Management of spinal dural arterio venous fistula with peri-medullar drainage: Experience of a north-African centre

Introduction: Spinal Dural Arterio Venous Fistula (SDAVF) is an arteriovenous communication on the spinal dura with peri-medullar venous drainage. It is a curable cause of myelopathy and the most common form of spinal arterio venous malformation (AVM). The average age of revelation is the fifth decade; it is a diagnostic and therapeutic emergency. Materials and methods: This is a retrospective study conducted in the neuro surgical department of CHU Bab El Oued in Algiers during a five years time from November 2013 to September 2018. We assessed the clinical status of patients according to the Aminoff-Logue disability score before and after surgery. All patients did a total spine MRI followed by a Medullar angiography which facilitated the pin-pointing of the exact location of the dural fistula. The mean follow-up is 30 months. Results: There were five males and two females, all of them older than 45 years of age. At the admission, patients presented with signs of neurological deficits. After the diagnosis of SDAVF the surgical intervention consisted of a disconnection of the arteriovenous communication by coagulation and section of the fistula at the foot of the vein after a laminectomy. Functional rehabilitation was prescribed for all patients and they were regularly followed-up. Conclusion: Treatment of AVF is surgical or endovascular. Results depend largely on preoperative neurological status

Long term study on the effects of microsurgical DREZotomy for chronic pain control

The DREZotomy (Dorsal Root Entry Zone tomy) is an analgesic procedure. The analgesic effect is evaluated on 30 patients with chronic pain resulting from respectively: brachial plexus avulsion (66.6%), postherpetic pain (10%), hyperspastic states (6.6%), phantom pain (6.6%), the pain in the stump (6.6%), and spinal cord injuries (3.3%). Pain intensity was evaluated using a visual analogue scale (VAS). At last evaluation, between 12 and 60 months, after DREZotomy, 93% had a good or excellent global pain relief after surgery. According to the component types of pain, 9.6% of patients had good or excellent control of the paroxysmal pain, and 84% of the continuous pain. Kaplan–Meier prediction of lasting global pain control at 60 months of follow-up was calculated at 75.5%. Comparison of the 2 corresponding Kaplan–Meier curves at long term, namely, pain control in 82.8% for the paroxysmal component and in 51.7% for the continuous component, showed a statistically significant difference (P < 0.0001). Functional effects are improved by more than 70% according to patients

A lateral meningocele in a 48 years lady revealed by a CSF fistula: Exceptional case

Background: Lateral meningocele is defined by the presence of protrusions of the arachnoid and the dura matter extending laterally through inter- or intravertebral foramina. It is an extremely rare condition; to the best of our knowledge, only a few cases are reported in the literature and most of them in childhood. Case presentation: Authors reported a case of a 48 years old lady who consulted for a lombo-sacral mass right-sided with a CSF fistula. The Spinal MRI objectified a meningocele lateralized in the right side associated with multiples malformations. The patient underwent surgery and the meningocele was closed after excision of the associated subcutaneous lipoma. The long term outcome was favourable and the follow up was assured by clinical examination monthly in the first year. Conclusion: Lateral meningocele is very rarely reported, it is usually associated with multiples malformations. Surgical treatment is a good option for treatment for avoiding complications. The prognostic depends on the preoperative status and the associated malformations

Study and Simulation of a Shunt Active Power Filter powered by a Photovoltaic Source Controlled by Sliding Mode

The development of energies from renewable sources and the increase in electricity consumption will require new solutions to maintain the levels of service, quality of voltage and availability of electricity networks. A tailor made role for power electronics. The objective of this work on this paper is the remediation of the problem caused by the injection of harmonics discharged by the non-linear load (i.e. by the rectifier in our case). This remediation consists in reducing as much as possible the impurities diffused in the electrical network. For this we used a Shunt Active Power Filter (SAPF) as a perfect solution by eliminating all harmonics one by one. In this article, we have proposed a control technique on the voltage inverter, it is the technique "Synchronous Reference Frame -SRF" and an MPPT regulator on the photovoltaic generator which is used as a continuous source of the SAPF, it is the “Sliding Mode Control- SMC” technique. The simulation results obtained under MATLAB / Simulink clearly showed us that the system sizing choices, as well as the control techniques are efficient and according to the international standard recommendations IEEE519-92 (The total Harmonic Distortion is less than 5 percent)

Pediatric colloid cysts: a multinational, multicenter study. An IFNE-ISPN-ESPN collaboration

