Management of delayed Sprengel malformation with intracanalar compressive omovertebral bone in a developing country's neurosurgery unit.

Sprengel deformity is a congenital abnormality done to the ascent of the scapular bone (which occurs probably between the 5th and 12th weeks of gestation). It can cause cosmetic or functional problems. The aim of our study was to describe this rare deformity, often neglected in our context, and its surgical management. We report a case of a 16-year-old boy with a Sprengel deformity associated with omovertebral intracanalar compressive bone seen on the CT scan. He reported neurological symptoms such as spastic paraparesis and walk disturbances. The bone was resected surgically and physiotherapy was set up. The outcome was good with noticeable neurological improvement of walk and balance, recovery of autonomy. Sprengel deformity is a rare pathology. Surgery must be done early and be adapted to the case.

[Diagnosis and surgical traitment of intracerebral hydatic cyst in Mali]. / Diagnostic et traitement chirurgical du kyste hydatique cerebral au Mali.

AIMS: Cerebral hydatic cysts are common in North African and pastoral countries but still underdiagnosed in sub-saharian ones.We report the first two casesoperated in Mali andhistologically proven of cerebral hydatic cysts. PATIENTS AND METHOD: Our study was aboutabout a 46 years old patient, admitted for Bravais-Jacksonian crisis, dysarthry and right hemiparesy, and another 38 years old male one, with a intracranial hypertension syndrome associated with cranial fistulized cerebral hydatic cyst.The CT scan has shown a cerebral cyst in the first case and multi-locular cysts in the second. The patients underwent surgery, with complete removal in one case and a rupture in the second case, but with a good outcome. Anatomo-pathological analysis concluded to hydatic cerebral cysts in both cases. CONCLUSION: With these first cases, the diagnosis of cerebral hydatic cyst must be evoked more frequently in our countries, because of the evolution of radiological diagnosis and surgical abilities.

INTRODUCTION: L'hydatidoseest une parasitose frequente dans les pays d'elevage de moutons (maghreb). Le kyste hydatique cerebral en est une localisation rare (1 a 4%) et souvent meconnue en afrique sub-saharienne. Nous rapportons2 cas de kystes hydatiques cerebraux operes au Mali. OBSERVATIONS: Le premier patient de 46 ans, cultivateur et éleveur, vivant en milieu rural, admis pour crises convulsives Bravais-Jacksoniennes, dysarthrie et hémiparésie droite. Le deuxième, âgé de 38 ans présentait un syndrome d'hypertension intra-crânienne et une tuméfaction occipitale fistulisée. La tomodensitométriecérébrale a objectivé une lésion kystique unique dans un cas et multi-cloisonnée dans le deuxième cas. Après concertation pluridisciplinaire, le diagnostic de kyste hydatique a été évoqué.Une exérèse complète des lésions a été effectuéeet l'anatomo-pathologie a confirmé un kyste hydatique cérébral dans les deux cas. Les suites ont été favorables. CONCLUSION: Le kyste hydatique cérébral est une affection rare et peu connue au Mali. Une hypertension intracranienne, des signes focaux, des crises convulsives, ainsi que les donnéesTDM et l'IRM sont les clés du diagnostic. La prise en charge neurochirurgicale permet une évolution favorable. La prévention permet l'interruption de la chaîne de transmission.