Cranial tomographic angiographic evaluation of suspected intracranial vascular abnormalities among a Nigerian cohort

Background: Lately, there has been an increased utilization of computed tomography angiography (CTA) as the preferred first-line modality for the evaluation and diagnosis of most cerebral vascular lesions.Objective: The objective of this study was to evaluate suspected intracranial vascular cases, using CTA at a major referral tertiary hospital in South West Nigeria.Materials and Methods: This was a hospital-based retrospective study of suspected intracranial vascular cases in all ages and both sexes that had CTA from January 2011 to December 2018. Data were analyzed with IBM SPSS version 23.0, and P < 0.005 was considered statistically significant.Results: A total of 128 patients were studied, the mean age was 44.1 ± 17.7 years, and male: female ratio was 1:1.06. The leading clinical diagnoses were as follows: intracranial aneurysms (34/128), subarachnoid hemorrhage (27/128), intracranial vascular tumors (26/128), brain hemorrhage from vascular abnormality (19/128), and arteriovenous malformations (AVMs) (10/128). At CTA, 61 patients had vascular abnormalities: intracranial aneurysm was seen in 63.9% with a peak age range of 41­60 years, and the leading location of aneurysms was posterior cerebral artery (18.8%), followed by posterior communicating artery (16.7%) and the cavernous segment of the internal carotid artery (16.7%). AVMs were more common in patients aged 40 years and below (91.7%) in males (66.7%) and in the parietal lobe. Intracranial aneurysms were 3.25 times as common as brain AVMs.Conclusion: Intracranial aneurysms are the predominant vascular lesions, occurring mostly in the older age group. AVMs occurred mostly in younger people, more in males, and predominantly in the parietal lobes. The hospital incidence of aneurysms to AVMs was 3.25:1

A Study of Extracranial Aneurysms at UNTH in Enugu; Nigeria

Previous studies on aneurysms in Nigeria have either been case reports or studies of peripheral aneurysms. No study has comprehensively evaluated all aspects of this disease as an entity among Nigerians. The need therefore arises to re-evaluate this lesion so as to make deductions on incidence; sex ratio; aetiology and management. This is a retrospective descriptive study of arterial aneurysms at the University of Nigeria Teaching Hospital (UNTH); Enugu. Those treated between January 1993 and December 2002 were included for the study. Datawere obtained frommedical records for all patients admittedwith aneurysms over the study period. Atotal of 26 patientswere admitted during the period; but 24 case noteswere analysed. The age rangewas 10-75 yearswithmale: female ratio of 1.4:1. Traumatic pseudo aneurysms accounted for 16 cases (67.0)while true aneurysms comprised the remaining.Of all the aneurysms; femoral artery with most of the pseudo aneurysms had 8 out of 24 (33.0).This is followed by the infra-renal abdominal aorta (5/24; 21.0) and other sites (11/24; 46.0). Diagnoses were made clinically in most cases and by abdominal ultrasonography in abdominal aortic aneurysms. Twenty-one patients had surgical interventionwith 9.5operativemortality. The incidence of aneurysm is low in our locality (2.6/year) based on the rate of diagnosis.Abdominal aorta harbours most of the true aneurysms with diameter ranging from 8.0-15.0cm without rupture. Untreated; all will eventually rupture with catastrophic consequences. Treatment involved excision with graft interposition. This is not only expensive but the graft is often not readily available. As a solution; grafts should be stocked with drug revolving fund

Anevrisme rompu de l'artere splenique revelant un syndrome d'Ehlers-Danlos

Dans cette observation; nous rapportons un cas d'anevrisme de l'artere splenique rompu qui simulait une pseudotumeur chez une patiente porteuse d'une maladie d'Ehlers-Danlos vasculaire. La non prise en compte initiale de son terrain avait conduit a un traitement chirurgical inutilement agressif. Nous insistons sur la necessite d'une attitude prudente pour les indications therapeutiques sur ces terrains fragiles

Peripheral False Aneurysms : an Evolution of Precedent Vascular Injury

With the rise in armed conflicts in Nigeria; major vascular injuries are seen more commonly. Unfortunately it is not well appreciated that securing haemostasis at the site of injury is not tantamount to adequate handling of the vascular situation. Occasioned by misdiagnosis of the extent and type of vascular damage; false aneurysms may develop long after the initial care of the damaged vessel. Presented here are eleven consecutive cases of peripheral false aneurysms of the extremities which developed between two weeks and nine months after the initial injury. Objective evaluation and prompt referral to vascular surgical units will improve the management of such cases and so obviate the development of false aneurysms

Apport de l'anatomie pathologique dans le diagnostic des tumeurs vasculaires cervico-faciales au C.N.H.U. de Cotonou

Sur une periode de 14 ans; les auteurs ont collige 43 cas de tumeurs vasculaires au niveau du cou et de la face. De leur etude ressortent les conclusions suivantes: sur le plan diagnostique le tableau clinique est evocateur mais la clef du diagnostic est apportee par l'examen anatomopathologique; la chirurgie d'exerese; parfois precedee d'infiltration locale des produits sclerosants a ete l'unique arme therapeutique compte tenu des ressources therapeutiques limitees; enfin les resultats therapeutiques ont ete bons dans l'ensemble (83;7 pour cent de bons resultats)

Rupture of dissecting aneurysm: autopsy study of 3 cases

Dissecting aneurysm (DA); more appropriately termed dissecting haematoma; is the separation of layers of the vascular wall by a column of blood from the lumen. Dissecting aneurysms of the aorta differ from atherosclerotic and syphilitic aneurysms in that they are not usually associated with marked dilatation of the aorta. DA of the aorta; irrespective of the etiology; if untreated; are associated with a rapidly fatal outcome in 75 per cent to 90 per cent of the patients. Death from DA most often results from rupture. Rupture sites frequently associated with a fatal outcome include the pericardial sac leading to acute haemopericardium; the mediastinum; the left pleural cavity and the retroperitoneum. Autopsy study on three cases of sudden death revealed haemopericardium as a result of rupture of DA of the ascending aorta. One case was seen in a young individual with Marfan's syndrome and two were present in elderly individuals with hypertension. The etiopathogenesis; presentation; outcome and management of this fatal complication is discussed

Les anevrysmes aux Cliniques Universiatires de Kinshasa : a propos de 30 cas

Les auteurs rapportent 39 cas d'anevrysmes diagnostiques sur une base d'explorations invasives et non invasives. L'etiologie est retenue apres examens biologiques; histopathologiques et paracliniques. En dessous de 50 ans les femmes sont les plus atteintes (1H/2F) surtout par la panarterite specifique (Maladie de Takayasu). Au dela de cet age c'est l'atherosclerose qui est plutot masculine (2H/1F). L'hypertension arterielle et l'hyperccholesterolemie totale sont presentes chacune dans 8 cas (32 pour cent). 24 patients sont operes avec succes: 17 protheses en Dacon ou Teflon et 3 autogreffes veineuses