5 research outputs found

    In-Hospital Evolution of Non Operated Aneurysmal Subarachnoid Hemorrhage at the Neurology Unit of Befelatanana University Teaching Hospital, Antananarivo

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    Subarachnoid hemorrhage is defined as a sudden irruption of blood in subarachnoid spaces. This study aims to determine the profile and in-hospital evolution of patients with post aneurysmal subarachnoid hemorrhage, who did not have surgical treatment in the Neurology Unit of Befelatanana University Hospital, Antananarivo, Madagascar. This study was a descriptive retrospective study within a period of 4 years, from January 1st, 2014 to December 31th, 2017. The study was carried out in hospitalized patients for subarachnoid hemorrhage with aneurysmal origin. We included 52 patients, with an average age of 48 years and a female predominance. They are housewives in majority of cases. 52% of the cases live in urban areas while 77% of cases have high blood pressure. The main clinical manifestation was a sudden headache, and intracranial aneurysm was located at the anterior communicating artery in 52% of cases. All patients benefited from drug treatments in majority of cases. Due to the lack of financial means, 60% had neurological complications. However, in-hospital mortality rate was at 13%. This study helps us to suggest to our patients medical treatment of their subarachnoid hemorrhage during hospitalization because of difficult access to surgery. It also aims to propose surgery outside the acute phase of the disease

    Facteurs Prédictifs de Survenue de la Fibrillation Auriculaire à L’origine des Accidents Vasculaires Cérébraux Ischémiques Auprès du Service de Neurologie de Befalatanana, Antananarivo

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    La fibrillation auriculaire (FA) est la première cause des infarctus cĂ©rĂ©braux cardio-emboliques. Cette Ă©tude a pour objet d'identifier les facteurs prĂ©dictifs des FA Ă  l'origine des accidents vasculaires ischĂ©miques cardio-emboliques auprès du service de Neurologie de Befelatanana. Il s’agit d’une Ă©tude rĂ©trospective, descriptive, transversale Ă  visĂ©e analytique sur 24 mois, allant du 01 janvier 2018 jusqu’au 31 dĂ©cembre 2019. Nous avons retenu 93 patients avec une recherche de FA au cours de l’hospitalisation. L’âge en moyen est de 64 ans ± 14,1 ans avec un sex-ratio Ă  1,325. Les principaux facteurs de risque cardiovasculaire identifiĂ©s Ă©taient l’hypertension artĂ©rielle (77,41%) ; le tabagisme (36,55 %) ; l’antĂ©cĂ©dent d’AVC (29,03%) ; l’antĂ©cĂ©dent d’une insuffisance cardiaque et/ou de cardiopathies (19,35%), le diabète sucrĂ© (10,75%). L’âge supĂ©rieur Ă  65 ans (p=0.048 ; OR  1.919 (1.012-3.639)) et l’antĂ©cĂ©dent d’une HTA (p=0.034 ; OR Ă  2.831 (0.964-8.310)) sont les facteurs prĂ©dictifs cliniques identifiĂ©s dans la survenue d’une FA. Les anomalies Ă  l’échodoppler cardiaque les plus retrouvĂ©es Ă©taient l’altĂ©ration de la FEVG (26,88%) ; la dilatation de l’oreillette gauche (5,37%) ; le thrombus intracardiaque (4,3%).  Aucun de ces paramètres n’était pas associĂ© Ă  la survenue de FA dans notre Ă©tude. Cette Ă©tude confirme la nĂ©cessitĂ© de rechercher systĂ©matiquement la FA chez les sujets âgĂ©s et les patients hypertendus afin de dĂ©buter un traitement adĂ©quat pour une meilleure prĂ©vention primaire et secondaire des infarctus cĂ©rĂ©braux.   Atrial fibrillation (AF) is the leading cause of cardioembolic cerebral infarction. The purpose of this study is to identify the predictive factors of AF at the origin of cardio-embolic ischemic vascular accidents in the Neurology department of Befelatanana. This is a retrospective, descriptive, cross-sectional study with an analytical aim over 24 months, from January 1, 2018 to December 31, 2019. We retained 93 patients with a search for AF during hospitalization. The average age is 64 ± 14.1 years with a sex ratio of 1.325. The main cardiovascular risk factors identified were high blood pressure (77.41%); smoking (36.55%); history of stroke (29.03%); history of heart failure and/or heart disease (19.35%), diabetes mellitus (10.75%). Age over 65 (p=0.048; OR 1.919 (1.012-3.639)) and history of hypertension (p=0.034; OR 2.831 (0.964-8.310)) are the clinical predictive factors identified in the occurrence of AF. The most common cardiac echo-doppler abnormalities were altered LVEF (26.88%); dilation of the left atrium (5.37%); intracardiac thrombus (4.3%). None of these parameters was associated with the occurrence of AF in our study. This study confirms the need to systematically search for AF in elderly subjects and hypertensive patients in order to start adequate treatment for better primary and secondary prevention of cerebral infarction

