<strong>Background: </strong>Endoscopic third ventriculocisternostomy (ETV) is the most common neuroendoscopic technique in the treatment of noncommunicating hydrocephalus. Since its introduction, ETV has ...<strong>Background: </strong>Endoscopic third ventriculocisternostomy (ETV) is the most common neuroendoscopic technique in the treatment of noncommunicating hydrocephalus. Since its introduction, ETV has been a safe alternative to ventriculoperitoneal shunt (VP shunt), which has a high complication rate with significant socio-economic consequences. The authors report the results of ETV performed in the neurosurgical department of FANN teaching hospital in Dakar. <strong>Methods: </strong>This retrospective study presents the results of ETV performed in 513 patients with hydrocephalus of various etiologies, ranging from February 2010 to February 2018. We have included in our series from 2010 to 2016, all patients with clinically revealed non-communicating hydrocephalus followed by a brain computed tomography (CT) scan or brain magnetic resonance imaging (MRI) and who have benefited from an ETV, in which the ETV Success Score was evaluated. <strong>Results:</strong> The mean age of our patients was 14.10 years, with 298 (58%) males. The clinical symptomatology varied in both children and adults and manifested in children as macrocrania in 67.8% of the patients, while in adults, it manifested as raised intracranial pressure (ICP) in 87.5% of patients. A brain CT scan was performed in 461 (89.86%) of patients. The causes of hydrocephalus were dominated in 49% of patients by malformative pathologies, followed by tumors in 41% of patients, infections in 2.33% of patients, and normal-pressure hydrocephalus in 3.8% of patients. During the postoperative period, we found 21.41% of various complications. <strong>Conclusions:</strong> The findings in our series were compared to those in the literature and were satisfactory, thus proving the effectiveness and safety of ventriculocisternostomy in our department. In resource-limited countries, ETV can be performed with good results and less mortality and morbidity.展开更多
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. ...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.展开更多
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 neu...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.展开更多
文摘<strong>Background: </strong>Endoscopic third ventriculocisternostomy (ETV) is the most common neuroendoscopic technique in the treatment of noncommunicating hydrocephalus. Since its introduction, ETV has been a safe alternative to ventriculoperitoneal shunt (VP shunt), which has a high complication rate with significant socio-economic consequences. The authors report the results of ETV performed in the neurosurgical department of FANN teaching hospital in Dakar. <strong>Methods: </strong>This retrospective study presents the results of ETV performed in 513 patients with hydrocephalus of various etiologies, ranging from February 2010 to February 2018. We have included in our series from 2010 to 2016, all patients with clinically revealed non-communicating hydrocephalus followed by a brain computed tomography (CT) scan or brain magnetic resonance imaging (MRI) and who have benefited from an ETV, in which the ETV Success Score was evaluated. <strong>Results:</strong> The mean age of our patients was 14.10 years, with 298 (58%) males. The clinical symptomatology varied in both children and adults and manifested in children as macrocrania in 67.8% of the patients, while in adults, it manifested as raised intracranial pressure (ICP) in 87.5% of patients. A brain CT scan was performed in 461 (89.86%) of patients. The causes of hydrocephalus were dominated in 49% of patients by malformative pathologies, followed by tumors in 41% of patients, infections in 2.33% of patients, and normal-pressure hydrocephalus in 3.8% of patients. During the postoperative period, we found 21.41% of various complications. <strong>Conclusions:</strong> The findings in our series were compared to those in the literature and were satisfactory, thus proving the effectiveness and safety of ventriculocisternostomy in our department. In resource-limited countries, ETV can be performed with good results and less mortality and morbidity.
文摘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.
文摘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.
