Anatomical study of the internal carotid artery of the aulacode (Thryonomys swindérianus, Temminck 1827)

The arterial circle at the base of the skull appears to be supplied only by the vertebrobasilar system. The anatomy of the internal carotid artery is not  known. The aim of this study was to contribute to a better understanding of the anatomy of the arterial system of the aulacode. A total of twelve (12)  carotid arteries from six (6) grasscutters were injected with neoprene latex to study the origin, path, termination, collateral branches and brain irrigation  areas of the. internal carotid artery. Originating from the common carotid artery, the internal carotid arteries, right and left, flowed forward and out to  reach the lateral surfaces of the trachea. In the cervical region, they emitted three collateral branches, the posterior laryngeal artery, the artery of the  neck muscles, and the encephalic artery. These different arteries supplied the larynx, neck and brain, respectively. The encephalic arteries were either  single or double. The arteries of the neck muscles were dividing at their endings or not. The observation of the latex in the brain reflects the participation  of the internal carotid artery in the vascularization of the brain, or at least of anastomoses between its branches and those of the external carotid artery  or the vertebro-basilar system

Etude Anatomique du Système Artériel Carotidien de l’Aulacode (Thryonomysswinderianus, Temminck 1827)

The Cane rat (Thryonomysswinderianus) is an African rodent described in 1827 by Temminck. In order to make of it a model animal of laboratory, it is subjected to research in many domains for few years. Objective: The aim of this work was to describe the anatomy of the carotid Artery System of the cane rate.Materials and methods: It was about a prospective experimental study carried out on a series of eight adult sacrificed and put at death cane rats. After realizing a previous thoracic shutter, a vascular washing was performed by cardiac path followed by two injections of latex colored differently. The first one in red color and the second in blue are respectively carried out on the left and right heart. The Craniospinal blocks carrying the heart and the supra cardiac vessels were removed and immersed in a solution of formaldehyde at 10% during 72 hours. The anatomy of carotid artery was studied after dissection of the blocks. Results: With their origin, the two common arteries carotid were born by a common trunk at the convexity level of the aortic arch. They had an ascending way along the trachea and were divided then into two branches under the solid massif of the mandible: An external branch for the bodies of the face and an internal branch which moves towards the cerebral trunk. Conclusion: This study enables us to show that the two arteries common carotids are born by a joint base from the aortic arc and that the internal artery carotid does not take part in the constitution of the arterial circle of the base

Chronic Hydrocephalus due to Congenital Membranous Obstruction of the Apertura Mediana Ventriculi Quartii in Adult Treated by Foraminotomy and Duroplasty

Un Cas D\'hydrocephalie Chronique de L\'adulte par Occlusion Congenitale de L\'ouverture Mediane du Quatrieme Ventricule Traitee par une Foraminotomie et une Duroplastie (Francais) Résumé  L\'hydrocéphalie chronique de l\'adulte par obstruction de l\'ouverture médiane du quatrième ventricule ou Foramen de Magendie est une entité rare. Le traitement consiste en une exploration de l\'ouverture médiane du quatrième ventricule associée à la mise en place d\'un drain ventriculo cisternal (entre le quatrième ventricule et la grande citerne basale) ou en une dérivation ventriculo péritonéale. Les auteurs rapportent l\'observation d\'un patient de 41 ans dans laquelle l\'attitude chirurgicale a consisté après l\'exploration de l\'ouverture médiane du quatrième ventricule, en une large foraminotomie et une duroplastie d\'agrandissement. L\'évolution est satisfaisante après un recul de 18 mois.   Congenital membranous obstruction of the apertura mediana ventriculi quartii is a rare entity. Only 8 cases are mentioned in all the medical literature. The surgical treatment consists in a ventriculo cisternal shunting. We report a case of a 41 year old man. The surgical treatment consisted in a foraminotomy associated with a duroplasty. The outcome 18 months later is favourable. Keywords: hydrocéphalie, hydrocéphalie chronique, hydrocépahlie à pression normale, quatrième ventricule, foramen de Magendie, hydrocephalus, normal - pressure hydrocephalus, foramen of Magendie, fourth ventricle Af J Neuro Sci: 2001 20(1

UN CAS D'HYDROCEPHALIE CHRONIQUE DE L'ADULTE PAR OCCLUSION CONGENITALE DE L'OUVERTURE MEDIANE DU QUATRIEME VENTRICULE TRAITEE PAR UNE FORAMINOTOMIE ET UNE DUROPLASTIE.

