Journal of clinical neurology and neuroscience最新文献

{"title":"Mortality and Morbities of Severe Stroke in Limited Ressources Neurological Service","authors":"K. Assogba, K. Apetse, Watouo Marlène Djobosse, L. Sonhaye, Nynèvi Anayo, Panabalo Waklatsi, Abdoulah Blakime, Victor Kokou Adjenou, K. Balogou","doi":"10.11648/J.CNN.20190302.15","DOIUrl":"https://doi.org/10.11648/J.CNN.20190302.15","url":null,"abstract":"Introduction: Severe strokes have poor prognosis by their heavy motor and cognitive consequences. Objective: To describe the epidemiological, clinical and therapeutic aspects of these strokes. Material and Method: A retrospective and analytical study was conducted from January 2015 to December 2016 in the neurology department of our University Hospital. The diagnosis of severe stroke was based on clinical criteria (NIHSS score greater than 17, Glasgow score less than 9, and a WFNS stage greater than or equal to IV); and CT scan criteria (stroke location in the posterior fossa, carotid and Sylvian malignant infarction, cerebral hemorrhage with ventricular flood and mass effect). Results: We recorded 1964 strokes and 163 patients had severe stroke with a frequency of 8.3%. Of the 163 severe strokes, ischemic were observed in 38.7% and hemorrhagic for 61.3%. The average age was 55.8 ± 12.8. The motor deficit (76.1%) and disturbances of consciousness (62.6%) were the most admission signs. High blood pressure was the main risk factor (64.8%) and the etiology of hemorrhage in 83.5%. Atherosclerosis was the main etiology (86.4%) of ischemia. The hemorrhagic lesions location was diencephalic (67.7%) and brainstem (21.7%). Overall mortality was 44.8%, including 72.6% of early mortality due to haemorrhage. Predictive factors of mortality were the high NIHSS score, low Glasgow score, presence of ventricular flood, and high volume of hematoma. Conclusion: The high incidence of severe stroke and its early mortality rate demonstrate that many challenges remain to be done to improve the management of patients and avoid disabling sequelae.","PeriodicalId":93199,"journal":{"name":"Journal of clinical neurology and neuroscience","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84429877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Types of Hyponatremia in Stroke Patients Admitted in a Referral Neuroscience Institute of Dhaka","authors":"M. A. Hakim, Mashfiqul-Hasan, Mahmudul Islam, Mohammad A. Hossain, J. Naznin, Saifur R. Khan","doi":"10.11648/J.CNN.20190302.14","DOIUrl":"https://doi.org/10.11648/J.CNN.20190302.14","url":null,"abstract":"Background: Hyponatremia is a common electrolyte abnormality in acute stroke patients and may be related to variable etiology. Objective: To observe the frequency and types of hyponatremia in hospitalized acute stroke patients. Materials and methods: This cross-sectional study, carried out in a referral neuroscience institute of Dhaka during February to November 2017, included 209 patients admitted with acute stroke (65 ischemic, age 61.5±13.3 years, M/F: 45/20; 144 hemorrhagic, age 59.2±13.1 years, M/F: 80/64). The clinical and laboratory values on admission were recorded. Those having hyponatremia (serum sodium <135 mmol/L) on admission were evaluated by clinical features (history of vomiting or diarrhoea, volume status, urine output) and laboratory parameters (urine osmolality, urine sodium, plasma osmolality, blood urea, hematocrit) to determine the types of hyponatremia. Results: Four patients died before the serum could be sent for electrolytes. Among the rest, 36 (17.6%) had hyponatremia on admission. Serum sodium level was <125 mmol/L in 7 (19.4%) and 125-134 mmol/L in rest of the patients having hyponatremia (29; 80.6%). The frequency of hyponatremia was similar in ischemic and hemorrhagic stroke (17.2% vs. 17.7%, p=0.925). Syndrome of inappropriate antidiuresis (SIAD) was most frequent cause of hyponatremia (50.0%), followed by cerebral salt wasting (CSW; 30.6%). The rest had either hyponatremia related to gastrointestinal (GI) fluid loss (2.8%) or died before a cause of hyponatremia could be ascertained (11.1%). There was no significant difference of age, gender, NIHSS score and GCS score on admission as well as in hospital stay and in-hospital mortality between patients with or without hyponatremia (p=ns for all). Frequency of CSW was relatively higher in hemorrhagic stroke (hemorrhagic vs. ischemic: 32.0% vs. 27.3%) and SIAD in ischemic stroke (hemorrhagic vs. ischemic: 40.0% vs. 72.7%) but did not reach level of statistical significance. Conclusion: Frequency of hyponatremia seems remarkable in hospitalized acute stroke patients, SIAD and CSW being the most frequent cause.","PeriodicalId":93199,"journal":{"name":"Journal of clinical neurology and neuroscience","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84735369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient with Refractory Epilepsy Associated with Oligondendroglioma","authors":"Mauricio Vaillant Amarante, Ozinelia Pedroni Batista, Camilia Lampier Lutzke, Shirley Kempin Quiqui","doi":"10.11648/J.CNN.20190302.13","DOIUrl":"https://doi.org/10.11648/J.CNN.20190302.13","url":null,"abstract":"Oligodendroglioma