[Metastatic epiduritis in neurosurgery: Hospital data from the Abidjan teaching hospital, 2007-2012]. / Les épidurites métastatiques en neurochirurgie : données hospitalières au CHU d'Abidjan de 2007 à 2012.

INTRODUCTION: Metastatic epiduritis is the most frequent extrinsic epidural cause of spinal cord compression. Although neurosurgery is essential to its management, the exact role of this discipline in the treatment of spinal cancer in sub-Saharan Africa has not yet been assessed. AIM: To analyze recent hospital data of patients with metastatic epiduritis managed in the Abidjan neurosurgery department. METHODOLOGY: We conducted a retrospective analysis of files of 56 patients admitted from January 2007 through December 2012. Our data are discussed in the light of the literature. RESULTS: The primary cancers in men were mostly lung (16%) and prostate (34%) cancers, and in women, breast cancer (23%). The two age brackets mainly involved were those aged 31-45 years (21%) and 46-60 years (39%). The reason for admission in all cases was functional disability of the lower limbs. Magnetic resonance imaging (MRI) was performed for 57%. The thoracic topography was dominant (60%), and vertebral damage was often associated with epiduritis (78%). This metastatic epiduritis was the initial sign leading to cancer diagnosis for 39%. Decompressive laminectomy with biopsy or lesionectomy was performed for 62%. Postoperative neurologic improvement was noted for 36%, and remained satisfactory at one year for 14 patients. Prostate-specific hormone therapy was performed for 30%. CONCLUSION: This study underlines the crucial importance of neurosurgery in management of metastatic epiduritis in our center. Our findings emphasize the need to improve access to neuroradiologic diagnostic resources and optimize surgical treatment in the sub-Saharan region.

[Oculomotor nerve schwannoma in a child: Case report and literature review]. / Schwannome du nerf oculomoteur chez l'enfant: cas clinique et revue de la littérature.

An isolated schwannoma of the oculomotor nerve is rare in children without an associated neurofibromatosis. A 13-year-old girl, with a previous medical history of migraine, was admitted for disabling ophthalmic migraine with oblique diplopia. The clinical examination showed a right incomplete ophthalmoplegia with reduced ipsilateral visual acuity (8/10). There was no particular skin reaction. The MRI revealed a right (isosignal-T1 and isosignal-T2) nodular schwannoma located within the cisternal segment of the oculomotor nerve. The angio-CT performed later confirmed the absence of any vascular malformation. The treatment consisted of analgesics and corticotherapy, with complete regression of symptoms three weeks later and a normal MRI follow-up. Therefore, radiosurgery was not performed.