OBJECTIVE Colloid cysts (CCs) are rare at all ages, and particularly among children. The current literature on pediatric CC is limited, and often included in mixed adult/pediatric series. The goal of this multinational, multicenter study was to combine forces among centers and investigate the clinical course of pediatric CCs. METHODS A multinational, multicenter retrospective study was performed to attain a large sample size, focusing on CC diagnosis in patients younger than 18 years of age. Collected data included clinical presentation, radiological characteristics, treatment, and outcome. RESULTS One hundred thirty-four children with CCs were included. Patient age at diagnosis ranged from 2.4 to 18 years (mean 12.8 ± 3.4 years, median 13.2 years, interquartile range 10.3–15.4 years; 22% were \u3c 10 years of age). Twenty-two cases (16%) were diagnosed incidentally, including 48% of those younger than 10 years of age. Most of the other patients had symptoms related to increased intracranial pressure and hydrocephalus. The average follow-up duration for the entire group was 49.5 ± 45.8 months. Fifty-nine patients were initially followed, of whom 28 were eventually operated on at a mean of 19 ± 32 months later due to cyst growth, increasing hydrocephalus, and/or new symptoms. There was a clear correlation between larger cysts and symptomatology, acuteness of symptoms, hydrocephalus, and need for surgery. Older age was also associated with the need for surgery. One hundred three children (77%) underwent cyst resection, 60% using a purely endoscopic approach. There was 1 death related to acute hydrocephalus at presentation. Ten percent of operated patients had some form of complication, and 7.7% of operated cases required a shunt at some point during follow-up. Functional outcome was good; however, the need for immediate surgery was associated with educational limitations. Twenty operated cases (20%) experienced a recurrence of their CC at a mean of 38 ± 46 months after the primary surgery. The CC recurrence rate was 24% following endoscopic resection and 15% following open resections (p = 0.28). CONCLUSIONS CCs may present in all pediatric age groups, although most that are symptomatic present after the age of 10 years. Incidentally discovered cysts should be closely followed, as many may grow, leading to hydrocephalus and other new symptoms. Presentation of CC may be acute and may cause life-threatening conditions related to hydrocephalus, necessitating urgent treatment. The outcome of treated children with CCs is favorable

Primary calvarial cavernous haemangioma in a child

A wide variety of bone lesions is encountered on the skull and usually with poor clinical presentations and non-specific radiological features. Primary cavernous hemangioma is one of these rare calvarial lesions that the symptoms are limited to a simple subcutaneous mass frequently neglected by the patient. Although seen in all ages from neonate to elderly; few cases were reported in the literature of patients in the first decade of life. We report a case of four years old boy with primary calvarial cavernous hemangioma in order to help to understand this pathology and to urge physicians to explore any chronic subcutaneous mass at any age. 

Primary calvarial cavernous haemangioma in a child: A case report

A wide variety of bone lesions is encountered on the skull and usually with poor clinical presentations and non-specific radiological features. Primary cavernous hemangioma is one of these rare calvarial lesions that the symptoms are limited to a simple subcutaneous mass frequently neglected by the patient. Although seen in all ages from neonate to elderly; few cases were reported in the literature of patients in the first decade of life. We report a case of four years old boy with primary calvarial cavernous hemangioma in order to help to understand this pathology and to urge physicians to explore any chronic subcutaneous mass at any age. 

Spontaneous height restoration of cervical traumatic non-pathological vertebral compression fracture: Short report

Spontaneous regaining of radiological normal shape with vertebral compression fracture is very uncommon in the cervical spine; conducting confusion regarding the presence of a potentially surgical lesion. We report the case of 48 years old man without past medical history who presented post traumatic compression fracture that resolved spontaneously after transcranial traction. The patient was operated on with a good outcome. This report aims to confirm the presence of such phenomena already reported in the dorso-lumbar spine

Upper cervical spine tuberculosis

Tuberculosis is an infection caused by Mycobacterium tuberculosis; mainly affects the lungs; spinal tuberculosis presents 6 % of the extrapulmonary locations; Upper cervical spine tuberculosis is a rare condition and counts only 0.3 to 1 % of all spinal tuberculosis; that makes it a rare condition studied by few case reports. We report a case of upper cervical spine tuberculosis of the atlantoaxial facet joint.

Upper cervical spine tuberculosis: A case report

Tuberculosis is an infection caused by Mycobacterium tuberculosis; mainly affects the lungs; spinal tuberculosis presents 6 % of the extrapulmonary locations; Upper cervical spine tuberculosis is a rare condition and counts only 0.3 to 1 % of all spinal tuberculosis; that makes it a rare condition studied by few case reports. We report a case of upper cervical spine tuberculosis of the atlantoaxial facet joint.