[Metastatic epiduritis in neurosurgery: Hospital data from the Abidjan teaching hospital, 2007-2012]. / Les épidurites métastatiques en neurochirurgie : données hospitalières au CHU d'Abidjan de 2007 à 2012.

INTRODUCTION: Metastatic epiduritis is the most frequent extrinsic epidural cause of spinal cord compression. Although neurosurgery is essential to its management, the exact role of this discipline in the treatment of spinal cancer in sub-Saharan Africa has not yet been assessed. AIM: To analyze recent hospital data of patients with metastatic epiduritis managed in the Abidjan neurosurgery department. METHODOLOGY: We conducted a retrospective analysis of files of 56 patients admitted from January 2007 through December 2012. Our data are discussed in the light of the literature. RESULTS: The primary cancers in men were mostly lung (16%) and prostate (34%) cancers, and in women, breast cancer (23%). The two age brackets mainly involved were those aged 31-45 years (21%) and 46-60 years (39%). The reason for admission in all cases was functional disability of the lower limbs. Magnetic resonance imaging (MRI) was performed for 57%. The thoracic topography was dominant (60%), and vertebral damage was often associated with epiduritis (78%). This metastatic epiduritis was the initial sign leading to cancer diagnosis for 39%. Decompressive laminectomy with biopsy or lesionectomy was performed for 62%. Postoperative neurologic improvement was noted for 36%, and remained satisfactory at one year for 14 patients. Prostate-specific hormone therapy was performed for 30%. CONCLUSION: This study underlines the crucial importance of neurosurgery in management of metastatic epiduritis in our center. Our findings emphasize the need to improve access to neuroradiologic diagnostic resources and optimize surgical treatment in the sub-Saharan region.

[Investigation of the collateral branches of the external carotid artery in a population from West Africa. About 60 cadaver dissections]. / Contribution à l'étude des branches collatérales de l'artère carotide externe chez le sujet originaire d'Afrique de l'Ouest. A propos de 60 dissections cadavériques.

OBJECTIVE: The goal of this survey was to study the level of emergence of the external carotid artery and the origin of its collateral branches about a dissection of 30 cadavers subjects of West Africa. MATERIAL AND METHOD: We dissected to the laboratory of Abidjan anatomy 30 cool adults' cadavers corresponding to 28 men and two women. At these 30 cadavers, we dissected 60 external carotids. We studied the level of bifurcation of the carotid artery in relation to hyoid bone and thyroid cartilage and the level of the emergence of the collaterals branches of the external carotid artery according to classic description. RESULTS: The origin of the external carotid artery was variable: in 46 cases (75%), the origin was between the hyoid bone and the thyroid cartilage; in 10 cases (15%), this origin was below the thyroid cartilage and in four cases (13%), this origin was over to the hyoid bone. In 46.5% of cases, we find five collaterals branches of the external carotid artery. According to classic description, we find some variations of the emergence of collateral arteries: the facial artery is not below the lingual artery in 28 cases (46.5%); the ascending pharyngeal artery do not emerge at the same level of lingual artery in 46 cases (76.5%) and in 44 cases (73%), the occipital artery do not emerge of the same level of the facial artery. CONCLUSION: Levels of collateral branch emergence in population of West Africa is variable. It is important to know that for practice cervical surgery safety.

[Spondylodiscitis due to Histoplasma duboisii. Report of two cases and review of the literature]. / Spondylodiscite à histoplasma duboisii. A propos de deux observations et revue de la littérature. A propos de deux observations et revue de la littérature.

We report two cases of African histoplasmosis caused by Histoplasma duboisii located in the spine, on two Malian adults aged 40 and 47 years respectively. Clinical signs consisted of dorsal spinal syndrome in both cases and a paraplegia in one case. Radiography and CT scan revealed a spondylodiscitis without any bone reconstruction in both cases and a prevertebral abscess in one case. Diagnosis was confirmed by mycological and pathological examinations of surgical specimen which revealed Histoplasma duboisii fungus. Medical treatment, after surgical repair, consisted in ketoconazola with positive results after 12 months. This localisation is rare. It raises diagnosis problems with tuberculous spondylodiscitis because of their radio-clinical resemblance.

[Dural metastasis of prostatic adenocarcinoma presenting as acute intracranial subdural hematoma: a case report]. / Métastase durale d'un adénocarcinome de la prostate simulant un hématome sous-dural aigu intracrânien. A propas d'une observation.

Intracranial malignant metastatic dissemination usually is seen as a unique nodular formation enhanced after intravenous injection of contrast medium. Forms mimicking meningioma or subdural hematoma have been described. We report a case of dural metastasis from an adenocarcinoma of the prostate in a 60-year-old man. The CT image suggested acute subdural hematoma.