is a rare form of primary brain tumor, accounting for about 2-5% of intracranial tumors, being more common in adult males but rare in children, accounting for about 1-2% of all primary brain tumors in children. It originates from oligodendrocytes or glial precursor cells and exhibits infiltrative and slow growth. They can be classified in two grades (Grade II and Grade III), where Grade II are low grade tumors and have tumor cells that grow slowly and invade nearby normal tissue, and Grade III are malignant and have rapidly growing tumors. It has low growth and 50-80% of cases first symptom is seizures. A seizure is a symptom that requires a rapid solution usually requiring empirical treatment at the initial time to cease seizures and promote some well-being for the patient's routine. Seizures can cause a lot of damage to the patient's life, especially if the patient is a child who does not know what to do and what to do. Depending on the intensity and frequency of seizure episodes, the patient may experience fractures with falls, may suffer discrimination and prejudice at school. The causes behind refractory epilepsy are diverse, so whenever a patient is found to be refractory to drug treatment, the origin of seizures should be investigated early, it is not enough to stop at empirical treatment.","PeriodicalId":93199,"journal":{"name":"Journal of clinical neurology and neuroscience","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72707913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological Disease Surveillance in Cameroon, a Rural and Urban-Based Inout Patient Population Study","authors":"J. Doumbe, Y. Mapoure, T. Nyinyikua, C. Kuate, K. Kompoliti, Hiral Shal, Bichum Ouyang, S. Calvo, Abel Fernandez-Sierra, E. Cubo","doi":"10.11648/J.CNN.20190301.15","DOIUrl":"https://doi.org/10.11648/J.CNN.20190301.15","url":null,"abstract":"Background: There is a paucity of literature on the burden of neurological diseases in sub-Saharan Africa. Objective: To create a registry and surveillance of neurological diseases from urban and rural health centers in Cameroon. Methods: Retrospective review of medical records of inpatients and outpatients from two urban public hospitals in Douala and two rural health care centers, from 2013 to 2015 was conducted. In the urban areas, the diagnosis was made by a neurologist but this was not the case in the rural areas. The following variables were analyzed: demographics, medical center characteristics, presenting neurological complaint, medical history, neurological diagnosis, death and disability. Neurological diseases were classified according to ICD-10. Results: Out of 20,131 medical charts available (13% from the rural area), 4,187 cases (20.7%) with neurological complaints were identified and reviewed, mean age 48.67 + 18.62 years, females 54.7%, 188 children (4.4%). The most frequent neurological complaints were: paresis/weakness (G.82, 25.2%) and headache (R.51, 22.0%). The most common concurrent medical history was hypertension (I10, 40.0%), and HIV (B20, 16.45%). The most common neurological diagnoses were cerebrovascular disease (G45, G46, 51.5%), and infection (B50, G00, G04, G06, 24.13%) in adults, and epilepsy (G40, 64.0%) in children. Death due to neurological cause was recorded in 428 patients (19.1%), and disability in 1,072 (57.2%). Neurodegenerative diseases were exclusively diagnosed in urban areas. Conclusion: Population aging and changes in the distribution of risk factors have accelerated the prevalence of non-communicable diseases such as cerebrovascular disease. However, additional work to characterize the nature of diagnosis, treatment and care is important to advance quality of care in the adult and pediatric neurological disorders. A health policy geared towards prevention and neurological training for health professionals is warranted.","PeriodicalId":93199,"journal":{"name":"Journal of clinical neurology and neuroscience","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74786639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological Complications of Myeloproliferative Syndromes with Negative Philadelphia Chromosome (MPS Ph-) in Lome Tertiary Hospital","authors":"K. Assogba, Kodzo Vinyo Kumako, K. Apetse, E. Padaro, A. Balaka, Abdoullaye Idrissou, Komi I Agbotsou, Nyenèvi Komla Anayo, Abdullah Blakime, A. Balogou","doi":"10.11648/J.CNN.20190301.13","DOIUrl":"https://doi.org/10.11648/J.CNN.20190301.13","url":null,"abstract":"Introduction: Myeloproliferative syndromes with philadelphia (MPS Ph) chromosome negative are diseases little known in our environment and cause grave neurological sequels. The study aimed to describe the neurological complications of these syndromes. Patients and method: It was a retrospective cross-sectional study carried out on the files of patients follow up or hospitalized in hematology or neurology departments of our tertiary hospital from January, 2008 to December, 2017. The variables analyzed were composed of epidemiological data, clinical signs, treatments used, neurological complications, and