Apport de la Tomodensitométrie dans les Pathologies Infectieuses Cérébroméningées au CHU du Point G

RESUME Introduction. Les moyens d'imagerie actuels sont d'un interet primordial dans la detection de ces anomalies ainsi que dans leur localisation. Le but de notre travail etait d’evaluer la place de la tomodensitometrie dans les pathologies infectieuses cerebromeningees. Materiel et methode. Nous avons mene une etude transversale retrospective qui a concerne les patients des deux sexes, adresses pour TDM cerebrale dans le service de radiologie et d’imagerie medicale du CHU du Point « G ». L’etude s’est deroulee du 01 janvier 2017 au 31 decembre 2018. A ete retenu dans l’etude, tout patient ayant une pathologie infectieuse cerebro-meningee provenant de ce CHU et ayant realise une TDM cerebrale. N’ont pas ete inclus tous les patients ayant une pathologie infectieuse cerebro-meningee dont le diagnostic a ete pose en dehors de la periode d’etude, les patients au dossier incomplet. Resultats. Vingt-huit patients ont ete colliges, representant 1,16% de l’ensemble des admissions. La tranche d’âge comprise entre 15-30 ans etait la plus touchee (42,9% des cas). L’âge moyen des sujets etait de 35,96 ± 15,58 ans. Le sex-ratio etait de 1,54 en faveur des hommes. 35,7% des patients provenait du Service de Medecine Interne. L’hemiplegie etait le motif de la demande d’examen le plus frequent (32%). La serologie VIH etait positive chez 54% des sujets avec 43% de type I. Au scanner, 96% des lesions cerebrales etait localisees a l’etage sus-tentoriel. L’effet de masse etait present dans 10 cas (39%). La majorite des lesions (92,9%) presentait un rehaussement ; il etait gyriforme dans 53,5%. Conclusion. La TDM permet de faire le diagnostic positif et topographique des lesions infectieuses du systeme nerveux central. De plus, elle permet la detection des complications eventuelles. ABSTRACT Introduction. Current imaging modalities are of paramount interest in the detection of infections of the central nervous system as well as in their precise localization. The aim of our work was to assess the value of computed tomography in the management of cerebromeningeal infections at the Point "G" University Teaching Hospital. Methods. We conducted a transversal retrospective study, which concerned patients of both sexes, referred for cerebral CT in the Radiology and Medical Imaging Department of the Point "G" CHU. The study took place from January 01, 2017 to December 31, 2018. Any patient from the "G" point CHU with a cerebromeningeal infection, who performed a brain CT scan, was included in the study. We excluded all patients whose date of diagnosis was outside the study period, and patients whose files were incomplete. Results. Twenty-eight patients were studied representing 1.16% of all admissions. The mean age of patients was 35.96 ± 15.58 years. The age group between 15-30 years was the most affected (42.9%). The sex ratio M/F was 1.54. 35.7% of our patients came from the Internal Medicine Department. Hemiplegia was the most common reason for requesting an exam (32%). HIV serology was positive in 54% of patients; among them, 43% was of type I. On CT scan, 96% of the brain lesions were located on the supratentorial level. A mass effect was present in 10 cases (39%). 92.9% of lesions were enhanced after contrast injection; in this group, gyriform enhancement was seen in 53.5% of cases. Conclusion. CT enables positive and topographic diagnosis of cerebromeningeal infections. Moreover, it allows the detection of complications.