Clinical pattern and neuropsychologic outcome of moderate traumatic brain injuries treated in Conakry

Abstract

Cognitive impairment and behavioral changes following post-traumatic brain injury are disabling sequelae of traumatic brain injury. Processing speed, attention, executive functions and memory are usually the most impaired functions and may go unnoticed during a routine follow up neurologic consult. The aim of this study was to evaluate the degree of impairment of cognitive functions in a Guinean population of moderate traumatic brain injury by assessing the adaptability of classical Western neuropsychological tests to Guinean socio-cultural context. Twenty-three patients treated in neurosurgery at the Ignace Deen Hospital of Conakry were retrospectively assessed with a mean follow-up of 8.2months, a sex ratio of 4.6.1 and a mean age of 30.5years. Patients were subjected to the Bell test, and to the measurement of verbal and visio-spatial memory scores compared to a group of 23 control patients. The results showed significant differences between the two groups with impaired short recall memory and intact attention functions although quickly exhausted (mental fatigability). Our results designate these 3 tests as simple and reliable neuropsychological evaluation tools to be put in place early during the skull trauma care network, to improve the neuropsychological outcomes in Africa.

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“…13 In most published series like the present, TBI was found to be predominant in young male. 14,15 Motor vehicle accidents (MVA) is the principal cause in our study and the most reported etiology in USA 16 and Australia. 17 The preponderance of moderate TBI (compared to mild TBI and severe TBI) in previous Guinean studies 4 as well as the current one is a direct consequence of the low level of development of local resources in neurosurgery.…”

“…During the study period 175 patients were treated in General Surgery for isolated moderate head injury. Of these, we were able to access data of 122 patients from our archives (69.7%) and 42 of them (34.4%) patients had available neurological and cognitive assessment data with a follow up of 9.7months (7)(8)(9)(10)(11)(12)(13)(14). Ten patients had motor and sensory sequelae, and 9 patients were not able to take the neuropsychological tests due to a profound impairment of their cognitive functions.…”