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Objective: To describe the pattern of intracranial tumors in Sylvanus Olympio teaching hospital of Lome (Togo). Method: We conducted a retrospective and descriptive study between November 2017 and December 2019. Data were obtained from the clinical records of patients with intracranial tumors treated in our neurosurgery unit, and histology obtained. Patients without a definitive histological diagnosis were excluded. Results: 53 patients were operated and had a histological diagnosis in the period of the study. The mean age at diagnosis was 32 ± 27.1 years. The majority of tumors were seen in adults at 88.7% with age range between 23 - 75 years and a mean age of 40 ± 10.5 years. Meningioma was the commonest intracranial tumor in adults (47.2%) and more seen in females. The histological type of meningioma is meningotheliomatous in our study. In children, principal tumors were medulloblastoma and ependymoma (11.3%). Conclusion: Meningioma is the most common intracranial tumor in adults, while embryonal tumors (medulloblastoma and ependymoma) are the most frequent in children in our environment.

Objective Intraventricular hemorrhage (IVH) often requires the insertion of an external ventricular drain (EVD), but blood clots could occlude the catheters. Large EVD catheters may help to reduce the risk of catheter occlusion. Here, we compared small catheters with large catheters for ventriculostomy in patients suffering from IVH. Methods We conducted a retrospective cohort study. Patients were included if they had IVH requiring EVD insertion. We then compared baseline characteristics and outcomes of patients treated with large catheters with patients treated with small catheters. Results Between 2011 and 2015, 227 IVH patients were admitted to our 2 hospitals. Among the patients, 28 were treated in first intention with large catheters, and 46 controls were identified. Insertion of large catheter decreased the risk of temporary and permanent catheter occlusion without impact on the occurrence of intracerebral hemorrhage (ICH) related to catheter insertion. There was 38.5% more catheter-related infections in the small catheter group when compared with the large catheter group, but this result was not significant. There was no impact on functional outcomes. Surprisingly, the rate of death was higher in the large catheter group. Conclusions In patients suffering from IVH, the use of large catheters for EVD reduced the risk of catheter occlusion without increasing the risk of ICH related to catheter insertion. The risk of catheter-related infection may subsequently be decreased by using large catheters. A prospective randomized trial would be necessary to seek out any benefits that large catheters may provide for the risk of death and functional outcome.

Background: Schwannomas are tumors of peripheral nerves that develop from the nerve sheath. Foraminal schwannomas are rare and account for 1-5% of all spinal schwannomas. The lumbosacral root schwannoma is a rare cause of sciatica and may raise confusion in diagnosis with late discovery of the tumor. Case Description: We report the case of a patient 30 years of age with chronic left sciatica in whom lumbosacral magnetic resonance imaging (MRI) revealed a tumor involving the S1 nerve root. The excision of the tumor was simple. Histological examination revealed a benign schwannoma. The evolution was favorable postoperative with no neurological deficit, which confirms the good prognosis of this tumor. Conclusion: Nerve root schwannomas should be considered in the differential diagnosis of sciatica, especially when signs and symptoms of sciatica cannot be simply explained by prolapsed disc syndrome, which can often delay the diagnosis. Through this case presentation, the authors try to discuss the clinical and radiological features of this condition.

Pre-eclampsia complicates approximately 5–8% of all pregnancies and may have adverse long-term effects on both mother and child. Chronic atraumatic subdural haematoma as a complication of severe pre-eclampsia, in the absence of clotting factor abnormalities, is a very rare condition. We present the case of a 30-year-old Moroccan woman who had a pregnancy 10 years previously, with an uneventful delivery. She presented with pre-eclampsia complicating a 29-week-old pregnancy. A few days preceding maternity unit admission the patient complained of headaches and malaise. Her blood pressure at admission was 150/120 mmHg and subsequently was treated with doses of methyldopa and magnesium sulphate. Her condition worsened with a loss of consciousness 24 hours later and was transferred to the neurosurgical unit. A brain computerized tomography (CT) scan revealed a left-sided subdural haematoma and the patient underwent surgery, with a good postoperative outcome. This article highlights the occurrence of neurological complications due to pre-eclampsia/eclampsia that require particular neurosurgical attention, its treatment and prognosis. We also review the literature regarding this pathology.

Infundibular dilatations (IFDs) are conical, triangular, or funnel-shaped enlargements at the origin of cerebral arteries, and they are primarily located (7-25%) on the posterior communicating artery (PComA). Progression over time into a saccular aneurysm with a risk of rupture of a previously demonstrated IFD has rarely been reported. We report the case of a 60-year-old female who presented 10 years earlier with a subarachnoid hemorrhage caused by a left internal carotid artery aneurysm rupture. At that time, the carotid angiography showed the left internal carotid artery aneurysm and a right posterior communicating artery infundibular dilatation. Neck clipping for the left internal carotid artery aneurysm was performed and the patient was discharged with no neurological deficit. Ten years later, the patient suffered a second fatal subarachnoid hemorrhage; carotid angiography revealed a right posterior communicating artery aneurysm developed from the previously documented infundibular dilatation with a de novo right anterior choroidal artery aneurysm. This case is another proof of the small but growing number of examples of infundibular transformation over time, as well as their risk of progression into saccular aneurysms and subsequent rupture.