Biomedical subjects

M C Ba

Publications and source records attributed to M C Ba.

At least 19 recordsLinked to original sources

PubMed2006

[Cranioencephalic complications of middle ear cholesteatoma: report of 4 cases].

INTRODUCTION: Cranial and intracranial complications can be observed during middle ear cholesteatoma's evolution. We report our experience of management of infectious cholesteatoma's cranioencephalic complications. MATERIAL AND METHODS: In a three year period, we had consecutively admitted 4 patients with cranioencephalic complications of middle ear cholesteatoma, in the Ear Nose and Throat (ENT) department of the university teaching hospital of Dakar. After preoperative investigations with computed tomography scan (CT scan) of brain and temporal bone. The patients had been operated after paraclinic assessment. RESULTS: The finding showed one case of temporal bone otogenic extensive osteomyelitis with multifocal extradural empyema, 3 cases of brain abscess associated with subdural empyema and meningitis in 1 case. For 3 patients (75%), neurosurgical drainage and mastoidectomy were performed, associated with antibiotic treatment. The mastaidectomy was performed in the same time of the surgical procedure or delayed. One patient, with brain abscess, died before surgical intervention. With a follow up of 15 months, we have noticed stable mastoidectomies cavities and no neurological recurrence symptoms. CONCLUSION: These complications can be prevented by early treatment of chronic otitis media diseases. The appropriated management of these complications necessitate collaboration between otorhinolaryngologists and neuro surgeons.

Adolescent↗

PubMed2006

[Posterior cranial fossa abscess secondary to cholesteatoma].

OBJECTIVE: The intra cranial complications of chronic ear disease continue to pose a challenge in Senegal, despite advances in anti microbial therapy. Posterior cranial fossa abscesses are rare and continue to be associated with significant morbidity and mortality rates. We describe the presentation and management of a large cerebellar abscess secondary to cholesteatoma. METHODS AND RESULTS: A 11-year-old female presented with an inflammed fluctuant swelling of the right temporal region with ipsilateral otorrhoea. Examination demonstrated an auto atticotomy, large marginal perforation of the tympanic membrane associated with polyp. A diagnosis of otomastoiditis secondary to cholesteatoma was made. The abscess of the right temporal region was incised and drained and the patient was commenced on broad spectrum antibiotics. However the patients clinical status did not improve and there was a deterioration in her neurological status. CT brain and temporal bones demonstrated a large abscess in the cerebellum. 30 CC of pus were drained through a posterior fossa burr hole by the neurosurgeons. A radical mastoidectomy for extensive cholesteatoma of the right ear was subsequently carried out when the patients condition improved. CONCLUSION: Cerebellar abscess is a life threathning condition. In the presence of complicated chronic ear disease, clinical suspicion must be high as early symptoms and signs may be misleading. A low threshold for the performance of brain imagining will aid early diagnosis and allow prompt definitive treatment.

Abscess↗

PubMed2005

[Cranial and cervical vertebral mycetoma. Report of three cases].

Mycetomas inflammatory-like tumors presenting as fistulas found in the skin and soft tissues. Inoculation, generally in tropical areas, occurs by skin injury. The foot is the main infection site. Other uncommon infection sites include the cranial and cervical areas which are rare. We present three cases of cranial and cervical mycetoma. Clinical sign were dominated by headache, cervical pain and cervico-occipital tumefaction with formation of pus and granules (red in two cases, black in one). A motor deficit was noted in one patient. Radiographic examinations including CT scan showed extensive mass lesions, associated with bone destruction. Laboratory tests identified Leptospheria senegalensis in one patient and Actinomadura pelletieri in two. A medicosurgical procedure was performed. The course was unfavourable in one patient. Several factors are important for treating such infections: early diagnosis, improvement of the social and economic environment, use of new drugs.

Adolescent↗

PubMed2005

[Subdural empyema complicating acute frontal sinusitis. Four cases report].

