Non-traumatic spinal cord compression in children: 45 cases

Spinal cord compression occurs rarely in childhood and the diagnosis is usually made too late. We report 45 cases of non-traumatic spinal cord compression collected in our department between January 1982 and December 2002. Mean age was 11 years old with a male sex predominance [sex-ratio: 1.6]. Average delay of admission was 5 months. The most frequent complaints were gait disturbance [84.4%], pain [radicular or spinal] [66%] and sphincter dysfunction [24.4%]. Plain radiographs showed abnormalities in 46%. Magnetic resonance imaging has been more indicated since 1994. The distribution of lesions can be summerised as follows: predominance of dorsal involvement [37.7%], extramedullary lesions [75.6%] tumoural aetiologies [71.5%]. Forty-three cases were operated; 40 cases via posterior approach with laminectomy [33 cases] and laminotomy [7 cases], while anterior approach was performed in only 3 cases. Postoperative course showed neurologic improvement in 11 cases [24.4%], a stationary state in 28 cases [62.2%], and 3 cases of death. Unfortunately the long term outcome could not be followed in the majority of cases

[Cerebral hydatic cyst in children: a 40 cases report]

The cerebral hydatic cyst is uncommon, representing only 2 to 3% of all the localizations. Children are the most concerned by this disease. This retrospective study is about 40 cases of cerebral hydatic cyst [CHC] collected in the department of neurosurgery of Ibn Rochd Universitary Hospital of Casablanca between 1986 and 2002. These 40 cases were 70% of all the CHC. The mean age was 9 years [4 to 15 years. 64% were boys. All the children had progressive intracranial hypertension and 95% had neurological deficit. The cerebral CT scan of all the patients permitted to assess the diagnosis. The right hemispheric localization was predominant. 3 children had multivesicular cyst and 2 children had multiple cysts. All the patients were operated according to Arana-Iniguez's technique with a post-operative course characterized by 2 cases of meningitis. The medical treatment is still not useful for this disease. The outcome was good in 94% of the cases. 2 cases recurred after one and two years and had surgery once more. In conclusion, the CHC has a good prognosis in children if the diagnosis and the treatment are assessed early. Prevention campaign can avoid the disease and its neurological effects

management of craniocerebral wounds about 73 cases

Our study was about 73 cases of craniocerebral wounds treated at the department of Neurosurgery in the UHC lbn Roshd in Casablanca. The mean age of our patients was 21 years old, with male predominance [87.7%]. 57.5% of these traumatisms were caused by aggression, 17,8% by road trafic accidents and 16.4% by falls. The neurological examination showed a normal consciousness in 80% of the cases, vigilance disorders in 20% of the cases, and signs of localizations in 23% of the cases. The radiography of the skull showed that the osseous damages [depressed fracture of the skull-pressed fracture of the skull were frequent in the parietal region [31%]. The computed tomography scan, achieved in all cases, was very useful in the detection of associated intracranial lesions. The management consists of a medical treatment and surgical intervention based on craniectomy and restoration of the dural plane. The craniocerebral wounds are rare but may have serious complications mainly infection and epilepsy