Radiation Dose from CT-Scan of Childhood’s Head: Results of the First Ivorian Survey in a Single Study Site

Objectives: This study aims to evaluate the level of X-ray doses used in childhood’s head as Local Diagnostic Reference Levels (LDRLs) in computed tomography (CT) at a university hospital in Côte d’Ivoire. The Diagnostic Reference Level (DRL) have been set up and used to prevent unusually high radiation doses used in radiology departments and is therefore an optimization tool for practices and procedures in medical X-ray imaging for the radiation protection of patients. Methods: A prospective study of volume CT dose index (CTDIvol) and dose length product (DLP) was performed on images of childhood’s head obtained from a CT-scanner of 64 bars equipped with the tube current modulation capability and manufactured by Hitachi Medical System. 122 CT-scan data from 55 childhood’s head were analyzed. The scan data were stratified in four age groups: Results: The 75th percentile of CTDIvol and DLP (set as LDRL) obtained with respect to the stratified age groups are: 22.5 mGy and 452.5 mGy∙cm, 27.7 mGy and 690.6 mGy∙cm, 28 mGy and 722.4 mGy∙cm, 33.6 mGy and 736.8 mGy∙cm respectively. These outcome values increase with respect to the age of pediatric patients and are comparable to DRLs values obtained internationally. Conclusions: Obtaining good image quality while using low dose in children’s head computed tomography for radiation protection require to setup more surveys in Côte d’Ivoire for regional and national DRL. We proposed through this survey LDRLs in terms of CTDIvol and DLP, comparable to international DRLs values. This survey will be strengthened by additional surveys in order to obtain national DRLs for the radiation protection of the child patient in Côte d’Ivoire.

Cytotoxic Lesions of the Corpus Callosum (CLOCCs) Associated with SARS-CoV-2 Infection in West Africa (Côte d’Ivoire)

Background: Cytotoxic lesions of the corpus callosum (CLOCCs) represent a collection of disparate conditions that can cause a signal change in the corpus callosum, usually involving the splenium. CLOCCs is present in a variety of disorders, such as cerebral infarction, bleeding, multiple sclerosis, acute disseminated encephalomyelitis, glioblastoma, lymphoma, metabolic diseases, and infections. Since 2020, World Health Organization (W.H.O) defined Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, as a pandemic. Numerous CLOCCs cases have been reported in adults in particular in Japan, in China, and recently in children in Turkey associated with SARS-CoV-2. We report the first case of CLOCCs diagnosed in West Africa (Côte d’Ivoire) in an adult associated with SARS-CoV-2. Case Report: A 60 year-old-woman with a medical history of high blood pressure and diabetes, presented to the emergency department with confusion without fever. Neurological examination was normal apart from temporospatial disorientation. Brain magnetic resonance imaging (MRI) showed abnormal signals in the splenium of the corpus callosum (SCC). Forty-eight hours (48 h) after admission, the patient experienced a fever (temperature: 385˚C), several episodes of hypoglycemia (capillary blood glycemia levels below 0.5 g/l) and a dry cough. Lung CT imaging showed typical features with ground-glass opacities. Oropharyngeal swab was positive for SARS-CoV-2 on reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. The clinical course was favorable. One month after disease onset, a follow-up Brain MRI showed considerable regression of SCC abnormal signal. The multiple episodes of hypoglycemia and SARS-COV 2 infection were incriminated as the causal factors. Conclusion: The improvement of the technical platform in our context of work gives us the possibility to identify the etiological factors of this rare clinico-radiological entity.