OBJECTIVE: Subdural empyema is a collected cranioencephalic suppuration between arachnoid and dura meninge space. Subdural empyema occurring after sinusitis is an uncommon but serious complication of paranasal sinus infections. The purpose of this study is to aware the clinician about this condition. MATERIAL ET METHOD: Four young male children had been admitted with expressed fronto-ethmoid sinusitis. The intracranial infection was confirmed by computed tomography scan of brain and sinus. Both drainage of the sinus and intracranial suppuration was performed at the same time surgical procedure and antibiotics administered during 4 weeks. RESULTS: The subdural empyema was localized in the right temporoparietal region in 1 case, in the frontal lobe in the others cases. In 1 case, the frontal subdural empyema was associated with an inerhemispherique collection. One patient underwent a second drainage. Immediate post-operative outcomes were temporally complicated with convulsions and focal neurological deficit, in 1 case. This symptoms had regressed spontaneously. There was no case of death. The functional prognosis was bad, marked by lost vision in 2 cases, which was bilateral in 1 case. CONCLUSION: A high index of suspicion of intracranial extension of sinus infection must recommended neuroradiological investigations. When suppurative collection is confirmed, an appropriated management of the infection between otorhinolaryngologists and neurosurgeons is necessary.

Acute Disease↗

PubMed2004

[Child cerebellar meningioma. A case report].

Meningioma is an uncommon tumor of childhood. In this group, supra tentorial forms predominate. We report the case of a 14 years old boy without any past medical history. He presented headaches, vomiting and cerebellar syndrome. CT scan shows cerebellar tumor, enhanced by contrast and surrounded by edema, looking like tuberculoma. After fail of tuberculosis treatment, the boy is operated by suboccipital approach. Histology and immuno histochemical examination show fibroblastic meningioma. Even if it is rare, meningioma can occur in childhood, without neurofibromatosis disease. It can present many points of likeness with tuberculoma and therefore biopsy is mandatory before tuberculosis drugs giving.

Adolescent↗

PubMed2003

[Fronto-ethmoïdal encephaloceles in Dakar. Report of 9 cases].

A retrospective study of 9 cases of fronto-ethmoïdal encephaloceles is reported. Cases have been gathered from the files of Dakar University Neurosurgical Unit. Fronto-ethmoïdal encephaloceles were about 9.8% of all encephaloceles. In all the cases the exit hole from the anterior cranial fossa is at the site of the foramen caecum. The location of the tumor was fronto-nasal in seven patients and naso-ethmoïdal in two. The cranio-facial deformity consisted of increase of local volume and a lateral displacement of medial canthus in six cases, a down ward drift of the tip of the nose in two cases and one case of orbital hypertelorism. Eight cases were meningo-encephaloceles and the last a meningo-encephocystocele. Diola was the most ethnic group involved. All patients have been operated by a simple neurosurgical procedure without obstruction of the cranial defect nor bony displacement. In five cases mental and aesthetic results were good when operation was done during the first year of live. The authors stress early surgical treatment for fronto-ethmoïdal encephaloceles.

Child, Preschool↗

PubMed2003

[Lumbar canal stenosis in Ouagadougou: aetiological, clinical aspects and prognosis regarding 80 cases].

The authors report their experience about 80 cases operated for lumbar spinal stenosis. Etiological clinical aspects and prognosis are studied. Lumbar arthrosis (83.8%) is the most frequent aetiology. The mean age is 50.7 years. Men are most affected than women (sex-ratio 2/1). Heavy work has a part to play in the genesis, in effect it tends to low the age of symptomatic stenosis. Lumbar and radicular pains are the most frequent symptoms (82.5%). Neurogenic intermittent claudication is less frequent (65%). Heavy cases with neurologic complications are frequent (32.5%). Surgical results are satisfactory in 74.3% of the cases. The authors insist in the interest of extensive laminectomy, respecting however as much as possible, the structure of stability of the vertebral column.

Adult↗

PubMed2003

[Commissural agenesis associated with inter hemispheric cyst].

The Objectives of this study were to Report a rare malformation and to try to understand the embryological origin of such lesion. We reported the case of an eight-month-old female infant, without any particular past medical history, who was refered for seizures and vomiting. The examination revealed normal anthropometric constants, a soft painless and renitent tumefaction of the vertex and a psychomotor delay. Skull x-ray showed a parietal lacuna opposite to an opacity. Ultrasound scan showed an encephalocystocele communicating with dilated ventricles. CT x-ray revealed a single ventricle with an important back and upper extension, which evokes a cystic formation of the centre line. The existence of this cystic formation suppose an agenesis of diencephalic and telencephalic structures notably commissural. Interest of such observation is in its rarity, its complexity, the possibility of its antenatal diagnosis and in the etiopathogenic discussions that she gives rise to.

