Background & Aim: Conjoined nerve root is defined as two adjacent nerve roots that share a common dural envelope at some points during their course from the thecal sac. This study reports our experience of conjoined roots involving three cases in Dakar.

Methods & Materials/Patients: This is a consecutive study from 2013 to 2015 involving patients supported for disc herniation and who have presented conjoined nerve root anomalie s.

Results: Three patients aged 32, 35 and 55 including two men have been concerned. Clinical analysis was done on sciatica with neuropathic occurrences in one case and lumbosciatica in two cases. The Lasegue sign was present in two patients at 45°. All three patients benefited a lumbar computerized tomography (CT scan) highlighting a degenerative disc disease with two in L5S1 space and one in L4L5 space. The imaging has not objectified radicular emerging anomalies. MRI objectified only one big root. A surgical root decompression was realized through interlaminar discectomy approach; foraminotomy and full laminectomy enabling diagnosis in intraoperative period. The evolution was favourable in all three cases with full recession of sympto matology.

Conclusion: This study is the first Senegalese series on the lumbo-sciatica by anomaly of root emergence and highlights especially the difficulties for the diagnosis of these anomalies like other sub-Saharan African countries where expansion of MRI for the diagnosis is low, and still very expensive. MRI provides guidance signs and a large root appearance can warn about the existence of these anomalies. A good root release improves the symptoms.  

Background and Importance: Abscess of the hypophysis or pituitary adenoma is a very rare entity, and its preoperative diagnosis could be challenging. The clinical presentation is less specific, and despite the recent advancement in imaging, diagnosis before surgery is still difficult.

Case Presentation: We reported two cases of pituitary abscesses in patients aged 38 and 42 years. The first patient was managed for maxillary sinusitis associated with pituitary adenoma whose diagnosis was made following surgery. For the second patient, the diagnosis was proposed before surgery following an MRI which showed a ring enhancement lesion of the hypophysis. Both patients benefitted from surgery where one had sub-labial rhino-septal trans-sphenoidal approach and the other through endoscopic endonasal trans-sphenoidal approach. Both received intravenous broad spectrum antibiotics.  

Conclusion:  Post-operative evolution was good with control MRI showing complete disappearance of the sellar lesion. Early diagnosis and treatment improved the prognosis.