    Facteurs Prédictifs de Survenue de la Fibrillation Auriculaire à L’origine des Accidents Vasculaires Cérébraux Ischémiques Auprès du Service de Neurologie de Befalatanana, Antananarivo

    Get PDF
    La fibrillation auriculaire (FA) est la première cause des infarctus cĂ©rĂ©braux cardio-emboliques. Cette Ă©tude a pour objet d'identifier les facteurs prĂ©dictifs des FA Ă  l'origine des accidents vasculaires ischĂ©miques cardio-emboliques auprès du service de Neurologie de Befelatanana. Il s’agit d’une Ă©tude rĂ©trospective, descriptive, transversale Ă  visĂ©e analytique sur 24 mois, allant du 01 janvier 2018 jusqu’au 31 dĂ©cembre 2019. Nous avons retenu 93 patients avec une recherche de FA au cours de l’hospitalisation. L’âge en moyen est de 64 ans ± 14,1 ans avec un sex-ratio Ă  1,325. Les principaux facteurs de risque cardiovasculaire identifiĂ©s Ă©taient l’hypertension artĂ©rielle (77,41%) ; le tabagisme (36,55 %) ; l’antĂ©cĂ©dent d’AVC (29,03%) ; l’antĂ©cĂ©dent d’une insuffisance cardiaque et/ou de cardiopathies (19,35%), le diabète sucrĂ© (10,75%). L’âge supĂ©rieur Ă  65 ans (p=0.048 ; OR  1.919 (1.012-3.639)) et l’antĂ©cĂ©dent d’une HTA (p=0.034 ; OR Ă  2.831 (0.964-8.310)) sont les facteurs prĂ©dictifs cliniques identifiĂ©s dans la survenue d’une FA. Les anomalies Ă  l’échodoppler cardiaque les plus retrouvĂ©es Ă©taient l’altĂ©ration de la FEVG (26,88%) ; la dilatation de l’oreillette gauche (5,37%) ; le thrombus intracardiaque (4,3%).  Aucun de ces paramètres n’était pas associĂ© Ă  la survenue de FA dans notre Ă©tude. Cette Ă©tude confirme la nĂ©cessitĂ© de rechercher systĂ©matiquement la FA chez les sujets âgĂ©s et les patients hypertendus afin de dĂ©buter un traitement adĂ©quat pour une meilleure prĂ©vention primaire et secondaire des infarctus cĂ©rĂ©braux.   Atrial fibrillation (AF) is the leading cause of cardioembolic cerebral infarction. The purpose of this study is to identify the predictive factors of AF at the origin of cardio-embolic ischemic vascular accidents in the Neurology department of Befelatanana. This is a retrospective, descriptive, cross-sectional study with an analytical aim over 24 months, from January 1, 2018 to December 31, 2019. We retained 93 patients with a search for AF during hospitalization. The average age is 64 ± 14.1 years with a sex ratio of 1.325. The main cardiovascular risk factors identified were high blood pressure (77.41%); smoking (36.55%); history of stroke (29.03%); history of heart failure and/or heart disease (19.35%), diabetes mellitus (10.75%). Age over 65 (p=0.048; OR 1.919 (1.012-3.639)) and history of hypertension (p=0.034; OR 2.831 (0.964-8.310)) are the clinical predictive factors identified in the occurrence of AF. The most common cardiac echo-doppler abnormalities were altered LVEF (26.88%); dilation of the left atrium (5.37%); intracardiac thrombus (4.3%). None of these parameters was associated with the occurrence of AF in our study. This study confirms the need to systematically search for AF in elderly subjects and hypertensive patients in order to start adequate treatment for better primary and secondary prevention of cerebral infarction
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