Surgical Management of Head Trauma: Problems, Results, and Perspectives at the Departmental Teaching Hospital of Borgou, Benin

Fatigba, Holden O.; Tové, Kofi-Mensa Savi de; Tchaou, Blaise A.; Mensah, Elsie; Allode, Allexandre S.; Padonou, J.

doi:10.1016/j.wneu.2011.09.016

Cited by 21 publications

(13 citation statements)

References 11 publications

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“…The diagnosis was based on the CT scan as well as accessibility of patients to this exam, which was restricted by its cost. As reported by an earlier study by Fatigba et al (14), such limited access to brain examination is a major diagnostic obstacle in low-income countries. Several African authors have reported their experiments in CSDH treatment (5-10).…”

Section: Discussionmentioning

confidence: 87%

Treatment and Outcome of Chronic Subdural Hematoma in Sub-Saharan Afrcia and the Country of Benin

Hodé

Quenum²,

Fatigba³

et al. 2015

IrJNS

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Background & Aim: Chronic subdural hematoma (CSDH) is a common neurosurgical pathology. The objective of this study was to describe the epidemiology of this pathology and the results in treating it combined from three hospital centers in Benin. Methods & Materials/Patients: From September 2010 to September 2013 a multi-center, retrospective and descriptive study was conducted in three hospital centers in Benin. Inventory was taken of all patients in whom CSDH was diagnosed. Patients were evaluated according to Markwalder classification. All patients received a brain scan. The variables studied include demographic and clinical characteristics, therapeutic modalities and post-operative followup. Results: 104 consecutive patients with CSDH were included in the study. The mean age was 49.66, but ranged from six months to 87 years. The M:F sex ratio was 5.11/1. Prior cranial trauma had occurred in 81 patients (77%). Preoperative neurological Grades 1 or 2 were observed in 56.4% of cases. Surgical treatment was given to 100 patients (96.15%). Events surrounding the surgery were straightforward and results satisfactory in 94% of cases. No relapses were observed. The morbidity was 4% and the mortality among surgical patients was 3%. Conclusion: CSDH is frequently treated in the country of Benin. The mean age of patients is lower than that observed in global literature, and patients are predominantly male. Regardless of the patient condition upon hospital admission, post-operative results compare favorably with the literature.

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Section: Discussionmentioning

confidence: 87%

Treatment and Outcome of Chronic Subdural Hematoma in Sub-Saharan Afrcia and the Country of Benin

Hodé

Quenum²,

Fatigba³

et al. 2015

IrJNS

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“…The mortality rates observed in previous studies with emergency surgery patients vary from 1.4% to 35.0%. (10,19,22,25) Some studies with emergency surgery patients analyzed factors associated with the risk of death: low scores in the GCS and anisocoria were identified as important factors associated with a worse prognosis. (6,9,20) Accordingly, in this study, patients who underwent emergency surgery had lower scores in the GCS compared to the elective surgery patients.…”

Section: Discussionmentioning

confidence: 99%

“…(16) For non-elective surgeries, pain (17) and nosocomial infections are also observed. (5) The overall mortality rate has been reported to be only 1% (1,18) after elective neurosurgery, as compared to 29% after emergency neurosurgery, (19) with postoperative complications increasing the risk of death in both groups. (5,18) The early recognition and management of the complications are crucial for the outcome of these patients.…”

Section: Introductionmentioning

confidence: 99%

Complicações pós-operatórias em neurocirurgia eletiva e não eletiva

Siqueira

Diccini

2017

Acta paul. enferm.

