Risk factors associated with congenital central nervous system abnormalities in the National Hospital of Zinder, Niger.

INTRODUCTION: Congenital malformations of the central nervous system (CNS) are morphological abnormalities of the brain and spinal cord that occur during fetal development. They constitute the second most common congenital disability, after congenital cardiac defects. Many risk factors have been identified; however, these studies included various types of congenital abnormality. Furthermore, there is a lack of information on risk factors for congenital CNS malformation, and notably in the Zinder region of Niger. OBJECTIVE: This study aimed to identify the risk factors associated with congenital CNS malformations in the Zinder region. METHODS: In a case-control design, patients with congenital CNS malformation were enrolled between June 2022 and April 2023 in the Department of Neurosurgery of the National Hospital of Zinder. RESULTS: Family history of malformation (aOR:3.31, 95% CI:1.25-8.78) and consanguine marriage (aOR:2.28, 95% CI:1.23-4.20) were significantly associated with congenital CNS malformation. In contrast, folic acid supplementation (aOR:0.34, 95% CI:0.13, 0.89), multiparity (aOR:0.34, 95% CI:0.13, 0.89), and grand multiparity (aOR, 0.47; 95% CI:0.23, 0.97) had a protective effect. CONCLUSION: Risk factors such as family malformation history and consanguine marriage increased the risk of developing congenital malformations of the central nervous system. In contrast, folic acid supplementation in the index period and multiparity had a significant protective effect.

[Intramedullary Pott's abscess: a case study]. / Abcès pottique intra médullaire: à propos d'un cas.

Central Nervous System (CNS) Tuberculosis (TB) is rare. It manifests in many forms, but the association between intramedullary abscess and multifocal Pott's disease is exceptional. We report the case of a 23-year old female patient diagnosed with multifocal Pott's disease at L2-L3 and L4-L5 based on computed tomography (CT) scan of the spine. She received antituberculous treatment. Two months after the beginning of treatment spinal cord compression occurred. Medullary magnetic resonance imaging (MRI) was performed, which showed intramedullary abscess at T4. She underwent surgery with drainage of intramedullary abscess and spinal stabilization. Outcome was favorable, during the 12-month follow-up. The association between intramedullary abscess and multifocal Pott's disease is exceptional. Treatment is based on anti-tuberculous drugs, surgery for spinal decompression and/or spine stabilization if possible.