Neurological Manifestations of Vitamin B12 Deficiency: About a Case

The authors report a case of deficient sensory neuropathy secondary to vitamin B12 deficiency, diagnosed in the neurology department of the Sino-Central African Friendship University Hospital in Bangui. The diagnosis was made possible by electroneuromyography which showed subclinical neurological damage associated with hematological damage (anemia). Through this observation, we recall the diagnostic criteria of the disease in a context of difficult medical practice. .

Profile and Prognostic Factors of Stroke in Age Subjects in Bangui

Introduction: The stroke is a real public health problem due to its frequency, its severity, its residual physical and cognitive handicap and its financial cost for society. Goal of the Study: To contribute to the knowledge of these conditions in neurological practice in the Central African Republic. Methodology: Analytical cross-sectional study which took place over a period of 4 months from June 1 to September 30, 2020, in subjects aged 55 and over hospitalized in the Neurology department of the Friendship Sino University Hospital. Central African woman for a stroke with a complete file. Results: During the study, 118 patients were hospitalized in the department, including 24 cases of stroke, for a hospital frequency of 20.33%. The average age was 67.1 years old and the male/female sex ratio was 1.6. Motor deficit and language disorder were the main reasons for consultation (100%). Hypertension was the main risk factor (91.7%). Stroke was the most predominant type of stroke (54.8%). Most of our patients (58.3%) were admitted to healthcare facilities before 6 a.m. The lethality was 25%. There was a statistically significant association between the severity of hypertension and the type of stroke as well as the patient’s condition at discharge. The NIHSS score and the KARNOFSKY score were significantly related to the patient’s condition at discharge. All the discharged patients presented with sequelae such as hemiparesis (75%) and dysarthria (45.8%). Conclusion: Stroke is a serious, disabling pathology that is increasingly common with the aging of the population. The creation of a neurovascular unit and a rehabilitation unit could improve the prognosis and course of stroke in our elderly patients. .

Epidemioclinical and Progressive Aspects of the Adult Hemorrhagic Stroke in Bangui

Introduction: Hemorrhagic strokes in the elderly constitute a diagnostic and therapeutic emergency and, by their frequency and severity, determine a public health problem. Goal of the Study: To elucidate knowledge and make our contribution to the study of this pathology (describe the epidemioclinical and evolutionary aspects of hemorrhagic cerebrovascular accidents in adults in Bangui). Methodology: It was a retrospective study with descriptive and analytical aims covering a period of two years (2) from January 2017 to December 2018, conducted in the Neurology department of the Sino-Central African Friendship University Hospital. Results: During the study, 255 patients were hospitalized for stroke, including 20 cases of AVCH, representing a hospital frequency of 7.8%. The average age was 60.05 years with extremes ranging from 50 to 78 years. The most represented age group was that of 50 to 60 years with a sex-ratio (M/F) of 1.2. Civil servants were more represented (35%) followed by housewives (25%). Alcohol was the main risk factor (95%) followed by hypertension (80%) and tobacco (40%). Most of the patients (75%) were admitted to the care facilities before 6 am (75%). Lethality was 35%. There was a significant statistical link between the Glasgow score and death (p = 0.007). In this series, 75% of the cases had sequelae dominated by hemiparesis (75%) and aphasia (25%). Conclusion: First study in the Central African Republic, with a high frequency, shows that the AVCH of the elderly poses a public health problem. Requires great mass awareness in order to reduce its mortality rate.

Epidemiological Aspects of Stroke in Young People at the Friendship University Hospital Center in Bangui in the Central African Republic

Introduction: Stroke is a major public health problem even more dramatic in young people. Goal of the study: To make our contribution to the knowledge of strokes of the young subject. Methodology: It was a retrospective study conducted over a period of 02 years (January 2017 to December 2018) including the files of patients aged 18 to 49 years hospitalized for any suspected case of stroke in the Department of Neurology of C between Hospitalier A Sino-Central African Friendship University (CHUSCA) from Bangui. Results: During the study, 225 cases of stroke were recorded, including 26 cases in young subjects, representing a hospital frequency of 11.5%. The average age was 42.5 years with extremes ranging from 24 to 49 years. The most represented age group was 45 and 49 with a sex ratio (M/F) of 1.36. The average age for men was 41.93 years compared to 39.27 years for women. Civil servants were in the majority in 50% of the cases. Alcohol was the main FDR (80.8%) followed by hypertension (61.5%) and tobacco (50%). The majority of patients (57.70%) were admitted to neurology after the first 24 hours. Ischemic stroke represented 73.08% compared to 26.92% of AVCH. The lethality was 20.08%. The sequelae were found in 69.20% of cases. Cardiac exploration had found 57.10% of LVH. Conclusion: This study confirms a high frequency of stroke in the young subject. The predominance of modifiable FRCVs requires the implementation of a specific strategy based on awareness, early detection and effective and adequate PEC.

Prognostic Factors Associated with Mortality Related to Stroke in Bangui (Central African Republic)

Stroke is a very common neurological condition that causes permanent disability in half of the cases, at least in sub-Saharan Africa. They represent the second most common cause of death in Africa. Objective of this study was to evaluate the prognostic value of the intake period of patients suffering from these conditions on the survival time of one month of hospitalization in hospitals in Bangui. We conducted a prospective study cross prognostic kind in the neurology departments, internal medicine and intensive care units of two large central hospitals from February to August 2017. Subject recruitment was complete with a made questionnaire based on the modified one of the World Health Organization on neurological disorders. A total of 154 patients were included, with a mean age of 63.15 years ± 10.98 and extremes ranging from 38 to 91 years. A male predominance was noted (60%) with a sex ratio (M/F) of 1.5. For 76 subjects (49.35%), care was taken with a hospital admission period of less than or equal to one day, while for 78 other 78 (50.65%) the admission period was higher to one day. Average admission time patients caught early was 1.00 day and the upper limit intake to one day was 4.59 ± 2.33 days with a statistically significant difference (p < 0.0001). Median admission delay for patients treated late was 4 days. Pre-hospital and hospital determinants by admission delay are presented in Table 1. The survival time was better in the group of patients who were treated early (p = 0.0039). This study shows the negative impact of late management on the survival time of patients.