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1Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo
2Department of Multipurpose Surgery, University Hospital Center of Brazzaville, Brazzaville, Congo
3Department of Intensive Care, University Hospital of Brazzaville, Brazzaville, Congo
The aim of this study was to describe the treatment of chronic subdural hematoma (CSDH) in a neurosurgical setting, at the University Hospital Centre of Brazzaville. We conducted a descriptive study with retrospective data collection from 2014 to 2021 (a period of eight years). We included adult patients treated at the hospital for this condition. The variables studied were diagnostic, therapeutic and evolutionary. We selected 81 patients. They were over 60 years old in 49 cases (60.5%). The Glasgow coma scale was between 13 and 15 in 50 cases (61.7%). The Markwalder grade was 1 in 34 cases (42%) and 3 in 24 cases (29.6%). The hematoma was unilateral in 62 cases (76.6%) and bilateral in 19 cases (23.4%). The thickness of the hematoma was greater than or equal to 2 cm in 64 cases (79%). All patients underwent surgery. Single burr hole surgery was performed in 68 patients (84%). Drainage was placed in all the patients. The outcome was favourable in 43 cases (53.1%). Complications were noted in 38 cases (46.9%). Five patients (6.2%) died, including two cases of empyema, two cases of neurological deterioration and one case of postoperative sepsis. In univariate analysis, we found a statistically significant association between the Glasgow coma scale (P = 0.0004) and the thickness of the CSDH (P = 0.02) with the occurrence of complications. In multivariate analysis, the Glasgow Coma Scale and bilateral nature were factors influencing the occurrence of complications, adjusting for age and the hematoma thickness. Patient care may be improved by early surgical treatment in a patient with a favourable Glasgow score. Surgical techniques are varied, but postoperative drainage seems essential.
Chronic Subdural Hematoma, Surgery, Brazzaville
Ekouele Mbaki Hugues Brieux, Gapoula Syntiche Cécilia, Boukaka Kala Rel Gerald, Thouassa Gédéon Colin, Ngackosso Olivier Brice, et al. (2023). Treatment of Chronic Subdural Hematoma in Adults at the University Hospital of Brazzaville (Congo). International Journal of Neurosurgery, 7(2), 41-45. https://doi.org/10.11648/j.ijn.20230702.15
Copyright © 2023 Authors retain the copyright of this article.
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