Neurological Disorders

Parkinson's disease is a progressive neurodegenerative disorder that is associated with the loss of dopaminergic neurons in the substantia nigra pars compacta (SNc). It is a degenerative disorder of the central nervous system that belongs to a group of conditions called movement disorders. It is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. As nerve cells (neurons) in parts of the brain become impaired or die, people may begin to notice problems with movement, tremor, stiffness in the limbs or the trunk of the body, or impaired balance. As these symptoms become more pronounced, people may have difficulty walking, talking, or completing other simple tasks .

Introduction: Hemorrhagic Stroke (HS) are uncommon among children. They have an etiological specificity and different risk factors that are different from those of adults. Prognosis depends on the etiology. Our objective was to study the characteristics of children's HS in Senegal. Methodology: Descriptive retrospective study from July 2003 to February 2014. Results: 13 patients were collected, including 9 boys. The mean age was 9.85 years. The antecedents were: rheumatic heart disease (2 patients); congenital heart disease (1 patient); arterial hypertension systolic-diastolic untreated (1 patient); heterozygous sickle cell anemia (1 patient). No history for (8 patients - 61.53%). The beginning was sudden or rapidly progressive in all patients. Clinical manifestations were hemiplegia (53.84%), headache and vomiting (46.15%), consciousness disorders (30.76%), partial motor seizures (7.69%). The topography was supratentorial (84.61%). The causes were: arteriovenous malformations (3 patients); severe thrombocytopenia (1 patient); systolic-diastolic arterial hypertension (1 patient); myeloblastic leukemia (1 patient). No etiology (7 patients). 4 patients died during the acute phase. 1 patient was transferred to pediatric oncology. 1 patient was transferred abroad for embolization. The mean follow-up was 11.8 months. Outcome was favorable in patients with ad integrum restitution. 7 patients had hemiparesis type of neurological sequelae (4 patients), motor partial epilepsy (4 patients) and aphasia (1 patient). 1 patient developed hydrocephalus. No recurrence was noted. Conclusion: This study provides a better diagnostic and etiological approach for better management.

Introduction: Diabetes influences the clinical and evaluative profile of stroke. Age of up come type, the severances are as well the parameters which intervenes in the evolution.

Objectives: It describes the epidemiologic profile, clinical scannographic and evaluative of hospitalized patients for cerebro-vascular accident associated to diabetes.

Methodology: It was about a retrospective and descriptive study on 2 years, realized in the general service of Neurology and at Neurovascular unit of Cocody Teaching Hospital. All patients hospitalized for stroke, diabetes know or discovered during hospitalization was included. We have studied the epidemiologic data, clinic, scannographic and the evolution in the process of hospitalization. The TOAST classification was used for the etiologic classification of ischemic stroke.

Results: 79 cases of stroke associated to diabetes were diagnose on 596 patients hospitalized for stroke, the hospitalized prevalence is 13.25%. The sex ratio was from 0.79 with an average age of 64.6 years. The diabetes type II predominated with 97.5% of cases. 79.2% of patients know they were diabetic but these ones, 61.9% were unobservant to their anti-diabetic treatment. High blood pressure was associated to diabetes in 87.3% of cases. The percentage of recidivist stroke was from 27.8%. The clinical examination found a hemi corporal motor deficit in 91.6% of cases, a vigilance disorder found in 31.6% of cases and a motor aphasia in 26% of cases. Ischemic vascular cerebral accidents were predominating in 85% in cases against 21.5% of hemorrhagic stroke cases. The arteriolosclerosis was retained as etiologic of ischemic stroke in 56.5% of patients and High blood pressure in 100% of cases of Hemorrhagic stroke. We note a significant statistically correlation between the increase of HbA1C rate and the intra-hospital mortality.

Conclusion: Stroke from diabetic is frequent, severe and highly dominated by lacunar infarcts in our context.