Agenesis of Corpus Callosum↗

PubMed2002

[Growing skull fracture with cerebral and ventricular hernia after brain trauma].

Authors report the case of 3 years old boy. He represented a severe head injury with dura mater damage and skull fracture. He has been operated and few years later, he present a vault tumefaction. CT scan show a very large bone defect, a cerebral and ventricular hernia. Mecanism and causal factors are discussed.

Brain Injuries↗

PubMed2002

[Arachnoid cyst with orbital meningocele: a case report].

Arachnoïd cysts are rare. 1% of cranial neoformation. We report the case of a six years old boy who presented an arachnoid cyst impressive by its compressive phenomena. Present complaint are macrocrania and right orbitary tumor. Tomodensitometry reveal a huge liquid collection which starts from the right cerebellopontine angle to the frontal region and invading the orbital cavity. In addition we have a thalamic fusion Its congenital origin is obvious. The associated malformations seem to be related to an anomaly of the centre line. This case point out the primum movens of malformations which are often complex and whose antenatal diagnosis is rare in our countries

Arachnoid Cysts↗

PubMed2002

[Calcified brain abscess: a case report].

Calcified brain abscesses are rare. A huge one is reported. A six years old feale had a fistula at the left frontal region for about three years. Patient was gored by a cow. Three years later Staphylococcus aureus was identified in the pus. The post operative neurological recovery was good.

Brain Abscess↗

PubMed2001

[Cauda equina compression: report of 20 cases].

The authors report in a retrospective study, 20 cases of cauda equina compressions operated in the Neurosurgical department of the University Hospital of Dakar. Clinical aspects, aetiologies, and prognosis are discussed. Cauda equina compressions represented 13.2% of all medullar and radicular compressions. Diagnosis was delayed with a mean duration of 11.2 months. Chronic lumbar pain is the main initial sign, diagnosis is made at the state of paraplegia with sphincter dysfunction. Lumbar canal stenosis (40%) and herniated disc (30%) were the most frequent causes, tumors were rare. Surgical treatment gave good results about motor deficit; urinary incontinence is a frequent sequella. The authors emphasize an early diagnosis for prognosis improvement.

Adult↗

PubMed2001

[Intraspinal abscess and HIV infection: a case report].

The intramedullary abscess (I.M.A.) is an uncommon and heavy etiology of intramedullary mass syndrom. Since the first description by HART in 1830, about 82 cases have been reported in literature and in one case, it was associated to H.I.V. infection. The authors report a new case in a 52 years old Senegalese man with per operative diagnosis of I.M.A. and post operative diagnosis of H.I.V. infection. They set up difficulties of pre operative diagnosis, and poor results of treatment in such an association. Also they discuss pathogeny and share Magnetic Resonance Imaging (R.M.I.) studies in management.

Epidural Abscess↗

PubMed1999

[Intracranial meningiomas. The Dakar experience apropos of 79 cases].

We report our experience with 79 intracranial meningiomas operated on between 1960 and 1995 in Dakar Senegal. In our geographical region issues concerning diagnosis, therapy and clinical course are still a topic of debate due mainly to the lack of high-performance technical units. All patients were admitted with evident symptoms. The classically described prevalence was not found in this series. Thirty-one cases presented intracranial hypertension with or without a focal syndrome which evidenced a motor deficit in 32 cases and irritative lesions in 24. External bulging of the meningioma was observed in a large number of cases (11.4%). Until 1994, angiography was the only available means of diagnosis. Mortality was high (30 cases) and results depended on delay to surgery, tumor localization and operative conditions. Our results have been improving over the years but cannot be sustained unless the technical unit is upgraded.

Adult↗

PubMed1999

[Our experience with laminectomy in the treatment of spinal cord disease caused by cervical arthrosis: apropos of 42 cases].

Cervical spondylotic arthRosis may lead to a myelopathy and the question which can rise is: posterior surgical decompression is adequate regarding the others surgical technics discussed? In this paper the authors describe the postoperative results of 42 patients who have been operated on by laminectomy from 1971 to 1995 at Fann Hospital in Dakar. The median age was 42 years and the median delay between the onset of neurological disorders and operation was 5.9 months. All patients showed symptoms of spinal cord and root disturbances. Neuro-imaging studies with plan X-rays and myelography reveal arthrosis and the impact of this arthrosis on nervous system. With a follow up of 6 months we found a mortality rate of 4.7% (two cases of death), 66.8% of good results and 28.5% of fail. Eighteen months post surgery results were respectively 52.3% and 45.7% of good and poor results. The complications of the laminectomy were peri operative hemorrhage (19%); sepsis (21.4%); spine cord traumatic injuries (9.5%) spondylolisthesis (4.7%). Laminectomy has been found to improve "spine syndrome"; paresthesia; fasciculations, and sensory deficits. Also three level laminectomy and surgery which can take place before six months are good prognosis factors. The authors stressed on laminectomy because of our low medical care situations particularly that no other surgical procedures through the modern literature leads to better results.

