A Case of VACTERL Association Complicated with Multiple Rib Abnormalities
Zeng Zhiguo,
Zhang Guowei,
Ji Zhisheng,
Yang Yuhao,
Yang Hua,
Lin Hongsheng
Issue:
Volume 4, Issue 1, March 2020
Pages:
1-4
Received:
17 December 2019
Accepted:
27 December 2019
Published:
4 February 2020
Abstract: VACTERL association is an acronym that includes vertebral anomalies (V), anal atresia (A), cardiac defects (C), tracheoesophageal fistula (TEF) or esophageal atresia (EA), renal anomalies (R), and limb defects (L). Rib abnormalities have rarely been reported with the VACTERL association. The second case of VACTERL association complicated with multiple rib abnormalities will be reported in this case report. A 4-year-old girl who had been diagnosed with congenital cardiovascular disease and received surgical corrections soon after birth consulted our institution by complaining congenital scoliosis. The little girl was diagnosed with VACTERL association (congenital cardiovascular disease, scoliosis with hemivertebra and butterfly vertebra, and nephrolithiasis) and congenital multiple rib abnormalities. The Cobb angle of the main curve was 29.3° before surgery, 19.9° after surgery, and 23° at last follow-up. Multiple rib abnormalities may be seen in the VACTERL association. Clinicians should have a high index of suspicion when evaluating patients with rib abnormalities associated with VACTERL. It is extremely necessary for careful physical examination and detailed auxiliary examination to each system (including echocardiography, computed tomography, magnetic resonance imaging, and so on) when diagnosing VACTERL association. Also, recognizing and understanding the congenital multiple system malformation is important, which aids in the diagnosis of disease and accordingly plan the therapeutic interventions. Early diagnosis of congenital scoliosis with appropriate surgical intervention decreases long-term morbidity.
Abstract: VACTERL association is an acronym that includes vertebral anomalies (V), anal atresia (A), cardiac defects (C), tracheoesophageal fistula (TEF) or esophageal atresia (EA), renal anomalies (R), and limb defects (L). Rib abnormalities have rarely been reported with the VACTERL association. The second case of VACTERL association complicated with multi...
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LVIS Blue as a Stand-alone “Flow Diverter”
Matthew Koch,
Mehr Nasir-Moin,
Scott Raymond,
Christopher Stapleton,
Thabele Leslie-Mazwi,
James Rabinov,
Aman Patel
Issue:
Volume 4, Issue 1, March 2020
Pages:
5-10
Received:
26 December 2019
Accepted:
10 January 2020
Published:
4 February 2020
Abstract: Flow diversion fundamentally changes the treatment approach towards intracranial aneurysms. Most currently available devices established efficacy and safety data in the proximal anterior circulation; the distal and posterior circulations remain areas of active research. LVIS Blue is a stent with 28% metal coverage approved for use as a coil adjuvant. Some studies indicate potential “flow diverter” properties. We sought to evaluate the LVIS Blue as a stand-alone “flow diverter” for the treatment of intracranial aneurysms. We performed an observational single-center study to evaluate initial occlusion and occlusion at six months follow-up for patients with distal or posterior circulation aneurysms treated with the LVIS Blue as a “flow diverter” at our institution. Ten aneurysms were treated over the course of two years with six-month angiographic follow-up. Seven lesions were in the distal anterior circulation and were unruptured (five anterior communicating artery, one M2 middle cerebral artery, one pericallosal). Three were posterior circulation (two basilar tip aneurysms, one P2 posterior cerebral artery aneurysm). Follow up demonstrated treatment effect in nine of ten aneurysms (four complete aneurysm occlusions, five lesions with decreased size and flow). One lesion showed no treatment response. No ischemic or hemorrhagic complications were noted during placement or clinical follow-up. LVIS Blue can function safely as a “flow diverter” in the distal and posterior circulations. Further data regarding long-term efficacy is needed.
Abstract: Flow diversion fundamentally changes the treatment approach towards intracranial aneurysms. Most currently available devices established efficacy and safety data in the proximal anterior circulation; the distal and posterior circulations remain areas of active research. LVIS Blue is a stent with 28% metal coverage approved for use as a coil adjuvan...