evolution. Results: Among 39 patients with MPS Ph negative, 30 (76.9%) had neurological complications at the time of diagnostic. Headaches, dizziness and splenomegaly were the most reported clinical signs in 95.2%, 73.6% and 66.7% respectively. Different types of MPS Ph negative were observed with 21 cases of polycythemia vera, 8 cases of essential thrombocythemia and one case of primary myelofibrosis. The research of Jack2V617F mutation was made in 25 patients (83.3%) and was positive in 15. The neurological complications were marked by peripheral neuropathy (20 cases), cerebral venous thrombosis (15 cases) and ischemic stroke in 11 cases. The average length of stay in hospital was 23.6 days. Concerning the treatment, 96.7% had received antiplatelet therapy and cytoreductive treatment was added in 66.7%. The outcome was marked by the remission of symptoms in 11.1% of cases, 46.7% with sequels and 20% of death. Conclusion: The MPS Ph negative patients are often discovered in late stage of the disease progression with neurological complications. Measures need to be taken to improve the early diagnosis and management of MPS Ph chromosome negative.","PeriodicalId":93199,"journal":{"name":"Journal of clinical neurology and neuroscience","volume":"129 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78126957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydrocephalus and Spasticity in Motor Area AVM, a Case Report","authors":"Veranis Sotiri, Papageorgiou Demetrios, Mpazinas Theodoros, Lagios Konstantinos","doi":"10.11648/J.CNN.20190301.12","DOIUrl":"https://doi.org/10.11648/J.CNN.20190301.12","url":null,"abstract":"Obstructive hydrocephalus is a rare complication of brain AVM’s. It usually diagnosed because of posterior fossa AVM’s. This article is about a case of a 40-year-old female patient suffering from a right fronto-parietal unruptured grade IV AVM located in the central sulcus who developed obstructive hydrocephalus and worsening of left sided weakness and spasticity. The AVM has been embolized twice in the past and no further treatment was offered because of the adjacent motor cortex and concerns of permanent neurological damage. Patient was treated with navigated ventricular-peritoneal shunt with a programmable valve. Interestingly there was an improvement of spasticity and weakness.","PeriodicalId":93199,"journal":{"name":"Journal of clinical neurology and neuroscience","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82445802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Cause of Facial Nerve Palsy (Petrous Apex Cholesteatoma)–Case Report and Review of Literature","authors":"R. Ahmed, Owais Makhdoomi, O. Shafi, Faheem Khalid","doi":"10.11648/J.CNN.20190301.11","DOIUrl":"https://doi.org/10.11648/J.CNN.20190301.11","url":null,"abstract":"The petrous apex is a pyramid-shaped struc­ture that is formed by the medial portions of the temporal bone. It is obliquely positioned within the skull base, with its apex pointing anteromedially and its base located postero­laterally. The petrous apex is bounded by the inner ear structures laterally, the petro-occipital fissure medially, the petrosphenoidal fissure and ICA anteriorly, and the posterior cranial fossa behind. Given its location, the petrous apex is susceptible to multiple pathologic processes which may be Inflammatory, developmental, vascular, benign and malignant lesions. We present a rare case of a 39 year old Male who presented wit unilateral facial nerve palsy and sensoneural hearing loss and was then diagnosed as petrous apex Cholesteatoma. Patient was treated surgically by Transchoclear trasnlabrynth technique.","PeriodicalId":93199,"journal":{"name":"Journal of clinical neurology and neuroscience","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83306615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profile of Swallowing Disorders in Acute Stroke in Brazzaville","authors":"Ghislain Armel Mpandzou","doi":"10.11648/j.cnn.20190301.14","DOIUrl":"https://doi.org/10.11648/j.cnn.20190301.14","url":null,"abstract":"","PeriodicalId":93199,"journal":{"name":"Journal of clinical neurology and neuroscience","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87949753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selected Physical Therapy Program for Balance Training of Neuropathic Patients After Lower Limb Burn","authors":"Rasha Mohamed El-Rewainy","doi":"10.11648/j.cnn.20190302.12","DOIUrl":"https://doi.org/10.11648/j.cnn.20190302.12","url":null,"abstract":"","PeriodicalId":93199,"journal":{"name":"Journal of clinical neurology and neuroscience","volume":"288 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73188066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Intra-Osseous Cystic Meningioma in a Child: A Rare Entity","authors":"Denléwendé Sylvain Zabsonre","doi":"10.11648/j.cnn.20190302.11","DOIUrl":"https://doi.org/10.11648/j.cnn.20190302.11","url":null,"abstract":"","PeriodicalId":93199,"journal":{"name":"Journal of clinical neurology and neuroscience","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88741022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}