Subject(s)
Arabs/statistics & numerical data , Black People/statistics & numerical data , Multiple Sclerosis, Chronic Progressive/ethnology , Multiple Sclerosis, Relapsing-Remitting/ethnology , Adult , Brain/pathology , Evoked Potentials, Visual , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Multiple Sclerosis, Chronic Progressive/complications , Multiple Sclerosis, Chronic Progressive/diagnosis , Multiple Sclerosis, Chronic Progressive/therapy , Multiple Sclerosis, Relapsing-Remitting/complications , Multiple Sclerosis, Relapsing-Remitting/diagnosis , Multiple Sclerosis, Relapsing-Remitting/therapy , Oligoclonal Bands/cerebrospinal fluid , Prevalence , Prospective Studies , Spinal Cord/pathology , Sudan/epidemiology , Treatment Outcome , Visual Pathways/physiopathology , Young AdultABSTRACT
OBJECTIVE: To describe the presentation and outcome of treatment of cerebral venous thrombosis (CVT) in patients from Sudan, an example of a developing country. METHODS: In a prospective study, we described the clinical features, risk factors, and outcome of CVT in patients admitted to the National Center for Neurological Diseases, Khartoum, Sudan, the only specialized neurological hospital in the country, during the period from February 2001-October 2006. Patients were referred from other hospitals in the town or from nearby hospitals in Khartoum state. RESULTS: We recruited only adult and adolescent patients aging >/=15 years. We reviewed 15 patients (12 females and 3 males) with a mean (+/-SD) age of 33.9+/-11.8 years. Headache (n=15), papilledema (n=13), paresis (n=3), and generalized seizures (n=3) were the most common symptoms, and signs encountered. A prothrombotic risk factor was often identified (n=12). At the time of the first visit namely, 12 weeks after discharge, 7 patients (46.7%) attained complete neurological recovery, 4 (26.7%) developed optic atrophy, and 2 (13.3%) died of pulmonary embolism. CONCLUSION: The clinical features and risk factors of CVT in Sudan are not different from elsewhere, but the outcome is less favorable. Places with less privileged health service resources, late presentation or delayed accessibility to appropriate diagnostic tools may negatively influence the final outcome.
ABSTRACT
OBJECTIVE: To screen and evaluate the significance of anticardiolipin seroprevalence in patients with acute ischemic stroke, in patients with infectious disease, and in healthy subjects resident in Sudan, a tropical country endemic for several infectious diseases. METHODS: We conducted the study in Khartoum Teaching Hospital in Khartoum, Sudan between July 2003 and January 2005. We included 89 stroke cases, 30 infectious disease patients, and 30 asymptomatic healthy subjects. We estimated IgG and IgM anticardiolipin antibody titers in serum samples from all subjects in the 3 study categories at the time of hospital admission. RESULTS: We found a significantly higher prevalence of anticardiolipin antibodies in the stroke and infection groups compared to the healthy subjects. However, there was no significant difference in anticardiolipin seroprevalence between patients with stroke and patients with infectious disease. CONCLUSION: Caution is necessary when interpreting the presence of antiphospholipid antibodies as a stroke risk in patients harboring infection or living in places with high endemicity of infectious diseases.