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Hemorrhagic Breakdown of the Cerebral Bridge: A Report of 5 Observations at Lomé Teaching Hospital, Togo
Komi Assogba,
Michel Faustin Tassa-Kayem,
Kossivi Martin Apetse,
Damelan Kombate,
Jean Joel Tajeuna Dongmo,
Josué Euberma Diatewa,
Komi Agbotsou,
Abdullah Blakime,
Veronique Afiwa Agbobli,
Kolou Dassa,
Koffi Agnon Ayélola Balogou
Issue:
Volume 4, Issue 1, March 2020
Pages:
11-17
Received:
13 February 2019
Accepted:
4 July 2019
Published:
10 February 2020
Abstract: Introduction: Intracerebral hemorrhage is a major public health problem in Africa. The care is well codified in developed nations but the medical outcome and the technical platform remains a thorny challenge in African countries. It is responsible for a heavy handicap and a high mortality. The corpus callosum is an anatomical structure that connects the two cerebral hemispheres and control neuropsychological behavior. The objective was to determine the epidemiological and clinical characteristics of hematomas located in the corpus callosum. Clinical presentation: The stuy was carried out in the neurlogical department of the big tertiary hospital of the country. The study had reported five cases of hematoma of the corpus callosum. That has represented 0.3% of hemorrhagic strokes in the service. The average age was 33.4 years old with four females. Clinical symptoms in the acute phase were dominated by speech disorders, intracranial hypertension and meningeal signs. In the subacute phase, all patients had neuropsychological symptoms. These disorders included aphasia, left tactile anomia, ideomotor and diagonostic apraxia, and mood and behavior disorders in two-third of cases. The brain scan was performed with an average delay of 6 days. In the cerebral scan, the posterior part of the corpus callosum was the initial seat of the hematomas observed in all cases. Cerebrovascular risk factors were high blood pressure in all cases and alcoholism in two cases. The factor of poor prognosis was the association with meningeal contamination. The evolution was favorable in all five cases. Conclusion: This work brings out that hematoma of the corpus callosum is rare but still a serious disease with a misleading semiology dominated by neuropsychological disorders. The early management is the best practice to preserve functional autonomy.
Abstract: Introduction: Intracerebral hemorrhage is a major public health problem in Africa. The care is well codified in developed nations but the medical outcome and the technical platform remains a thorny challenge in African countries. It is responsible for a heavy handicap and a high mortality. The corpus callosum is an anatomical structure that connect...
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Therapeutic Itinerary of the Patients Followed for Myasthenia Gravis in Dakar
Kaba Yacouba,
Mourabit Salaheddine,
Atsa Kouda Daniel,
Affognon Cadnelle Christelle,
Bugeme Marcellin,
Fall Maouly,
Seck Lala Bouna,
Ndiaye Moustapha,
Diop Gallo Amadou
Issue:
Volume 4, Issue 1, March 2020
Pages:
18-23
Received:
19 June 2019
Accepted:
6 February 2020
Published:
14 February 2020
Abstract: Introduction: Myasthenia gravis is an autoimmune disease caused by specific autoantibodies that induce dysfunction of neuromuscular transmission. The diagnostic procedure is similar regardless of the age of the subject. As in any disease, the management starts with the diagnosis, which is often unduly delayed. The purpose of our study was to evaluate the reasons for this delay. Methodology: This was a retrospective, transversal, and descriptive study on the files of myasthenic subjects followed over a period of four years (2014 to 2017) at the neuroscience clinic of the Univresity National Center of Fann and at the consultation of neurology of the Pikine National Hospital Center where a hetero-administered questionnaire was completed. Results: The study involved 18 myasthenic patients including 13 women and 5 men with a sex ratio of 2.6. The median age of the patients was 32 years [14 - 60 years]. The average time to patient diagnosis was 24 months. The patients had consulted on average four times before the diagnosis of myasthenia gravis. The referral hospital was the facility attended by 78% of patients and the ophthalmology service was the first service consulted by 13 patients, or 72%. The median age at onset of symptoms was 28 years. Ptosis was the first symptom in 56% of the cases. Conclusion: Myasthenia gravis is a disorder little known to the public and to practitioners. The ophthalmologist was the first remedy. It would be wise for any practitioner to know the main manifestations.
Abstract: Introduction: Myasthenia gravis is an autoimmune disease caused by specific autoantibodies that induce dysfunction of neuromuscular transmission. The diagnostic procedure is similar regardless of the age of the subject. As in any disease, the management starts with the diagnosis, which is often unduly delayed. The purpose of our study was to evalua...
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