[Central Post-Stroke Pain at the Tingandogo University Teaching Hospital of Ouagadougou (Burkina Faso): Frequency, Clinical Profile, Quality of Life of Patients and Associated Factors]. / La Douleur Centrale Post Accident Vasculaire Cérébral au Chu Tingandogo de Ouagadougou (Burkina Faso): Fréquence, Profil Clinique, Qualité de Vie des Patients et Facteurs Associés.

Objective: Few studies have been done on central post-stroke pain (CPSP) in Sub-Saharan Africa, while taking it into account would improve the quality of life of stroke survivors. The purpose of this study was to determine the prevalence of CPSP, to describe its clinical profile, to assess the quality of life of patients and to identify the factors associated with its occurrence, from a prospective hospital series in Ouagadougou, Burkina Faso. Methodology: It was a prospective, descriptive and analytical longitudinal follow-up study, conducted from January 2015 to March 2020, at the Tingandogo University Hospital, in Ouagadougou, Burkina Faso. The study involved all patients over the age of 16, consecutively hospitalized for stroke confirmed by CT and / or brain MRI, then reviewed every three months in outpatient Neurology, during at least 9 months after their stroke. The sociodemographic and clinical characteristics of the patients, the nature of the stroke, the existence of CPSP and, if applicable, its clinical characteristics, its treatment and its impact on the quality of life of the patients were recorded; a bivariate then multivariate analysis with logistic regression step by step, made it possible to search for the factors associated with the occurrence of CPSP. The significance threshold used was p < 0.05. Results: A total of 236 patients were collected, out of which 28 patients presented a CPSP (11.9%), after a mean duration of post-stroke follow-up of 12.9 months. Cerebral infarction, intracerebral hemorrhage and cerebral venous thrombosis accounted for 69.5%, 29.7% and 0.8% respectively. The mean age of patients with CPSP was 54.6 years, with a male predominance (53.6%). The mean time to onset for CPSP was 3.8 months after stroke. Pains such as burning (75%) and allodynia (67.8%) were the most common. The average CPSP intensity was 7.6 / 10 on the visual analog scale. Hypoaesthesia (96.4%) and paraesthesia (71.4%) were the signs or symptoms most commonly associated with CPSP. CPSP had a moderate to severe negative impact on usual work, general activity and mood of patients in 60.7%, 50% and 46.4% of patients, respectively. Amitriptyline (75%) and / or level II analgesics (60.7%,) were the most used molecules, and effective in 57% of cases. Only age ≤ 50 years was independently associated with the occurrence of CPSP (OR 2.86; p = 0.03). Conclusion: CPSP affects more than 1 in 10 stroke patients and moderately to severely affects the quality of life for most of these patients. Screening and adequate management of CPSP as part of multidisciplinary post-stroke follow-up will contribute to improve the quality of life of stroke patients and will facilitate their social and professional reintegration.

[Toxocara canis cerebral vasculitis revealed by iterative strokes]. / Vascularite cérébrale àToxocara canis révélée par des AVC itératifs.

INTRODUCTION: Cerebral vasculitis is a rare and severe condition, posing problems for diagnosis and treatment. Toxocara canis cerebral vasculitis is exceptionally rare, with only 4 cases having been reported. We report an additional case revealed by iterative strokes. OBSERVATION: A 49-years-old Laotian man presented with right ACA infarction associated with contrast enhancement of cerebrospinal fluid, and multiple segmental stenoses in small and medium caliber encephalic arteries, in a context of hypereosinophilia and chronic headaches. Laboratory tests showed lymphocytic meningitis and T. canis antibody IgE in the blood and CSF. The diagnosis of T. canis cerebral vasculitis was retained. During follow-up, the patient presented again with left pontine hemorrhagic stroke. Conventional cerebral angiography confirmed progression of vasculitis despite treatment. CONCLUSION: This case-report illustrates the diagnostic and therapeutic difficulties associated with vasculitis.

[Strokes and hemoglobinopathies in Burkina Faso]. / Accidents vasculaires cérébraux et hémoglobinopathies au Burkina Faso.

S and C hemoglobinopathies are a group of inherited blood disorders including sickle cell disease, characterized by the presence of abnormal S and C hemoglobins. They are common in tropical Africa. Stroke is a common complication of sickle cell disease. Studies of the relation between these two diseases are virtually nonexistent in sub-saharan Africa. Our work aimed to study the influence of these hemoglobinopathies on the onset of strokes in adults. This cross-sectional study took place from 1st December 2009 to 31st May 2010 at University Hospital Yalgado Ouedraogo. Out of 142 patients admitted to our neurology department during this period, 74 patients had had strokes. Their mean age was 55.9 years and their sex ratio 1.53. Ischemic strokes accounted for 57% of the total, followed by cerebral hemorrhage (39%). Forty-six patients (62%) were AA genotype, 27 (36%) patients had sickle cell trait (16 AC and 11 AS) and three patients were homozygous CC. This study showed a higher prevalence of hemoglobinopathies in patients with stroke than in the general population. Unlike heterozygous SC and homozygous SS forms, the existence of sickle cell trait in this population does not appear to increase the risk of onset of ischemic stroke but may reduce the age at onset of cerebral hemorrhage.