Background:
Intraorbital foreign bodies are a global injury and occur with a frequency of one in six orbital injuries; however, intraorbital wooden foreign bodies are uncommon. Intraorbital wooden ...foreign bodies predominantly affect the male population with a mean age ranging from 21 to 22 years. The diagnosis of intraorbital wooden foreign bodies depending on their size can be challenging on imaging and if not removed early the risk of infection is high.
Case Description:
A 23-year-old motorcyclist presented to the ER following a collision with a donkey cart carrying wood 3 h before presentation. Examination revealed an acutely ill-looking man in painful distress with a right supraorbital laceration associated with ipsilateral ptosis and periorbital edema. There was a retained intraorbital wooden foreign body. Computed tomography scan showed evidence of both an intraorbital bone fragment and a wooden foreign body. Surgery was done 3
rd
day of admission before which vision has declined with only perception to light. Only the wooden foreign body was removed. Evolution was favorable with recovery of vision and improvement of the ptosis.
Conclusion:
The management of intraorbital wooden foreign bodies demands a multidisciplinary approach after a thorough history, examination, and imaging. Treatment of choice is timely and meticulous removal of the foreign body to avoid infection and other associated complications.
Child plexiform neurofibroma of the lumbar region. Case report Canton Kessely, Yannick; Aouami, Aboubacar; Ouambi, Li-iyané Olivier ...
Interdisciplinary neurosurgery : Advanced techniques and case management,
December 2021, 2021-12-00, 2021-12-01, Letnik:
26
Journal Article
Recenzirano
Odprti dostop
•The objective of this study is to share our experience of the management of this condition in children and to show the difficulties of taking care in certain regions.•The relevance: This rare benign ...tumor has potential for malignant transformation, in some area where the conventional therapies (clinical trial) are not avalaible surgery remains the gold standard although it is not radical.•The clinical results are: aesthetic results and delay of the disease evolution.
Tumors of the peripheral nerves are not well described. Plexiform neurofibromas are common NF1 benign tumors that carry a low malignant risk of transformation. In some area where the conventional therapies (clinical trial) are not available, surgery remains the gold standard although this one is not radical. There is not a lot of publications related to this subject in Africa. The aim of study is to share our experience and show the difficulties of managing this pathology in children.
We report a case of a 4 year old boy without any family history of neurofibromatosis. He presented to our department of neurosurgery at renaissance hospital of Ndjamena (Chad) with primary skin concern about a right lumbar swelling which was progressive increase in size over the last few years. Physical examination revealed the presence of several cafe-au-lait macules (CALM) more than forty, freckling, hypertrichosis, hyperpigmentation, and thoraco-lumbar scoliosis without other associated lesions. Ultrasonography, CT scan and Magnetic resonance imaging (MRI) of the swelling was done, and gave features description of this lesion. The patient underwent surgery and the diagnosis of plexiform neurofibromatosis was made at the histological examination. After a follow-up of 16 months there is no tumor recurrence. A regular follow-up is necessary for this young patient.
The surgery has an aesthetic purpose and it delays the progression of the disease.
Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to reduce associated ...complications and costs. A significant resource limitation in low- and middle-income countries constrains the usage of AC.
To review the published literature on AC in African countries, identify challenges, and propose pragmatic solutions by practicing neurosurgeons in Africa.
We conducted a scoping review under Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Scoping Review guidelines across 3 databases (PubMed, Scopus, and Web of Science). English articles investigating AC in Africa were included.
Nineteen studies consisting of 396 patients were included. Egypt was the most represented country with 8 studies (42.1%), followed by Nigeria with 6 records (31.6%). Glioma was the most common lesion type, corresponding to 120 of 396 patients (30.3%), followed by epilepsy in 71 patients (17.9%). Awake-awake-awake was the most common protocol used in 7 studies (36.8%). Sixteen studies (84.2%) contained adult patients. The youngest reported AC patient was 11 years old, whereas the oldest one was 92. Nine studies (47.4%) reported infrastructure limitations for performing AC, including the lack of funding, intraoperative monitoring equipment, imaging, medications, and limited human resources.
Despite many constraints, AC is being safely performed in low-resource settings. International collaborations among centers are a move forward, but adequate resources and management are essential to make AC an accessible procedure in many more African neurosurgical centers.
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