:</strong> 53 patients were operated and had a histological diagnosis in the period of the study. The mean age at diagnosis was 32 ± 27.1 years. The majority of tumors were seen in adults at 88.7% with age range between 23 - 75 years and a mean age of 40 ± 10.5 years. Meningioma was the commonest intracranial tumor in adults (47.2%) and more seen in females. The histological type of meningioma is meningotheliomatous in our study. In children, principal tumors were medulloblastoma and ependymoma (11.3%). <strong>Conclusion: </strong>Meningioma is the most common intracranial tumor in adults, while embryonal tumors (medulloblastoma and ependymoma) are the most frequent in children in our environment.展开更多
Introduction: Calcified forms with pseudo-tumor symptomatology of chronic subdural hematomas are rare. They are the result of slow bleeding over several years. The main etiology is related to the complications of the ...Introduction: Calcified forms with pseudo-tumor symptomatology of chronic subdural hematomas are rare. They are the result of slow bleeding over several years. The main etiology is related to the complications of the ventriculo-peritoneal shunt (VP). The purpose of this study was to recall the peculiarities and physiopathology of its pseudotumoral hematomas through 2 observations. Observation: Case 1: 8-year-old patient with a history of ventriculoperitoneal shunt at 3 months of age for congenital hydrocephalus, was admitted for functional impotence of the left-side of the body of insidious onset spreading over 9 months in a chronic headache, blurred vision and generalized seizure. CT scan showed a heterogeneous subdural hematoma of the right frontoparietal with calcifications. The patient underwent an excision by morcellation of a yellowish, friable partly calcific mass. The postoperative history was marked by a total recovery of the neurological deficit. There was no recurrence at 6 months postoperatively. Case 2: 11-year-old adolescent, treated with VP shunt at 6 months of age for post-meningitic hydrocephalus, was admitted for helmet headache, dizziness, lightheadedness and apathy progressing for 3 years. CT scan showed hypodensity of right peri-hemisphere with calcified linings, exerting a mass effect on the medial structures. The patient was given a block excision of a calcific mass with blood content. The evolution was marked by the complete resolution of seizures and hemiparesis. There was no recurrence at 6 months postoperatively. Conclusion: Calcified subdural hematomas are rare and consecutive to the complications of VPS. The clinical signs are those of a benign brain tumor. Treatment is dominated by the difficulties of cerebral reexpression.展开更多
文摘Intracranial arachnoid cysts (AC) are believed to be congenital and chronic subdural hematomas tend to occur in elderly patients with a history of mild head injury. The association between these two entities sporadically occur in relatively young patients but rare in elderly patients. We report a 65-year-old man who presented with headache and dizziness of 2 months’ duration with a history of head injury. Brain computed tomography (CT) a CSDH in right side and a hygroma in left side. After first operation with burr holes in both sides, the patient underwent an early recurrence of acute subdural hematoma in the right side. The evacuation of this hematoma by a craniotomy allowed seeing an AC that we resected partially with complete recovery of the patient. The association CSDH/AC is rare and possible in elderly patients and there is no consensus on treatment.
文摘Objective: Intracranial suppurations are a cosmopolitan pathology whose prevalence depend of the region of the world. They are mostly caused by otolaryngological infections. Despite the progress, they remain serious diseases in Africa. The objective of this study was to report the epidemiology, clinical and etiological aspects of intracranial suppurations in Togo. Method: This was a retrospective and descriptive study carried out from January 1, 2012 to December 31, 2020 including all cases of intracranial suppuration treated in the neurosurgery unit of Sylvanus Olympio university hospital in Lomé. The evolution was evaluated at discharge, at 3 and 6 months after. Results: We collected 185 cases of intracranial suppuration. The average age of the patients was 12.6 years with a male predominance (72.4%). The main clinical signs were the infectious syndrome (92.4%), intracranial high pressure (51.4%), focal deficit (38.4%) and seizures (20.5%). An otolaryngological infections history was noted within 3 months in 72.4%. The brain CT scan noted a predominance of empyema (63.8%) mostly subdural (64.4%). Radiological sinusitis was found in 57.3%. We identified etiology in 69.2% predominated by otolaryngological causes. Patients received medical and surgical treatment in 77.3%. The bacteriology was positive only in 7 cases. The mortality rate was 15.1%, mostly no operated cases (78.6%). At 6 months 84% recovered without sequelae. The predictive prognostic factors for mortality were: coma (p 0.001), absence of surgical treatment (p 0.02). Conclusion: Intracranial suppuration remains frequent in our country, mainly due to otolaryngological pathologies. The clinical presentation is not always specific and Bergman’s triad is rarely complete. The results of treatment are good if it is early.
文摘<strong>Objective:</strong> To describe the pattern of intracranial tumors in Sylvanus Olympio teaching hospital of Lomé (Togo). <strong>Method:</strong> We conducted a retrospective and descriptive study between November 2017 and December 2019. Data were obtained from the clinical records of patients with intracranial tumors treated in our neurosurgery unit, and histology obtained. Patients without a definitive histological diagnosis were excluded. <strong>Results:</strong> 53 patients were operated and had a histological diagnosis in the period of the study. The mean age at diagnosis was 32 ± 27.1 years. The majority of tumors were seen in adults at 88.7% with age range between 23 - 75 years and a mean age of 40 ± 10.5 years. Meningioma was the commonest intracranial tumor in adults (47.2%) and more seen in females. The histological type of meningioma is meningotheliomatous in our study. In children, principal tumors were medulloblastoma and ependymoma (11.3%). <strong>Conclusion: </strong>Meningioma is the most common intracranial tumor in adults, while embryonal tumors (medulloblastoma and ependymoma) are the most frequent in children in our environment.
文摘Introduction: Calcified forms with pseudo-tumor symptomatology of chronic subdural hematomas are rare. They are the result of slow bleeding over several years. The main etiology is related to the complications of the ventriculo-peritoneal shunt (VP). The purpose of this study was to recall the peculiarities and physiopathology of its pseudotumoral hematomas through 2 observations. Observation: Case 1: 8-year-old patient with a history of ventriculoperitoneal shunt at 3 months of age for congenital hydrocephalus, was admitted for functional impotence of the left-side of the body of insidious onset spreading over 9 months in a chronic headache, blurred vision and generalized seizure. CT scan showed a heterogeneous subdural hematoma of the right frontoparietal with calcifications. The patient underwent an excision by morcellation of a yellowish, friable partly calcific mass. The postoperative history was marked by a total recovery of the neurological deficit. There was no recurrence at 6 months postoperatively. Case 2: 11-year-old adolescent, treated with VP shunt at 6 months of age for post-meningitic hydrocephalus, was admitted for helmet headache, dizziness, lightheadedness and apathy progressing for 3 years. CT scan showed hypodensity of right peri-hemisphere with calcified linings, exerting a mass effect on the medial structures. The patient was given a block excision of a calcific mass with blood content. The evolution was marked by the complete resolution of seizures and hemiparesis. There was no recurrence at 6 months postoperatively. Conclusion: Calcified subdural hematomas are rare and consecutive to the complications of VPS. The clinical signs are those of a benign brain tumor. Treatment is dominated by the difficulties of cerebral reexpression.
