Dernier numéro du Journal de Neurochirurgie

N° 25 - Juillet 2017

A télécharger dans la page Archives


Journal de Neurochirurgie 2017 July 25:7-15
Authors: L. HOUARI, M. DEBBOU, I. ASSOUMANE, A. MORSLI, T. BENBOUZID – Service de Neurochirurgie, CHU Bab El Oued, Alger
Ophthalmic segment aneurysms of the internal carotid are rare; the clinical expression is mainly about optic nerve compression more than sub-arachnoid hemorrhage related symptoms. Surrounded by bone, dural and neural structures, the ophthalmic segment aneurysms can reach important size; these structures may also be an obstacle to the surgical approach. We report by this article the literature review about the management of this kind of aneurysms with a case report of our series of 09 patients operated in the department of neuro-surgery of Bab El Oued, Algiers from 2006 to 2016.
Journal de Neurochirurgie 2017 July 25:16-18
Authors: M. ABOUDJABEL- K. DJOULANE- H. HIMEUR- F. LALAM – Service de Neurochirurgie CHU Tizi Ouzou
Tolosa Hunt Syndrome (STH) is a diagnosis of elimination; it is retained after having discarded the tumoral, infectious and inflammatory diseases. Our study concerns two patients, hospitalized into our department for retro orbital pain associated with ophtalmoplegia. Brain MRI which is a gold standard for the diagnosis Tolosa Hunt Syndrome showed cavernous sinus tissue formation iso signal in T1 and T2 iso signal enhanced after Gadolinium injection. The treatment of our patients was based on corticotherapy which prompted a dramatic resolution of symptoms (rapid clinical improvement).Note that few cases of painful ophthalmoplegia have been reported in the literature including the Tolosa Hunt syndrome. The etiology is unknown in 25% of cases, despite a wide etiological investigation. The use of cortisone (steroid) gives excellent results, but however, clinical monitoring is required to detect possible recurrences.
Journal de Neurochirurgie 2017 July 25:19-25
Authors: KE BADOU-N’GUESSAN*, D SISSOKO**, F BURAIMA*, L DROGBA**, MJ TANON-ANOH*, V BA ZEZE**, B KOUASSI* – *Service d’otorhinolaryngologie et Chirurgie Cervico-faciale du CHU Yopougon – **Service de neurochirurgie du CHU Yopougon
Objective: to analyze the epidemiological characteristics, diagnosis and therapy of intracranial abscesses (ICS) to ENT origin in children in our context. Patients and methods: this was a retrospective descriptive study of the type carried out from 1 January 2003 to 31 December 2014 at the Teaching Hospital of Yopougon. Were included children aged 0 to 15 years admitted to a secondary ICS ENT infection confirmed by computed tomography (CT).
Results : we identified twenty eight children, twenty boys. The mean age was 12.21 ± 3.72 years (range, 7 months -15 years). The mean time to consultation was 31 ± 11.31 days. The initial infection was sinusitis, otitis and rhinopharyngitis in respectively 23 cases (82.14%), 3 cases (10.71%) and 2 cases (7.14%). ICS was a subdural empyema (17 cases are 60.71%), extra dural empyema (4 cases are 14.28%), a single brain abscess (4 cases are 14.28%) or multiple (2 cases are 7.14%). The brain abscess was associated with a subdural empyema in one case (3.57%). A puncture of the CIS for bacteriological analysis was performed in 19 cases. It was possible to isolate a germ in six cases. The treatment was medical and surgical in 19 cases. The outcome was favorable in 21 cases (75%) and negative in 3 cases (10.71%). It was not specified in three cases. We noted a death.
Conclusion : access to CT was essential to guide therapeutic management in order to improve the prognosis.
Journal de Neurochirurgie 2017 July 25:26-29
Authors: N. KASRI, F. BOUROU, F. LABACI, M. SAADI, M. HADBI, N. LAGHA, N. FELLAH, A. MORSLI, T. BENBOUZID – Service D’Anesthésie Réanimation et de Neurochirurgie CHU Bab El Oued
Craniosynostosis surgery is a major reconstructive procedure, the main risk being intraoperative bleeding. The aim of our study was to evaluate the anesthetic management and the postoperative care in this surgery. This is a descriptive retrospective study including 10 children who underwent surgical craniosynostosis during the period between 2012 and 2015. RESULTS: The mean age of patients was 8.73 years ± 6, 9 months, half of the children had a scaphocephaly and the predominance was male. The intraoperative complications were essentially hemorrhagic the majority of our patients were transfused. This surgery is usually performed in infants whose tolerance to hemorrhage is low because of the absolute value of their blood mass but invasive hemodynamic monitoring allows precise compensation of blood loss.
Journal de Neurochirurgie 2017 July 25:30-33
Authors: T. SELMANE, M. BENLAHRECHE, F. SEDKAOUI, Z. SCHABAY, L. BOUBLATA, S. BAKHTI – Service de Neurochirurgie, EHS Ali Ait Idir
The meningioma of the tubercle sellae, pose a problem of therapeutic management, because of their vasculo-nervous relationships. The chiasma and the optic nerves are the most vulnerable structures in this type of meningioma, by direct compression, by their surgical dissection, and especially by the sacrifice of opto-chiasmatic arterioles. The choice of surgical approach, arteriolar dissection, tumor volume, and preoperative visual status, are the factors involving the visual prognosis, will be discussed in our development. A review of the literature will be presented and studied for each element that determines the visual prognosis
Journal de Neurochirurgie 2017 July 25:34-36
Authors: S. MEZIANI, T. BENAFAA, F. HANDIS, M. DEBBOU, A. MORSLI, T. BENBOUZID. – Service de Neurochirurgie – CHU de Bab el Oued
