Objective: To evaluate the impact of urinary tract and pulmonary infection on mortality after cerebral hemorrhage. Method: We conducted at the University Hospital of Brazzaville, a cross-sectional study from January to August 2012 in the emergency department, neurology and intensive care unit. It included patients admitted for cerebral hemorrhage confirmed by CT-scan. A statistical analysis by logistic regression was carried out to evaluate the correlation between infection and death. Result: Among total of 261 patients for stroke, 82 admitted for cerebral hemorrhage (31.4%). The mean age was 55 ± 11 years (range 26 to 83 years). The sex ratio men/women was 1.7. Hypertension was the most important risk factor to 80.5%. The average intake in neurology time was 28 ± 13 hours. The average time for completion of the CT-scan was 2.4 ± 2 days. Thirty-eight (46.3%) patients had a fever linked to an infectious cause from the third day of hospitalization. The most frequent infectious complications were sepsis (n = 16%; 42%), pulmonary infection (n = 14%; 37%) and urinary tract infection (n = 8%; 21%). Specific mortality of infection was 31.7% (n = 26). The multivariate analysis showed a positive correlation between the occurrence of infection and mortality (p = 0.002), specifically between sepsis and mortality (p = 0.0004), and an association between the time of admission late in neurology and the occurrence of infectious complications (p = 0.0001). Conclusion: Infection is one of the dreaded complications of cerebral hemorrhage. It is often associated with delayed care in specialized areas, nd is thereby a preventable cause of death.
The association between stroke and meningioma is rarely reported in the data. In most etiology classification, there is no compressive cause. The association between meningioma and stroke is increasingly reported. We report a case of 52year-old woman, previously healthy, presented with sudden right hemiplegia with some transient mood disorders. The CT-scan revealed acute left anterior cerebral artery infarction associated with fronto-basale meningioma infiltrating both anterior cerebral arteries. She was treated by corticosteroid and rehabilitation, with partial recovery. No stroke prevention was used before surgical treatment.
IntroductionLes céphalées par abus médicamenteux (CAM) restent le type de céphalées le moins étudié en Afrique.MéthodesDans le but de rapporter l'expérience Brazzavilloise, nous avons mené une étude longitudinale durant 4 ans, de septembre 2010 à août 2014, en consultation de neurologie à Brazzaville. Nous avons inclus tous les patients présentant des céphalées primaires chroniques selon la International Classification of Headache Disorders-2 (ICHD-2). Tout patient présentant des céphalées secondaires ou n'ayant pas donné son consentement a été exclu. Les patients ont été divisés en deux groupes: ceux ayant évolué vers une CAM, et ceux qui ne présentent pas des critères d'abus médicamenteux (sans-CAM). Les variables d'études ont été sociodémographiques, les caractéristiques de la céphalée primaire initiale et la prise en charge de la CAM.RésultatsSur 212 patients inclus, 193 ont constitué notre population d'étude. L'âge moyen de 42±14 ans, dont 66,32% de femmes. La fréquence des CAM était de 35,75%. Les facteurs associés identifiés étaient: l'âge jeune (p=0,003), l'utilisation de l'association antiinflammatoire non stéroïdien (AINS) et paracétamol (p=0,0001) et l'automédication (p<0,0001). Par contre, le niveau d'instruction supérieur (p<0,0001) et l'utilisation de l'AINS seul (0,002) étaient protecteurs contre la survenue de la CAM. Le sevrage ambulatoire a été le plus pratiqué, l'amitriptyline reste le médicament le plus utilisé.ConclusionLes CAM sont fréquentes en consultation de neurologie en Afrique et méritent d'être identifiées pour une meilleure prise en charge.
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