Adult↗

PubMed1998

[Spinal neurinomas and neurofibromas in Senegal].

Authors present 13 cases of spinal neurinomas and neurofibromas out of 418 non- pottic, non-traumatic medullary compression operated between 1965 and 1995. All cases were histologically documented. Neurinomas and neurofibromas represent 3.1% of all non pottic, non traumatic medullary compression and 12.8% of tumour medullary compression operated in our service. The illness started with radicular pains (6 cases) and spinal ache (5 cases) and most of the time, the medullary compression diagnosis is completed at the spasmodic paraplegia status. No patient has done any C.T. scan but in the other hand a myelography has been completed in all cases, resulting in the blockage of the contrast product which in 4 cases was of an epidural type, and in 2 cases of intra dural type. All patients were operated through a posterior approach, which ended in 10 cases to a total removal, and in 3 cases to a partial one. 7 extradural localizations were noticed and 3 neurinomas, 3 neurofibromas and 1 neurofibrosarcoma were histologically identified. A post operative follow-up was done on 11 patients and a satisfactory result was obtained on 6 of them. In 2 cases, the neurological status remained unchanged. In 2 cases a deterioration occurred and a patient with neurofibrosarcoma passed away.

Adolescent↗

PubMed1998

[Spinal cord injuries in Senegal: 16 cases].

Penetrating spinal cord injuries (P.S.C.I.) are rarely described in Sub Saharian countries in spite of an increasing number of wars. To study epidemiology management and prognosis of P.S.C.I. in Senegal, population of 16 patients collected from Fann Hospital in Dakar has been studied. 9 cases were related on gunshot or shrapnel injuries and 6 were stab-wounded. 8 came from war practice and 7 from civilian practice. The point of entry was at the posterior or lateral part of the body and continuous leaking of cerebral spinal fluid from this point was founded only in one patient. Patients showed a clinical picture of a complete spinal cord section syndrome, 3 spinal cord hemisection Brown Sequard syndromes, 3 cauda equina syndromes and 1 monoradicular syndrome. Spinal X-rays or myelography may lead to an accurate evaluation of the extent of bone tissue destruction. Anatomical evaluation of roots and spinal cord lesions were more difficult when C.T. scan or R.M.I. is not available. Penetrating spinal cord injury with foreign body included or myelography stop or showing cauda equina syndrome should be operated on. 9 of our patients has benefited of spine surgical posterior approach (laminectomy). Immediate vital prognosis is good regarding the fact that visceral associated lesions were rare (2 cases). Functional recovery is fair only 46.6% of patients expressed partial or complete recovery. Prognosis factors such as injuring agent and initial neurological status has been discussed. Prognosis of penetrating spinal cord injuries could be improved by immediate and multidisciplinary management.

Adolescent↗

PubMed1998

[Lumbosacral intraspinal lipomas associated or not with a tethered cord syndrome (series of 8 cases)].

The authors report a surgical experience on eight case of intra spinal lipomas. These lumbo-sacral malformations belong to post-neurulation defect, in such conditions spinal cord undergoes tethering while child growing that lead to a slow neurological disturbance. Through this study, authors show that female is more involved than male (5/3. On 6 cases the diagnosis have been made before the age of 2 years old. Three groups of signs characterize dramatically intra spinal lipomas: skin-median lumbo-sacral stigmata (8 cases) such as hypertrichosis, nevi etc. neuro-orthopedic disturbance(3 cases): club foot, paraparesis. sphincter disturbance: vesical or anal incontinence. In the lack of C.T. scan and M.R.I. contrast medium myelography confirm the diagnosis. Surgical excision lead to characterization of 4 extra dural lipomas, one sub dural, and 3 mixed lipomas. 75% of the patient improved well. One dealing with this kind of pathology must avoid the misdiagnosis of enuresis.

Child↗