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- Title
HEMATOME SOUS-DURAL AIGU SPONTANE DU PATIENT EN HEMODIALYSE CHRONIQUE: A PROPOS DE UN CAS ET REVUE DE LA LITTERATURE.
- Authors
A. S., Fofana; S., Sy; M., Coulibaly; H., Yattara; S. B., Coulibaly; D., Diallo; S., Magara; A. C., Koné; B., Sogoba; M. B., Sanogo; S., Fongoro
- Abstract
Introduction: The appearance of spontaneous subdural hematoma (SSDH) is a rare phenomenon in chronic hemodialysis and is burdened with significant morbidity and mortality. It's prevalence remains low in Sub-Saharan Africa, is 0.43%. We report a case of SSDH in a young hemodialysis patient with favorable outcome after medico-surgical management. Clinical observation: This is a 35-year-old patient who has been hemodialysed since June 2016 for chronic renal insufficiency of hypertensive origin. He was admitted on 18 July 2018 in the nephrology department of CHU Point G for intense headaches in a context of dysarthria. They associate themselves with speech disorders, photophonophobia, uncontrollable nausea and vomiting. It does not report any notion of head trauma. The physical examination noted dysarthria, a right pyramidal syndrome made of right Babinsky sign, right arm deficit at 4/5, and right hemicorporeal hyperkinesia. He weighed 62 kg for 165 cm, the blood pressure was 187 / 110 mmHg. The patient had clinical signs of extracellular dehydration. Noninjected cerebral CT showed an acute left sub-dural hematoma with peri-lesional cerebral hypodensity. Surgical evacuation of the hematoma through a trephine hole is performed under local anesthesia. The postoperative course was simple. His hemodialysis sessions were done without heparin from diagnosis until 23 days post operatively. Conclusion: Spontaneous subdural hematoma is multifactorial and rare in the dialysis patient. Despite high morbidity and mortality, hemodialysis should not refute surgical management of subdural hematoma.
- Publication
Mali Médical, 2020, Vol 35, Issue 2, p52
- ISSN
0464-7874
- Publication type
Article