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Stroke represents the 2nd cause of mortality and 1st cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the mortality in the department of neurology in the capital city, Dakar. Objective: To specify the types of stroke and to evaluate diagnostic delays in Senegal’s regional hospitals. Materials and Methods: This was a retrospective, cross-sectional, descriptive, multicentric study for 4 years (from 2014 to 2017) including any patient presenting a clinical suspicion with a CT scan confirmation of stroke in one of the 9 regional hospitals in Senegal with a recruitment period of 6 months per hospital. CT scans were performed with a 16 slices machine in 6 hospitals, 4 slices in 2 hospitals and 2 slices in 1 hospital. We studied the types and location of strokes, the associated signs and the time from stroke onset to admission and the time from admission to CT scan. Results: 655 patients were retained including 322 men and 333 women for an M/F ratio of 0.96. The average age was 63 years (range: 7 years, 112 years). High blood pressure was noted in 59.2% of patients and diabetes in 10.7% of patients. Strokes were ischemic in 76% of cases involving the middle cerebral artery in 73% of cases and hemorrhagic in 24%, of which 80.7% were deep localized. A mass effect was noted in 7.5% of cases, an engagement in 6.9% of cases and ventricular hemorrhage in 2.7% of cases. The delay between the onset of the deficit and admission was less than 6 hours in 10.6% of patients. The time between the onset of stroke and admission to hospital was specified in 416 patients (63.5%) of the study population, it was less than 6 hours in 10.6% of patients, between 6 hours and 24 hours for 29.3% and more than 24 hours for 60.1%. Between admission and the CT scan, the time was precise in 459 patients (70%), it was less than 6 hours in 37.9%, between 6 hours and 24 hours in 43.6 % and more than 24 hours in 18.5%. Conclusion: CT is central to the diagnosis of stroke in rural areas. However, there is a significant delay in diagnosis and management.

Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease who poses a real public health problem in East and Central Africa. The purpose of our observation was to report a rare condition in a Senegalese HIV-positive child. It was an 11-year-old girl from a region in central Senegal. She was an orphan of both parents, tested and monitored since the age of 5 for HIV infection 1. She was on the 1st line protocol. Due to a lack of support and good observance, she was referred to us at the age of 11 for follow-up in our structure in the suburbs of Dakar. The initial follow-up assessment showed a very low CD4 count and a very high viral load. Before the lack of clinical and immune-virological response, a genotypic resistance test was performed and showed immunological and virological failure. The initial development was marked by the appearance of lesions which were highly suggestive of Kaposi’s disease. She was on 2nd line treatment. The histopathological aspect of cutaneous biopsy was very suggestive of Kaposi’s disease. The subsequent course after ART and bleomycin treatment was clinically marked by regression of skin lesions. Virologically, it was marked by a fall in the viral load. Immunologically there was a gradual recovery of CD4 levels which came back to normal. Our observation demonstrates that absence of effective antiretroviral therapy for HIV increases the risk to develop Kaposi’s sarcoma.

Introduction Les mucoceles du sinus frontal realisent des formations pseudokystiques, lentement evolutives. Elles sont benignes mais peuvent evoluer vers l\'endocrane. Objectif L\'objectif de notre etude est de decrire les aspects cliniques,paracliniques et therapeutiques d\'un telle affection. Patients et methodes Il s\'agit d\'une serie retrospective de six patients colligee de Janvier 1994 a Decembre 2003. Tous les patients ont beneficie d\'un examen clinique et d\'explorations radiologiques : radiographie standard et tomodensitometrie. Une voie d\'abord neurochirurgicale a ete effectuee dans tous les cas. Le diagnostic est confirme par un examen histologique. Le suivi est assuree pour une duree minimale de 6 mois. Resultat Il s\'agit de trois hommes et trois femmes. L\'âge moyen est de 33 ans. Le signe clinique le plus frequent est la tumefaction frontale progressive. Le delai de consultation varie de 1 a 6 ans. Aucun deficit neurologique n\'est note. Le signe radiologique standard le plus frequent est la lyse de la paroi sinusale. La tomodensitometrie montre une extension intra cranienne dans 2 cas. Une voie d\'abord frontale a permis une exerese complete dans tous les cas. Conclusion Malgre leur benignite,les mucoceles du sinus frontal peuvent presenter d\'importantes extensions intracrâniennes sources de souffrance cerebrale. Le diagnostic tardif explique l\'etendue des lesions. Introduction Frontal sinus mucoceles are benign mass lesions developing slowly. They can involve intra cranial areas et make brain tissues compression. Objective The aim of our work is to describe clinical, radiological and therapeutical aspects of such affection. Patients and methods Six patients are received from 1993 to 2003. Three Xrays examination and three CT scans are performed. All patients are operated by neurosurgical approach. Diagnosis is confirmed by histological examination. Results The main clinical sign is frontal tumefaction growing during one till six years. None neurological deficit is found. Radiological examinations show lytic frontal sinus wall destruction with intracranial involvement in two cases. Bilateral approach is performed and therefore permit complete mass lesion removal. Conclusion Frontal sinus mucoceles can induce important bone destruction because in developing countries, diagnosis is made lately. Keywords : Afrique, Mucocele, Senegal, Sinus frontal, Frontal sinus tumors, Mucoceles African Journal of Neurological Sciences Vol. 24 (2) 2005: pp. 40-47

Introduction L\'hematome sous dural est une complication observee lors du traitement chirurgical de l\'hydrocephalie. Avant l\'avenement de la tomodensitometrie a Dakar, une incidence de 0,8 % etait trouvee. Objectif L\'objectif de notre travail est de reevaluer cette incidence a la lumiere de cet examen et de determiner les divers facteurs etiologiques. Patients et Methode Nos patients ont ete operes par derivation ventriculo-peritoneale et sont âges de 8 a 30 ans au moment du diagnostic. Quatre sont de sexe feminin. Le signe le plus frequent est l\'hypertension intra-cranienne. La tomodensitometrie a etabli le diagnostic dans tous les cas. Elle montrait dans 4 cas, un hematome unilateral et dans deux cas, une forme bilaterale. D\'importantes calcifications sont retrouvees dans deux cas. Cinq patients ont ete operes et nous notons deux deces. Les valves utilisees sont a debit de drainage fixe. Resultat Il existe une augmentation de l\'incidence par rapport a notre premiere serie datant de 12 ans. Par rapport aux autres systemes de drainage, nous ne notons pas de difference significative. Aucun facteur etiologique determinant n\'est retrouve. Conclusion Cette complication pouvant pauci-symptomatique, la realisation d\'examens tomodensitometriques systematiques permettrait de constater une plus grande frequence de cette complication Introduction Subdural hematoma is a complication which can occur seen after setting a shunt for hydrocephalus. Prior to CT scan installation in Dakar, the incidence was 0,8%. Objective Our aim is to consider twelve years later this complication and others causal factors. Six patients were observed, between 8 and 30 years. Four of them were female. The main sign is increased intra cranial pressure. CT scan shows the hematoma : two bilateral and two calcified.Two patients deceased after surgical treatment. Results The frequency is not due to shunt type or any specific cause. Conclusion The complication may occur without clinical complain and CT scan for all surgically treated patient is mandatory Keywords : Afrique, derivation ventriculo-peritoneal, hematome sous dural, hydrocephalie, valve, Senegal, Africa, subdural hematoma, hydrocephalus, shunt, Senegal African Journal of Neurological Sciences Vol. 24 (2) 2005: pp. 28-32