To study the prevalence and semiotic characteristics of neuropathic pain in the common low back pain to the Black African subject. This was a prospective cross-sectional survey carried on from April 1 2009 to August 31 2009 in consultations of rheumatology, neurology, and neurosurgery at the University Hospital Yalgado Ouédraogo in Ouagadougou (Burkina Faso). All patients with a low back pain or a common lomboradiculalgie were included. DN4 questionnaire was used for the diagnosis of neuropathic pain. One hundred and seven patients have been recruited during the study period; Sixty-four (59.80%) were female (sex ratio M/F: 0.67). The average age was 34.11 ± 13.46 years of age with extremes of 20 and 79. The average duration of disease was 48.53 months with extremes of 10 days and 50 years. Eighty-seven patients (81.31%) had a disease duration, which was 3 months longer. Sixty-six patients (61.70%) had a predominant lomboradiculalgie; among the remaining 41, low back pain predominated. Average intensity of pain was 62.81 ± 22.43 (on a scale of 100). A sign of Lasèque was present in the 41 (38.30%) patients. Fifty-three (49.5%) patients had a neuropathic pain. The prevalence of neuropathy signs according to the DN4 questionnaire was as follows: burning (n = 37; 34.58%), painful cold (n = 13; 12.15%), electric shocks (n = 31; 38.97%), pins and needles (n = 34; 31.77%), tingling (n = 35; 32.71%), numbness (n = 45; 42.05%), itching (n = 18; 16.82%), touch hypoesthesia (n = 35; 32.71%), pinprick (n = 33; 30.84%), and tactile allodynia (n = 21; 19.62%). Among the studied variables, the presence of a radiculalgy was statistically associated with neuropathic pain. The lomboradiculalgie of the Black African subject associates neuropathic pain observed in half of patients. Treatment must therefore always take account of this association. However, further studies are needed before any definitive conclusion.
Introduction: Frontoethmoidal or sincipital cephaloceles are congenital malformations characterized by externalization of the meninges and/or brain tissue through a congenital bone defect between the frontal and ethmoid bones. These sincipital cephaloceles are very infrequent. While in developed countries the measures taken have brought about virtually zero frequency of this pathology, in our work environment these measures are virtually nonexistent, so that frontoethmoidal cephaloceles remain one of our concerns. Aim: To describe the particularity of the management of frontoethmoidal cephaloceles in our country. Methods: This was a retrospective study carried out between January 1, 2007 and June 30, 2013. It concerned all cases of frontoethmoidal cephaloceles managed in the Neurosurgery Department of the University Hospital of Ouagadougou. Results: A total of 11 patients (6 females and 5 males) were attended to in 6.5 years. The age of the patients ranged from 1 day to 12 years, and 8 patients (72.72%) were less than 4 months old; 1 case was diagnosed at antenatal ultrasound. Clinically, all cases consisted of congenital cephalic swelling of gradual increase. A CT scan was performed in all cases and an ultrasound of the associated mass was carried out in 2 cases. Transcranial approach was done for all patients with 3 patients having had an incision of the mass to reduce redundant skin. The immediate postoperative course was favorable in 10 cases; 1 death was observed by cerebrospinal meningitis. We noted 1 case of recurrence. Conclusion: The surgical treatment of frontoethmoidal cephaloceles is complex, sometimes requiring a multidisciplinary team. However, early closing of the malformation before the appearance of important bone deformities can prevent maxillofacial surgery. The results of the surgery are satisfactory as regards the vital prognosis. However, the fear of a more or less long-term occurrence of psychomotor retardation and the complications of early surgery make the recommendation and emphasis of prevention our main concern.
Background: Neural tube defects (spina bifidas or cephaloceles) are congenital malformations that can be associated with hydrocephalus. Even if the surgical management of each of these pathologies separately is well established, this is not the case for a combination of these conditions. Aim: To report our results of simultaneous or separate surgery for the association of hydrocephalus with neural tube defect in the same patient. Methods: This was a retrospective study of the association of hydrocephalus with neural tube defect (spina bifida or cephalocele) managed over a period of 7 years at the Department of Neurosurgery, Yalgado Ouedraogo University Hospital, Ouagadougou, Burkina Faso. Results: Thirty-eight cases were included. The mean age was 8.1 months, and the sex ratio was 0.81. There were 27 cases of spina bifida and 11 cases of cephalocele associated with hydrocephalus. A cerebral CT scan was performed in all patients. In 30 cases, the operative management of these pathologies was performed at the same operative time. Eight cases were operated in 2 separate operative stages with a mean time of 30 days between the 2 operations. The course was favorable in 22 patients operated by the simultaneous approach and in 3 patients operated by the separate approach (p = 0.07). Conclusion: Surgical management of the association of hydrocephalus with neural tube defect in 1 or 2 operative stages gave similar clinical results. However, the treatment in 1 surgical stage would considerably reduce the charges.
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