脳研究ジャーナル

Benign Intracranial hypertension (BIH) is defined by the existence of intracranial pressure greater than 15 mm Hg
sustained. The clinical signs revealing a BIH are headaches that are resistant to analgesics most also complained of
blurred vision, dizziness, vomiting, and drowsiness. The objective of our study is to evaluate the management of
BIH’s patients hospitalized in our neurosurgery department, propose protocol and develop recommendations and
consensus for the management and treatment of patients with benign HIC. We have a retrospective series of 138
patients admitted and/or operated for BIH from January 2011 to June 2018. The patients are aged from 10 to 50
years with an average age of 33, 5 years, 30% have age between 20 and 30 years. The sex ratio f/h is 34/1. The
clinical manifestations of the BIH are those of any HIC. The headache with nausea and/or vomiting is major initial
manifestations in most series as in our series. 49 patients have blurred vision in periphery bilaterally (68%) and one
patient has bilateral blindness; 8 patients have optic atrophy (9%), the papillary edema found on all patients (100%),
bilateral papillary edema occurred in 62 (45%) patients, of whom grades II, III, IV were 9%, 22%, 16% respectively,
25 patients had optic atrophy (18,1%). Brain MRI has shown no abnormality in all patients (100%). All patients
underwent a lumbar puncture with manometry always greater than or equal to 30 cm H2O, with extremes ranging
from 50 to 60 cm H2O (visual prognosis compromise on 25 patients (18,10%). Medical treatment is used for 83
patients (60,14%), it is based on steroids and Diamox. The surgical treatment has to be associated in the cases of
high intracranial pressure ( >50 cm H2O) and/or because of visual risk, it is necessary to perform lumbar-peritoneal
shunt in 81 patients (59%) and ventriculo peritoneal shunt (VPS) in 22 patients (16%); 90% of patients who have
benefited lombo-peritoneal shunt (LPS) saw their clinical and especially their balance sheets ophthalmic (VA and OF
normalized within 1 month), however 10% of patients have no modification of their clinical situation. In the presence
of papillary edema and oculomotor disturbances, which are abruptly associated with normal neuroradiological
investigations, we must consider the diagnosis of BIC, start the treatment as quickly as possible in order to preserve
the visual function.

Background: Chewing the leaves of Khat is a social habit in East African countries including Ethiopia. Its health
and the socio-economic burden is becoming a severe problem in Ethiopia. Its effects on Doppler velocities in
common carotid arteries have not been studied. The present study was, therefore, designed to evaluate its
hemodynamic effects on these arteries in wild- type male white albino rats.
Materials and methods: A total of 42 adult (7-8 weeks) wild-type male white albino rats weighing between 213
and 229 g were used in this study. The rats were received Khat extract sub chronically (kesc, 100 mg/kg, 200 mg/kg
and 300 mg/kg b.w.), Khat juice (khJ, 2.5 ml/kg), ascorbic acid (AA, 200 mg/kg), 2% tween 80 in distilled water
(T80W-v/v) and Khat extract sub acutely (kesa) 300 mg/kg. The blood flow velocities and indices were measured
using an ultrasonic Doppler flow meter. The Doppler waveforms were measured three times and the average values
were taken for analysis using SPSS version 21.0 and Microsoft Excel.
Results: The SysV of common carotid artery was significantly reduced in rats received the middle (p<0.01) and
higher (p<0.01) doses of Khat extract sub chronically compared with rats received vehicle. However, the DiaV has
significantly reduced in rats receiving a higher dose of extract compared with the vehicle (p<0.05) and ascorbic acid
(p<0.001). The SysV and DiaV in rats received the lower dose of Khat extract, Khat juice, AA sub chronically and the
higher dose of Khat extract sub acutely were not affected (p>0.05). The RI (p<0.001) and the PI (p<0.01) of this
artery was significantly higher in rats received a higher dose of extract compared with the rats received the lower
dose. The size (in g) of the brain at a higher dose (p<0.001) of extract administered sub chronically was significantly
reduced compared with rats received the vehicle.
Conclusions: Khat affected the common carotid artery Doppler velocities and indices particular at the higher
doses and prolonged administration. The organ bath in vitro effects of Khat on these arteries should be investigated
in the future.