Infratentorial subdural empyemas are rare. It is an important neurological infection requiring immediate neurosurgical treatment. The nonsurgical treatment of subdural empyema has been reported sporadically. In this paper the authors report the nonsurgical treatment of a case of infratentorial subdural empyema. The patient with left recurrent otitis was hospitalized with symptoms of headache and fever of 3 weeks duration. Examination revealed that the patient had Glasgow Coma Scale score of 15, fever, mild cerebellar signs, no focal deficit, and abundant suppuration from the left ear. A contrast-enhanced CT scan showed an infratentorial supracerebellar hypodense fluid collection with the peripheral rim enhancement to the left of the midline that mimicked a subdural empyema. Routine hematological investigation revealed polymorphic leukocytosis and elevated erythrocyte sedimentation rate. After the left mastoidectomy and antibiotic treatment, the patient recovered with complete resolution of the subdural empyema on CT scan.
Grisel's syndrome is a rare complication that is characterized by non-traumatic atlantoaxial subluxation. It is most commonly seen in children after an upper respiratory tract infection or neck surgery, such as an adenoidectomy, tonsillectomy and mastoidectomy. Grisel's Syndrome is characterized by torticollis and a limited range of motion of the neck with pain. Here the authors report a case of a Malian 5-year-old girl with Grisel's syndrome following tonsillectomy. The patient's complaints were fully resolved after 2 weeks of conservative treatment.
Les fistules œsotrachéales représentent une entité pathologique caractérisée par la présence d'une communication anormale entre l'arbre trachéal et l'œsophage. A travers un cas clinique de fistule œsotrachéale suite à l'ingestion d'un corps étranger, nous abordions l'aspect étiopathogénique, évaluer notre principe thérapeutique et faire une revue de la littérature. Il s'agit d'un patient de 15ans admis pour dysphagie évoluant depuis deux mois suite à l'ingestion d'un corps étranger à type de morceau d'os. L'œsophagoscopie sous anesthésie générale a permis l'extraction du corps étranger. Le Transit Oeso-gastro-duodénal (TOGD) en post-opératoire a objectivé l'orifice fistulaire siégeant au niveau de C7. L'absence de l'orifice fistulaire a été notée à J30 post-endoscopie au TOGD de contrôle. Le traitement médical est une alternative thérapeutique de la fistule œsotrachéale et doit être basé sur des critères bien définis.
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