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[Post-traumatic subdural hygroma: diagnostic conditions and therapeutic attitude in Gabon].

An excessive collection of cerebrospinal fluid in the subdural space is known as subdural hygroma, or hydroma. By far, the most common cause is severe cranial trauma. The diagnosis can be made by angiography or computer tomography and, with certainly, only by trephine or burr hole evacuation. 11 cases of post-traumatic subdural hygromas, mainly diagnosed during operative interventions, from April 1981 to September 1988, are reported. Most patients had acute forms of hygroma requiring acute surgical intervention. The acuteness could broken down as: coma (medium Glasgow coma scale: 6), lateralizing neurologic signs (4 cases) and temporal lobe herniation signs (7 cases). There were difficulties in obtaining angiographic studies. 10 patients underwent burr hole evacuation. Craniectomy was performed in one case. Time between cranial trauma and surgical intervention varied from 24 hours (6 cases) to 34 days. It appears that the prognosis is related to the extent of primary brain damage and not to the pressure exerted by the (usually) small mass lesion. The authors propose a clinical management of this lesion and hope for improvement in the diagnostic technics available.

Adolescent↗
PubMed1985

Severe neurological sequelae of childhood bacterial meningitis.

Bacterial meningitis remains the most common type of central nervous system infection in both developing and developed countries. Despite modern antimicrobial chemotherapy, the incidence of severe neurological sequelae remains high. We review the pathogenesis of these sequelae and correlate them with computed tomography (CT) appearances. Early diagnosis and appropriate chemotherapy remain the cornerstones of management. Early and accurate diagnosis of complicating space-occupying lesions with the aid of CT and appropriate aggressive therapy are suggested if the prognosis is to be improved.

Atrophy↗
PubMed1986

Radiologic techniques in the diagnosis of CNS infections.

The radiologic diagnosis of CNS infections remains a challenge. CT scan findings, though admittedly nonspecific to a large extent, assume great diagnostic significance when considered in conjunction with clinical and laboratory findings. MRI is expected to show abnormalities in the earlier stages of these infections.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Clinical aspects of Menkes syndrome].

The difficulties of early diagnosis of Menkes' kinky hair syndrome are described guided by the clinical courses of three related patients. One of these children could be observed continuously from birth. Different from other descriptions the diagnostic value of the clinical features observed in our patients is estimated as follows: 1. severe cerebral degeneration with seizures in the first year of life; 2. subdural hygroma; 3. decreased levels of serum copper and serum coeruloplasmin; 4. hair abnormalities; 5. skin abnormalities. The diagnosis is likely, if serum copper and serum coeruloplasmin are decreased. The diagnosis is proved by increased copper uptake into cultured fibroblasts. The prenatal diagnosis is possible by chorionic villus biopsy or amniocentesis. The importance of carrier detection by cultured fibroblasts and subsequent genetic counselling is underlined.

Brain↗
PubMed1986

Role of traumatic subdural fluid collection in developing process of chronic subdural hematoma.

We investigated the role of traumatic subdural fluid collection in the genesis of chronic subdural hematoma (CSDH) in 43 consecutive patients with traumatic subdural fluid collection. Traumatic subdural fluid collection was found in 43 (6%) of 715 patients who underwent CT scans because of head injury. Twenty-four of the 43 patients were more than 65 years of age and this problem occurred in 30% of the 79 head-injured patients over 65 years of age. In 20 (Group 1) of the 43 patients CSDH subsequently developed. During the same period, 30 other patients were treated for CSDH. Twenty-four (Group 2) of these 30 patients had a history of head injury more than two weeks prior to the developing signs and symptoms and had hyper- or iso-dense hematomas on their first CT scan. It may have been that they too first had a traumatic subdural collection. Forty to sixty percent of the patients with asymptomatic traumatic subdural fluid collection may develop CSDH, and this may occur especially in the older patients. Careful observations after the head injury are particularly important in the aged because of the frequent occurrence of traumatic subdural fluid collection and the subsequent development of CSDH.

Adult↗
PubMed1986

Pyogenic bacterial infections of the CNS.

The etiology of pyogenic infections of the brain and meninges varies principally by age, predisposing causes or conditions, and anatomic site of the infection. An appreciation of these factors, plus the prudent use of noninvasive anatomic diagnostic techniques (such as CT) and examination of the CSF, will provide a basis for the empiric use of appropriate antibiotics. The beta-lactam antibiotics remain the preferred drugs whenever possible because of their broad spectrum on antimicrobial activity, efficacy in CNS infections, low cost, and low toxicity.

Adult↗
PubMed1977

Computerized axial tomography in neurologic disorders of children.

Computerized axial tomography offers major advantages over air encephalography and angiography for studies of neurologic disorders in children. The low morbidity and the ease of the procedure permit the accurate diagnosis of intracranial pathology in situations where more invasive procedures would not be undertaken. The techniques of the procedure and its uses and limitations are emphasized in a number of neurologic problems of children.

Anesthesia↗