Basilar artery fenestration is a rare anatomical variation resulting from the failed fusion of the two vertebral arteries during embryonic life. In order of frequency, it is the second most common location of vascular...Basilar artery fenestration is a rare anatomical variation resulting from the failed fusion of the two vertebral arteries during embryonic life. In order of frequency, it is the second most common location of vascular fenestrations after the anterior communicating artery. Vertebrobasilar junction aneurysms are uncommon but often associated with basilar artery fenestration. We report the case of a fenestrated vertebrobasilar junction saccular aneurysm in a 57-year-old woman. The diagnosis was incidentally made on CT angiography which found the anatomical variant and the aneurysm. The radiological features illustrating this association are detailed here and a brief discussion of its pathogenesis and management was made. Vertebrobasilar junction aneurysms are rare and their presence should suggest an associated basilar fenestration.展开更多
Penetrating wounds of the neck are often life-threatening. The victims are exposed to vascular and laryngotracheal lesions. The purpose of this work is to report the various aspects of the management of penetrating wo...Penetrating wounds of the neck are often life-threatening. The victims are exposed to vascular and laryngotracheal lesions. The purpose of this work is to report the various aspects of the management of penetrating wounds in our context and to make the medico-legal assessment of incapacity in the criminal sense or total incapacity for work. This is a retrospective study (2002-2014) on thirty-nine (39) cases of penetrating neck wounds, received at the ENT departments of the Aristide Le Dantec and Fann University Hospital Centers. Patients were predominantly male, representing 94% of cases with an average age of 27 years. Seventy (70%) of the accidents occurred in the region of Dakar. In 42% of cases, the circumstance of occurrence was a fight or an assault. The weapon used in most cases by the aggressor was a cutter or a knife. The average waiting time was 37 hours with extremes of 02 and 216 hours. Surgically, all patients had been examined under general anesthesia. In terms of lesions, 37 cases had profound cervical muscle injuries, i.e. 94%. There were 17 vascular lesions (43%). The medico-legal distribution of patients showed that among them, 10% had a total incapacity to work exceeding 21 days. The determination of total incapacity for work is an important medical procedure that requires capability and experience. The doctor must not fall into the trap of the confusion between the TIW on the criminal level and the TIW on the civil level. He must limit medically and should not make judgments.展开更多
The total hip prosthesis is the ultimate treatment of the hip joint’s wear. It is a delicate surgery and the most common replacements. This study was performed in the Orthopaedic-Traumatology Department of Public Hea...The total hip prosthesis is the ultimate treatment of the hip joint’s wear. It is a delicate surgery and the most common replacements. This study was performed in the Orthopaedic-Traumatology Department of Public Health Establishment of Aristide Le Dantec in Dakar. It aimed to determine the complications of our total hip and highlight their forensic implications. This is a retrospective study from patients collected from January 2000 up to December 2010. The collection of elements records was performed for each patient, based on a file including age, sex, primary-location’s etiology, and types of complications of total hip prostheses. The analysis of these complications has shown that infections, poorly lit information, poor operational planning and technical foul may be the main cause of a forensic implication. This is a retrospective study from patients collected from January 2000 up to December 2010. No lawsuit has been recorded for the complications identified in this work. This is due to the belief in fate, ignorance of the victims and solidarity of the medical profession, the high cost and slow pace of judicial proceedings. The diagnosis of total hip prosthesis complications is mainly based on imaging tests. The absence of scintigraphy in our center remains a limit to the early diagnosis of multiple complications and the proper establishment of the epidemiological profile of these lesions. Taking consciences patients of their rights encourages a legitimate requirement repair the harm inflicted.展开更多
文摘Basilar artery fenestration is a rare anatomical variation resulting from the failed fusion of the two vertebral arteries during embryonic life. In order of frequency, it is the second most common location of vascular fenestrations after the anterior communicating artery. Vertebrobasilar junction aneurysms are uncommon but often associated with basilar artery fenestration. We report the case of a fenestrated vertebrobasilar junction saccular aneurysm in a 57-year-old woman. The diagnosis was incidentally made on CT angiography which found the anatomical variant and the aneurysm. The radiological features illustrating this association are detailed here and a brief discussion of its pathogenesis and management was made. Vertebrobasilar junction aneurysms are rare and their presence should suggest an associated basilar fenestration.
文摘Penetrating wounds of the neck are often life-threatening. The victims are exposed to vascular and laryngotracheal lesions. The purpose of this work is to report the various aspects of the management of penetrating wounds in our context and to make the medico-legal assessment of incapacity in the criminal sense or total incapacity for work. This is a retrospective study (2002-2014) on thirty-nine (39) cases of penetrating neck wounds, received at the ENT departments of the Aristide Le Dantec and Fann University Hospital Centers. Patients were predominantly male, representing 94% of cases with an average age of 27 years. Seventy (70%) of the accidents occurred in the region of Dakar. In 42% of cases, the circumstance of occurrence was a fight or an assault. The weapon used in most cases by the aggressor was a cutter or a knife. The average waiting time was 37 hours with extremes of 02 and 216 hours. Surgically, all patients had been examined under general anesthesia. In terms of lesions, 37 cases had profound cervical muscle injuries, i.e. 94%. There were 17 vascular lesions (43%). The medico-legal distribution of patients showed that among them, 10% had a total incapacity to work exceeding 21 days. The determination of total incapacity for work is an important medical procedure that requires capability and experience. The doctor must not fall into the trap of the confusion between the TIW on the criminal level and the TIW on the civil level. He must limit medically and should not make judgments.
文摘The total hip prosthesis is the ultimate treatment of the hip joint’s wear. It is a delicate surgery and the most common replacements. This study was performed in the Orthopaedic-Traumatology Department of Public Health Establishment of Aristide Le Dantec in Dakar. It aimed to determine the complications of our total hip and highlight their forensic implications. This is a retrospective study from patients collected from January 2000 up to December 2010. The collection of elements records was performed for each patient, based on a file including age, sex, primary-location’s etiology, and types of complications of total hip prostheses. The analysis of these complications has shown that infections, poorly lit information, poor operational planning and technical foul may be the main cause of a forensic implication. This is a retrospective study from patients collected from January 2000 up to December 2010. No lawsuit has been recorded for the complications identified in this work. This is due to the belief in fate, ignorance of the victims and solidarity of the medical profession, the high cost and slow pace of judicial proceedings. The diagnosis of total hip prosthesis complications is mainly based on imaging tests. The absence of scintigraphy in our center remains a limit to the early diagnosis of multiple complications and the proper establishment of the epidemiological profile of these lesions. Taking consciences patients of their rights encourages a legitimate requirement repair the harm inflicted.
