TITLE:
Carotid Web as a Cause of Ischemic Stroke in Sub-Saharan Africa: A Preliminary Monocentric Descriptive Study of 6 Cases Collected at the Fann Teaching Hospital (Senegal)
AUTHORS:
Ndiaga Matar Gaye, Alassane Mamadou Diop, Adjaratou Dieynabou Sow, Abdoul Salam Soumaré, Didier Smadja, Moustapha Ndiaye, Sokhna Ba, Amadou Gallo Diop
KEYWORDS:
Carotid Web, Sub-Saharan Africa, Senegal, AngioCT-Scan, Acenocoumarol
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.12 No.3,
March
11,
2022
ABSTRACT: Introduction: Carotid web (CW), a rare and probably unknown arterial cause of ischemic stroke (IS), is commonly reported in young black
patients, although most of the published
cases resided in a non-African country. We describe the features of the
first six Senegalese cases diagnosed at the Neurology Department of the Fann
Teaching Hospital in Dakar. Patients and Method: It was a preliminary
retrospective and prospective study conducted at the Neurology department of Fann teaching hospital (Dakar-Senegal). The symptomatic
CW diagnosis was based on angioCT-scan of the neck arteries. The National
Institute of Health Stroke Scale (NIHSS) and the modified-Rankin Scale (mRS)
were used to assess the severity of the IS and the functional disability after
the event, respectively. Results: CW was causing a left sylvian infarction in 4 patients. The mean age of
the patients at the IS diagnosis was 41 ± 6 years with a sex ratio of 1.
The mean time to diagnosis of CW was 13 months. Smoking (1/6), hypertension
(1/6), and obesity (1/6) were the main vascular risk factors. The mean LDL
cholesterol level was 1.52 g/L ± 0.49. The mean initial NIHSS was 15 ± 6
(8-22). Half of the patients had a severe infarction (NIHSS ≥ 15). For
secondary prevention, half of the patients were treated with aspirin and the
other half with acenocoumarol. After 18 months ± 17 of follow-up, the mean mRS
score was 2 ± 1 (1-3). Conclusion: CW is an unknown cause of IS in young
black patients. An early and appropriate multidisciplinary management could
help to reduce the risk of recurrences.