ABSTRACT
L'accident vasculaire cérébral hémorragique (AVCH) est une interruption de la circulation sanguine par la rupture d'une artère cérébrale qui va provoquer une perte soudaine d'une ou plusieurs fonctions cérébrales. L'objectif de notre étude était de déterminer l'aspect épidemio-clinique et radiologique et de décrire la prise en charge chirurgicale d'un AVCH au Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHU JRA), Antananarivo Madagascar. Méthodes : Il s'agit d'une étude rétrospective et descriptive de 125 cas d'AVCH opérés sur des patients hospitalisés du Janvier 2017 au 31 Décembre 2019. Résultats : Nous avons noté une prédominance masculine de 55% avec un Sex ratio de 0,82 ; dont l'âge moyen était de 52,8 ans. Le facteur de risque le plus rencontré était l'hypertension artérielle (HTA) avec 58,4% des cas. Les motifs d'admission étaient les troubles de la conscience (63,2%) et les déficits moteurs (44,8%). Les signes à l'examen étaient surtout l'hémiplégie (55,2%), la dysarthrie (22,4%). Les hématomes étaient lobaires dans 80,8% des cas et 19,2% au niveau de la fosse postérieure. La technique chirurgicale la plus utilisée était l'évacuation de l'hématome par craniotomie. Les séquelles étaient dominées par l'hémiparésie et l'aphasie respectivement 53.6% et 10.4%. Le taux de mortalité a été de 8%. Conclusion : La chirurgie tient une place primordiale dans la prise en charge des AVCH au CHU JRA.
Subject(s)
Humans , Decompressive Craniectomy , Cerebral Intraventricular Hemorrhage , General Surgery , Radiologic Health , Cerebral Hemorrhage , Clinical Diagnosis , HemiplegiaABSTRACT
Defi ned as circumferential eversion of the epithelium of the distal urethra, mucosal prolapse of the urethra occurs in the girl child. The diagnosis is clinical but may be overlooked or confused with other conditions. Treatment remains controversial. The aim was to describe the anatomical and therapeutic aspects. Methods. This was a retrospective and descriptive study over 5 years. Age, time of admission and circumstances of occurrence were analysed. Clinical aspects were based on the length of the prolapse (small less than 1 cm, medium: between 1 and 2 cm, large more than 2 cm), the colour of the prolapse and the presence or absence of bleeding. The treatment was medical (hormonal) and surgical in case of failure of hormonal treatment. The evaluation of the results was based on the occurrence of recurrence and urinary incontinence. The average follow-up was 18 months. Results. Twenty-one patients were included in the study with a mean age of 6.5 years. The mean time to onset was 12.4 days. Vulvar bleeding was the reason for consultation in n=9 patients. The prolapse was large in 12 patients, medium in 9 patients and small in 3 patients. The prolapse was violaceous in 15 patients. Medical
Subject(s)
Humans , Therapeutics , Uterine Prolapse , Intraepithelial Lymphocytes , Urethra , Clinical DiagnosisABSTRACT
BACKGROUND: Acute ischemic stroke has been reported to occur in a significantly higher number of COVID-19 patients as compared to healthy controls with variable proposed pathophysiologic mechanisms. To our knowledge, sufficient data regarding this subject is lacking in Ethiopia and the African continent at large. In this case series, we report the clinical characteristics and management of 5 cases with COVID-19 infection and acute ischemic stroke to shed light on the diagnostic and therapeutic challenges in resource-limited setups. METHODS: This is a case series including data collected from the medical records of 5 participants with confirmed RT-PCR positive COVID-19 infection and radiologically confirmed acute ischemic stroke, admitted at Eka Kotebe General Hospital Intensive Care Unit (ICU) in Addis Ababa, Ethiopia from June 10, 2020, to November 04, 2020. RESULTS: Cryptogenic stroke was documented in 4/5 participants included in this series with the most common vascular risk factors identified for stroke being hypertension and diabetes mellitus. The median time from onset of COVID-19 symptoms to the identification of stroke was 07 days. Two fifth of the participants in this series died during their ICU admission with the immediate cause of deaths reported to be related to the severe COVID-19 infection but not stroke. CONCLUSION: Cryptogenic stroke was documented in 4/5 patients in this series despite the presence of vascular risk factors for other stroke subtypes. The overall prevalence, subtypes, and outcomes of stroke in COVID-19 patients in Ethiopia and the African continent as a whole needs additional research to elucidate the local burden of the disease and define the predominant pathophysiologic mechanisms for stroke in COVID-19 in the region