CHRONIC HYDROCEPHALUS DUE TO CONGENITAL MEMBRANOUS OBSTRUCTION OF THE APERTURA MEDIANA VENTRICULI QUARTII IN ADULT TREATED BY FORAMINOTOMY AND DUROPLASTY Congenital membranous obstruction of the apertura mediana ventriculi quartii is a rare entity. Only 8 cases are mentioned in all the medical literature. The surgical treatment consists in a ventriculo cisternal shunting. We report a case of a 41 year old man. Ils surgical treatment consisted in Foraminotomy associated with Duroplasty. The outcome 18 months later is favourable

Cerebral Abcess and Intracranial Empyemas in Children (Francais)

Abces et Empyemes Intracraniens chez l\'Enfant Résumé Introduction Les abcès et empyèmes sont des lésions intracrâniennes fréquentes chez l\'enfant. Objectif Les auteurs rapportent et étudient les aspects cliniques, paracliniques et thérapeutiques de ces suppurations intracrâniennes observées à Abidjan. Méthode Une étude rétrospective est effectuée dans le service de neurochirurgie du CHU de Yopougon sur une période de 5 ans (décembre 1993 à décembre 1998). Cette étude a porté sur 34 observations cliniques dont l\'âge variait entre 7 mois et 15 ans. Résultats Les empyèmes sous-duraux représentaient 44,1 %, les abcès 20,5 % et les deux lésions étaient associées dans 17,6 % des cas. Les germes isolés chez 12 patients étaient : Cocci Gram positif (3 cas), Enterobactéries (2 cas), Streptocoque (2 cas), Hémophilus (2 cas) flore mixte aéroanaérobie (1 cas) et une association pseudomonas acinétobacter (1 cas). La principale porte d\'entrée était une infection ORL. L\'évolution a été favorable chez 32 patients avec des séquelles retrouvées dans 8 cas. Nous avons enregistré deux (2) cas de décès dont l\'un à l\'arrivée et l\'autre un jour apès l\'intervention, imputables à un engagement cérébral consécutif à l\'hypertension intracrânienne. Il n\'y a pas eu de récidive de la suppuration. Conclusion Les empyèmes sous-duraux sont les plus fréquentes de ces suppurations intracrâniennes chez l\'enfant. A travers cette étude, les auteurs argumentent en faveur de l\'utilisation de la tréphine ou du trou de trépan pour évacuer ces collections suppurées intracrâniennes. Ils insistent sur la prophylaxie qui passe par le traitement des infections ORL, dentaires, méningées et le parage correct des plaies crânio-encéphaliques.   Background Abcess and empyemas are frequent intracranial lesions in children. Objective The s report the clinical, radiological bacteriological and therapeutical aspects of these intracranial suppurations observed in Abidjan. Methods A retrospective analysis has been conducted in the neurosurgical department of university teaching hospital of Yopougon over a 5 years period (December\' 93 to december\' 98). The study was based on 34 clinical observations on patients whom age ranges between 7 months and 15 years. Results The s report 34 cases of abscesses and intracranial empyemas of the cases in children. Subdural empyemas represented 44,1 % of the cases, abcess 20,5 % and the two lesions were associated in 17,6 %. Bacteriological agents isolated on 12 patients were gram positif cocci (3 cases) heamophilus (2 cases) flora mixed (2 cases) and a combination of pseudomonas acinetobacter (1 case). The predisposing factors were ENT diseases. Two patients died, the first day soon after admission, and the second one day after surgery. And in both cases because of brain herniation secondary to severe raised intracranial pressure. We observed no recurrence of pus collection. Neurological sequelae was observed in 8 cases. Conclusion Intracranial subdural empyemas are most common form of intracranial suppurations seen in children in our unit. This study emphasizes the importance of treating theses intracranial sepsis through a burrhole. The s stress the interest of eradication of primary source of the sepsis and the appropriate treatment of head trauma. Keywords: Africa, Child, Cerebral abscess, Intracranial empyema, Abcès cérébral, Afrique, Empyème intracrânien, Enfant. Af J Neuro Sci: 2002 21(1

Les adénomes hypophysaires cliniquement non-fonctionnels: Peuvent-ils être diagnotiqués plus tôt?