Hypophysitis is a rare disease, it is a chronic inflammation of the pituitary gland, the cause of which is complex, preoperative diagnosis is difficult, posing a problem to neurosurgeons, especially to differentiate between hypophysitis and adenoma Pituitary, however there are some clinical and radiological data that direct us towards the diagnosis of a hypophysitis, we will expose them in our article.
Journal de Neurochirurgie 2017 July 25:37-40
Authors: BENMAMAR.T, SHABAY.Z, BOUAITA.K – Neurosurgery, EHS Ali Ait Idir, Algiers, Algeria
Intracerebral cavernomas represent 5-10% of all vascular malformations of the central nervous system. Their location in the third ventricle is very rare. Only about a hundred cases have been reported in the literature so far. We present for the first time a case of third ventricular cavernoma encountered in a 39-year-old patient admitted in our department, while detailing the various difficulties encountered in the management of this rare entity.
Journal de Neurochirurgie 2017 July 25:41-44
Authors: A. N’DA HERMANN, L. DROGBA KPOROU, L. DEROU KEABLEON, G. VARLET, V. BA ZÉZÉ. Service de Neurochirurgie CHU de Yopougon, Abidjan, Côte d’Ivoire
Traumatic lumbar spine fracture-dislocation are rare and the result of high energy trauma. We report a complex fracture-dislocation of lumbar spine and discuss the mechanism and management of this unusual lesion. A 20 old male patient was expelled from a high speed moving vehicle. Neurological assessment showed complete paraplegia. Computed tomography scan revealed L2-L3 complete and complex fracture-dislocation. The patient underwent only posterior approach for reduction and stabilization. At 2 years follow up, he remained stable and pain free at sitting position. Complex fracture-dislocations of lumbar spine are caused by high energy trauma and are remarkably unstable lesion. Reduction and stabilization of these fracture is a challenge for spine surgeons because of heavy forces acting in the lumbar spine.
Journal de Neurochirurgie 2017 July 25:45-47
Authors: DIALLO M1, TRAORE Y1, FAYE M2, KANIKOMO D1 – 1-Service de neurochirurgie CHU Gabriel Touré Bamako (Mali) – 2- Service de neurochirurgie CHU Fann- Dakar (Sénégal)
The ventriculo-peritoneal shunt is a therapeutic method that involves the implantation of a catheter into the ventricle; the shunt continues in the peritoneal cavity through the distal end of the system. It reduces intracranial pressure by draining the cerebrospinal fluid. This technique represents the classic treatment of hydrocephalus and is by far the most used method of treatment especially in children. There are several methods to treat hydrocephalus; none of them is without complications. Despite the simplicity of performing a shunt, complications can arise; the intracranial migration of the whole system is one, but exceptional. Regular follow-up of patients in the first 24 months after surgery is a necessity in order to prevent complications and to take care of them early
Journal de Neurochirurgie 2017 July 25:48-50
Authors: S. BAKHTI, N. BOUMAHDI, N. TIGHILT, M. DJENNAS – Neurosurgery Department, Academic Hospital Mustapha Pacha, Algiers Algeria
Spinal tuberculous arachnoiditis is one of the presentations of tuberculosis of central nervous system. It can occur after extension of intracranial tuberculous meningitis or after a hematogenous dissemination of systemic tuberculosis. We report a case of spinal tuberculous arachnoiditis occurring in a 22-year-old woman who was treated during 3 months for pulmonary tuberculosis. She was successfully treated by antituberculous chemotherapy. This case is reported to emphasize the possibility of occurrence of central nervous system involvement during treatment for systemic tuberculous and then a high level of awareness is mandatory during monitoring of patients with systemic tuberculous.
Journal de Neurochirurgie 2017 July 25:51-56
Authors: B. YAKOUBI, L. BERCHICHE, S. BACHIR, F. ZEKOUR, M. SAADI, T. BENBOUZID – Serv. Neurochirurgie – CHU Bab El-Oued – Alger
Objective : Jaffe and Lichtenstein in 1956 recognized Osteoblastoma as a separate pathologic entity, independently. It is an uncommon primary osseous benign tumor involving predominantly the vertebral column and the long bones. Craniofacial osteoblastoma is extremely rare with only twenty-four cases of nasal cavity and paranasal sinus osteoblastomas reported in 2010.These included eight ethmoid sinus, seven maxillary sinus, five nasal cavity, and four frontal sinus. Of slow growing, they can be responsible for ophthalmological complications. It occurs in the 2nd and 3rd decade, without predominance of sex. Their treatment is only surgical.
Case report :We report the medical observation of an 18-year-old woman. The tumor was revealed by an exophthalmos of progressive onset evolving during two years associated with headaches. The ophthalmologic examination showed a hard mass at the superior-internal angle of the right eye. The visual acuity is 9/10 right, 10/10 left. The neuroradiological assessment (CT and MRI) led to the diagnosis of osteoma of the frontal sinus with intra-orbital extension. The Unterberger bi-coronal pathway and the surgical approach through the right orbital arch permitted the removal of a sinus osteoblastoma compressing the right eye’s muscles. The release of the oblique muscle tendon and its pulley was very laborious. The anatomopathological examination was in favor of an osteoblastoma. The clinical and radiological evolution was very favourable.
Conclusion : the sinus osteoblastoma is a benign bone neoformation with surgical treatment in symptomatic forms. The surgical approach depends on tumor location. A complete resection is recommended to prevent the possibility of postoperative recurrence and malignant transformation.