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Objective: To evaluate the incidence of postoperative complications and mortality among patients submitted to elective or non-elective neurosurgery. Methods: Prospective cohort study in adult patients, followed from preoperative period until hospital discharge or death. Results: One hundred and twenty seven patients were included in elective surgery group and 75 patients in non-elective surgery group. The elective group had more vomiting (p=0.010) and pain (p<0.001) and the non-elective group presented more intracranial hypertension (p=0.001), anisocoria (p=0.002), cerebral vasospasm (p=0.043), light-unresponsive pupil (p=0.006) and reoperation (p=0.046). The mortality rate was 5.5% in the elective surgery group and 26.7% in the non-elective surgery group (p<0.001). Conclusion: Elective procedures in neurosurgery are related to higher frequencies of systemic complications while non-elective surgeries had significantly higher rates of neurological complications and mortality. ResumoObjetivo: Avaliar a incidência de complicações pós-operatorias e mortalidade entre pacientes submetidos a neurocirurcia eletiva e não eletiva. Metodos: Estudo de coorte prospectivo com pacientes adultos, acompanhados desde o período pré-operatório até a alta hospitalar ou óbito. Resultados: Foram incluídos 127 pacientes no grupo cirúrgico eletivo e 75 pacientes no grupo cirúrgico não eletivo. O grupo eletivo teve mais vômitos (p=0,010) e dor (p<0,001) e o grupo não eletivo apresentou mais hipertensão intracraniana (p=0,001), anisocoria (p=0,002), vasoespasmo cerebral (p=0,043), pupilas não fotorreagentes (p=0,006) e reoperação (p=0,046). A taxa de mortalidade foi de 5,5% no grupo de cirurgia eletiva e 26,7% no grupo de cirurgia não eletiva (p<0,001). Conclusão: Os procedimentos eletivos em neurocirurgia estão relacionados a maior frequência de complicações sistêmicas, enquanto as cirurgias não eletivas tiveram taxas significativamente mais altas de complicações neurológicas e mortalidade.

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“…The lack of scanner or the impossibility to have or do some for whatever reasons revealed the only opportunity in performing exploratory burr hole for which outcomes are well known [3, 5, 13]. Even though, exploratory burr hole is still frequently performed, it is not a systematic therapeutic choice in our practice; it is just an illustration of our difficulties concerning TBI management in satisfactory manners [14]. This situation is similar to the one reported by Natarajan et al [9] in 1989 in India or Viswanathan et al [10] in Ethiopian in 2008.…”

Section: Discussionmentioning

confidence: 99%

The Exploratory Burr Hole: Indication and Results at One Departmental Hospital of Benin

et al. 2013

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Objective. The aim of this study was to describe the indications and results of exploratory burr hole performed at the Departmental Teaching Hospital of Borgou (Benin). Methods. It was a retrospective study performed from January 2008 to February 2011. It concerned patients with a closed traumatic brain injury (TBI) in which an exploratory burr hole was performed. The selection criteria were unilateral mydriasis associated with neurological deficits on the opposite side or the occurrence of a decreased consciousness associated with the appearance of a motor deficit after a lucid interval. Results. Amongst the 74 patients operated, 23 (31%) underwent an exploratory burr hole for which the average age was 24.8 ± 17.3 years. Sex ratio male/female was 3.6. TBI was due to road traffic accident (56.5%), a fall (26.1%), and an assault (17.4%). It was severe (47.8%), moderate (39.1%), and mild (13.1%). Mydriasis was observed in 69.6% of cases as well as neurological deficit in all patients. A lesion was observed in 15 (65.2%) cases. Conclusion. The exploratory burr hole seemed as an old practice, still no longer performed in full practice in Benin, and is a diagnosis and therapeutic approach. Better technical conditions would allow more relevant therapeutic options.

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Surgical Management of Head Trauma: Problems, Results, and Perspectives at the Departmental Teaching Hospital of Borgou, Benin

Cited by 21 publications

References 11 publications

Treatment and Outcome of Chronic Subdural Hematoma in Sub-Saharan Afrcia and the Country of Benin

Treatment and Outcome of Chronic Subdural Hematoma in Sub-Saharan Afrcia and the Country of Benin

Complicações pós-operatórias em neurocirurgia eletiva e não eletiva

The Exploratory Burr Hole: Indication and Results at One Departmental Hospital of Benin

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