(fr) Introduction Les adénomes pituitaires « silencieux » n’entraînent pas de tableau en rapport avec une hypersécrétion hormonale. Ils posent un problème de diagnostic tardif au stade des complications comprimant les voies visuelles. Le but de ce travail est de permettre un diagnostic précoce en dégageant un profil clinique et biologique de ces adenomes.Matériels et méthodes 44 dossiers de malades opérés entre 1994 et 2005, tous des macroadénomes de plusieurs types histochimiques, ont été analysés au plan clinique :Le sexe, le status gynéco-obstétrique, l’âge, le délai diagnostic, les circonstances de découverte, le tableau clinique ont été notés. Le dosage de base des gonadotrophines ainsi que les tests dynamiques aux GnRH et TRH ont ete etudies separement chez les hommes, les femmes menopausees, et celles en periode d’activite genitale. L’anatomopathologie et l’immunohistochimie ont ete realisees. La loi des moyennes a été utiliséeRésultats 28 hommes (63,6%) et 16 femmes (36,4%) dont 10 ménopausées. L’âge moyen était de 58 ans et demi, le délai diagnostic moyen était de 9 mois et demi. Le syndrome tumoral était au premier plan (86,4%) avec des troubles visuels dans tous les cas (100%), dominés par les anomalies campimétriques. Les signes cliniques d’hypopituitarisme (41%) qui sont en rapport avec la compression/destruction de l’hypophyse saine par la tumeur predominaient sur ceux d’hypersécrétion de gonadotrophines (9,1%) vus essentiellement dans les adénomes gonadotropes. Le bilan hypophysaire montrait des insuffisances antehypophysaires (IAH) chez plus de 60% des patients, surtout gonadotropes, dans tous les groupes. L’hyperprolactinemie variait de 41 a 89% mais toujours inferieure a 150 ng/ml. A l’immunohistochimie les adenomes gonadotropes etaient les plus nombreux (81,8%) suivis des non-secretants vrais (11%), des corticotropes (4,5%) et d’un plurisecretant (2,3%)Conclusion Le tableau clinique évocateur est exceptionnel ;il faut donc, par une analyse plus fine, retrouver ces signes au début, qui sont pourtant perçus à posteriori à l’interrogatoire, par un examen rigoureux et faire ainsi realiser un bilan hypophysaire qui montrerait une IAH gonadotrope et une hyperprolactinemie moderee. Le dosage des sous-unites α et β devra etre realise. Les tests dynamiques et de freinage devront etre faits exceptionellement en cas de doute, voire supprimes. L’interprétation reste cependant difficile chez la femme ménopausée.(en) Introduction Clinically silent pituitary adenomas are not diagnosed because of hormonal hypersecretion. They are detected late when the optic pathway is compressed. The objective of this work is to define clinical and biological profile which will allow an early diagnosis.Material and methods 44 files of patients operated on between 1994 and 2005 were analyzed. They all had macroadenomas of different histochemical types. Sex, gynecological and obstetrical history, age, delay before diagnosis, circumstances of diagnosis and clinical data were obtained in each case. Basic gonadotrophins level, GnRH and TRH dynamical tests were separately performed in men, sexually active women and women in menopause. Histopathology and immunohistochemistry studies were performed.Results the series comprised 28 men(63.6%) and 16 women (36.4%) (10 of them were in menopause). Mean age was 58.5 years and diagnostic delay was 9.5 months. Tumoral syndrome was present in 86.4 % of cases, all the patients had visual impairment, mainly visual’s field amputation or restriction. Hypopituitarism syndrome was present (41 %) according to the degree of compression or destruction of the normal pituitary gland by the tumor, except for gonadotrophic hypersecretion signs (9.1%). Hormonal dosage showed more than 60% of pituitary gland insufficiency in all three groups, particularly the gonadotrophic one. Moderate prolactin hypersecretion was found in 41 to 89% of cases, but the absolute value was always less than 150 ng/ml At histoimmunochemistry, gonadotroph cell adenomas predominate (81.8%), followed by the real non-secreting one(11%), then corticotroph (4.5%) and lastly the multi-secreting adenomas (2.3%)Conclusion The clinical syndrome of non secretory pituitary adenoma is not clearly defined. Practitionners need to identify early these symptoms, which were actually present from the beginning of the clinical history, by a meticulous examination. If patient presents cephalalgia and visual impairment, cerebral CT scan or MRI explorations are mandatory to explore the presence of a pituitary tumor. In case of non-functioning pituitary adenoma, basic endocrine exploration should find a hypopituitarism, mainly gonadotropic, with a moderate prolactin hypersecretion. The dosage of α and β subunits must be done. Dynamic tests should be performed only in case of difficulty. Analysis is difficult in menopausal women.info:eu-repo/semantics/publishe

