No abstract

Background: Intracranial suppurations (ICS) due to banal germs are medical-surgical emergencies, despite their little removed frequency. Represented by abscesses and empyemas, their management has been improved by the combined contributions of new diagnostic and therapeutic methods. Objective: Appreciate the management of intracranial suppurations banal germ in our service. Material and methods: A retrospective study of 41 cases of intra-cranial suppurations was conducted at Brazzaville University Hospital, from January 2007 to June 2019. Diagnostic, therapeutic and evolution aspects have been studied. Results: They are divided into 24 empyemas, 8 abscesses and 9 associations abscess-empyema. The average age was 20.2 years old in general. The male predominance is noted in all groups. The sex ratio is 3.1 for all of these intracranial suppurations (ICS). They frequently complicated Oto-Rhino-Laryngology (ORL) infections (41.4%). The clinic was mostly represented by the Bergman's triad 51.2%, followed by headache 14.6% and seizures 12.2%. The lesions were predominant in supratentorial 97.5%. Frontal location was found in 67.4%. Germs were isolated in 29.4% of samples. There were 5 Streptococci, 3 Staphylococci and 2 Gram-negative Bacilli. The medico-surgical treatment indicated in 80.5% combined often probabilistic tri-antibiotherapy with the evacuation of the pus by the trepano-puncture. Evolution under this treatment was marked by healing in 90.2%. The lethality was 9.7%. Conclusion: The pursuit of the improvement of these infections requires the adequate treatment of their gateways, most of them loco-regional.

Background and Aim: Histoplasma capsulatum var. duboisii is a rare fungus that is endemic in the Sahara and Madagascar in southern Africa. The present study was conducted to explain the confirmed cases of histoplasmosis. Methods and Materials/Patients: This retrospective study was conducted at the Division of Neurosurgery of Brazzaville teaching hospital in the Republic of Congo. The clinical records of all of the confirmed cases admitted between January 2014 and December 2017 were reviewed.Results: All of the five cases of confirmed histoplasmosis, including two women and three men, with a mean age of 42 years old, admitted to the Division of Neurosurgery over four years were immunocompetent to HIV. Radiological imaging identified a localized form of cold abscess in two of the patients and disseminated forms in three male cases. Lung lesions were also observed in two patients with multilevel spondylodiscitis and lung diseases, and clavicular osteitis in the other patient. Clavicular osteitis was also found to be associated with cutaneous fistulization in one of the patients, with cutaneous nodules in the second patient and with cutaneous nodules and pulmonary lesions in the third. Appropriate outcomes were observed for the localized forms but undesirable ones for the disseminated forms. Four patients had received medical and surgical treatments. This treatment caused an appropriate evolution in patients with localized forms and an undesirable evolution in the two scattered forms. These patients died upon admission due to the complications associated with their severe neurological condition. The final case died before beginning the antifungal treatment following a septic shock with the fistulization of osteitis clavicularis as its potential cause. Conclusion:Although infections with Histoplasma capsulatum var. duboisii are rare, the lack of comprehensive knowledge on this fungus in the majority of medical staff can explain the delays in treating these infections. Microbiological analyses are therefore required to be performed on pathological materials in the event of suppuration to assist with early diagnosis and effective management.

The aim of this study was to evaluate socio-demographic profile of adults admitted in emergency for Traumatic Brain Injury (TBI) at the University Hospital of Brazzaville in the Republic of Congo. We performed a prospective study within a period of six months, into the surgical unit of the emergency department of the University Hospital of Brazzaville. A total of 2617 patients were recorded, among which 268 cases were TBI (10.25%) where 142 cases were sampled in our series. The average age was 36.7 ± 16.6 years. The sex ratio was 6.1. The TBI was mainly due to road accident in 121 cases (85.2%) described as follows: motorcycle accident about 48 cases (39.7%) and the pedestrian's injuries about 42 (34.8%). In the majority of the cases, cautions were not taken by the drivers; during the case of the motorcycle accident, about 97.9% of the riders did not wear a helmet. The TBI remains a growing public health concern in the low-income countries, like in Africa. Measurements on the road traffic regulation are to be strengthened to reduce the growth of this silent epidemic.

Introduction: Tumors of the central nervous system are the most common group of solid neoplasm in children and account for 20% to 25%. They are common in Sub-Saharan countries, despite the insufficiency of histological diagnosis. No study has been performed concerning the pediatric brain tumors in the Republic of Congo. The aim of this study was to describe the conditions of neurosurgical management of pediatric tumors in Brazzaville. Materials and Methods: We performed a retrospective and descriptive study, from January 2014 to December 2017 (48 months), into the neurological unit of the surgical department of Brazzaville. We included all patients aged from 17 years old and below, hospitalized for a brain tumor. Results: We have identified 11 cases of brain tumors. The average age was 8.1 ± 4.3 years old, a sex ratio of 0.57. Ten out of the eleven patients of our series have intracranial hypertension. We found six cases of infratentorial tumors and five of supratentorial location. Only three cases had histology. Ten patients were operated, limited by ventriculoperitoneal shunt in 6 cases, surgical resection in three cases, biopsy in one case. There were no possibilities of radiotherapy and chemotherapy during this period of study. Conclusion: A multidisciplinary team must be organized to improve the management of pediatric brain tumors in our context. Histological diagnosis and possibilities of radiotherapy are imperatively needed.