Intra medullary tuberculoma: A rare cause of paraparesis

(fr) Le tuberculome intra-médullaire (TIM) est une localisation de la tuberculose du système nerveux central. Nous rapportons un cas de TIM, chez un patient de 48 ans, sans antécédents particuliers, qui a consulté pour un déficit moteur des 2 membres inférieurs d’installation progressive. L’examen clinque a permis d’objectiver un syndrome de compression médullaire thoracique. La découverte d’une masse intramédullaire, après les explorations neuroradiologiques (myéloscanner et IRM), nous a fait poser l’indication d’une exérèse micro-chirurgicale. Le diagnostique de TIM a été affirmé par l’examen anatomo-pathologique de la pièce opératoire. L’association d’une chimiothérapie anti-tuberculeuse au delà de 6 mois après l’exérèse chirurgicale, à permis une guérison complète après un recul de 18 mois.(en) The intra-medullary tuberculoma (IMT) is a rare tuberculosis located in the central nervous system. We report a case of IMT in a 48-year-old man with a progressive paresis of the lower limbs. The patient had previously been healthy. The neuroradiologic investigations showed an intra-medullary mass. A total exeresis was performed via a micro-surgical approach. The IMT diagnosis was confirmed by the anatomopathological examination.The association of an anti-tuberculosis chemotherapy for 6 months after the surgery led to a complete healing after an 18 months lapse.info:eu-repo/semantics/publishe

A case of non traumatic cercical extradural hematoma

(fr) L’hématome extradural cervical spontané est une pathologie rare mais une sévère cause de compression médullaire. Il requiert un diagnostic et une prise en charge urgents. Nous en rapportons un cas chez une patiente de 20 ans sans antécédent pathologique, révélé par un syndrome de compression médullaire cervical sévère (grade A de Frankel). Une décompression neurochirurgicale est intervenue avec un délai de 48H avec comme corollaire de lourdes séquelles. Les auteurs insistent sur l’intérêt d’un diagnostic et d’une prise en charge précoces pour en minimiser les séquelles neurologiques.(en) Spontaneous cervical extradural hematoma is a rare pathology but a severe spinal cord compression cause.We report a case revealed by a severe spinal cord compression (Frankel rank A) in a 20 old female patient without past medical history. A neurosurgical decompression has been performed 48 hours later which result of important after-effects. The authors insist for the early diagnostic and treatment to minimize neurological deficits.info:eu-repo/semantics/publishe

History of African women in neurosurgery

The number of women in the medical field has increased in Africa over the last few decades, yet the underrepresentation of women within neurosurgery has been a recurrent theme. Of all surgical disciplines, neurosurgery is among the least equitable, and the rate of increase in female surgeons lags behind other surgical disciplines such as general surgery. This historical review provides an overview of the history of women in neurosurgery and their current status on the African continent. To the authors\u27 knowledge, this is the first article to provide such an overview