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Abstract
RÉSUMÉ
Objectif. Le but de ce travail était d’évaluer la prise en charge des traumatismes crâniens de l’enfant au CHU Sylvanus Olympio de Lomé au Togo. Patients et méthode. Nous avons réalisé une étude rétrospective descriptive de novembre 2017 et juin 2021. Nous avons exploité les dossiers médicaux de tous les enfants de 0 à 17 ans admis pour un traumatisme cranio-encéphalique, au CHU Sylvanus Olympio de Lomé. Les paramètres étudiés étaient les données démographiques, cliniques paracliniques, les modalités du traitement chirurgical. Résultats. Cent quatre-vingt-quatorze enfants ont été retenus. Leur âge moyen était de 9,48 ± 5,43 ans. La tranche de 12 – 17 ans était la plus représentée. Notre série comportait 73 (37,6%) filles et 121 (62,4%) garçons, soit un sex-ratio de 1,65. Les accidents de la voie publique (62,88% ; n = 122) ont été la principale cause des traumatismes crâniens, suivis des chutes (31,95% ; n= 62). La contusion cérébrale était la lésion la plus observée (38,7% ; n=75), suivie des plaies crânio-cérébrales (12,4% ; n=24). La chirurgie a concerné 81 cas (41,8%) avec une évolution favorable. Quinze enfants (7,73%) de la série ont présenté des séquelles à la sortie. Pour l’ensemble de la série, l’évolution a été favorable dans 92,24% des cas (n=179) ; et la mortalité était de 1% (2 enfants). Conclusion. Les accidents de la voie publique et les chutes sont les principales causes de traumatismes crâniens chez l'enfant. Les lésions chirurgicales doivent être opérées dans les délais. L’évolution dépend du score de Glasgow à l’admission. La prévention routière doit être accentuée.
ABSTRACT
Background. This study aims to describe the management of pediatric traumatic brain injuries (TBI) at Sylvanus Olympio Teaching Hospital, in Lomé (Togo). Patients and methods. We reviewed the data of children aged between one month to 17 years old, who were admitted for TBI, in the neurosurgical unit of Sylvanus Olympio Teaching Hospital. This study was conducted from november 2017 and june 2021. We analysed epidemiological, clinical and diagnostic features, management and outcome variables. Results. During the sutdy period, 194 children were included. There were 73 (37.6%) girls and 121 (62,4%) boys. The average age was 9.48 ± 5.43. The common mechanism of injury overall was road traffic injury, which was responsible for TBI in 62.88% of all TBI cases. Brain contusion was the commonest lesion in 38.7% of cases. Surgery concerned 81 patients (41.8%), with good evolution. Fifteen children (7.73%) had a sequela at discharge from the hospital. The global mortality was 1%. Conclusion. Road traffic accidents and falls are the main causes of TBI in children. Surgical injuries must be operated on in a timely manner. The evolution depends on the Glasgow score on admission. Road safety should be emphasized.
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References
- Mathé J-F, Richard I, Rome J. Santé publique et traumatismes crâniens graves. Aspects épidémiologiques et financiers, structures et filières de soins. Ann Fr Anesth Réanimation. 2005 Jun 1;24(6):688–94.
- Assiry KA, Abdulmutali HA, Alqahtani AA, Alyahya AA, Elawad ME. Traumatic Head Injuries in Children: Experience from Asir, KSA.
- Qureshi JS, Ohm R, Rajala H, Mabedi C, Sadr-Azodi O, Andrén-Sandberg Å, et al. Head injury triage in a sub Saharan African urban population. Int J Surg. 2013 Apr 1;11(3):265–9.
- Udoh DO, Adeyemo AA. Traumatic brain injuries in children: A hospital-based study in Nigeria. Afr J Paediatr Surg. 2013 Jan 4;10(2):154.
- Ekouele Mbaki H, Moyen E, Mieret J, Ngackosso O, Moyen G. Article Original Traumatismes Crâniens de l’Enfant: Aspects Épidémiologiques et Prise en Charge au Centre Hospitalier Universitaire de Brazzaville. 2018 Apr 2;
- Skull fractures in children: a population study. | Emergency Medicine Journal [Internet]. [cited 2021 Aug 23]. Available from: https://emj.bmj.com/content/13/6/386.short
- Shahrokh Yousefzadeh C, Sara R, Leila K, Zahra S. Epidemiology of pediatric head trauma in Guilan. 2012;19–22.
- Chong S-L, Chew SY, Feng JXY, Teo PYL, Chin ST, Liu N, et al. A prospective surveillance of paediatric head injuries in Singapore: a dual-centre study. BMJ Open. 2016 Feb 1;6(2):e010618.
- Abdelgadir J, Punchak M, Smith ER, Tarnasky A, Muhindo A, Nickenig Vissoci JR, et al. Pediatric traumatic brain injury at Mbarara Regional Referral Hospital, Uganda. J Clin Neurosci. 2018 Jan 1;47:79–83.
- Pd A, Sl B, Na C, Rm C, He du C, B G, et al. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Chapter 5. Indications for intracranial pressure monitoring in pediatric patients with severe traumatic brain injury. Pediatr Crit Care Med J Soc Crit Care Med World Fed Pediatr Intensive Crit Care Soc. 2003 Jul 1;4(3 Suppl):S19-24.
- Hode L , Sogbo DHO, Hounnou MG, Houessou GF, Voyeme A.K.A, Chobli M. Prise en charge des traumatismes cranioencéphaliques chez les enfants à Cotonou. AJNS 2016; 35(1): 55-65
- Agrawal A, Agrawal CS, Kumar A, Lewis O, Malla G, Khatiwada R, et al. Epidemiology and management of paediatric head injury in eastern Nepal. Afr J Paediatr Surg AJPS. 2008 Jun;5(1):15–8.
- Satapathy MC, Dash D, Mishra SS, Tripathy SR, Nath PC, Jena SP. Spectrum and outcome of traumatic brain injury in children <15 years: A tertiary level experience in India. Int J Crit Illn Inj Sci. 2016 Mar;6(1):16–20.
- Esmaeil F, Mahdi M, Samin B, Atoosa B, Sadat MA, Javad M. A SEVEN-YEAR STUDY ON HEAD INJURY IN INFANTS: THE CHANGING PATTERN. 2015 Jan 1;20(0):9–9.
- Johnstone AJ, Zuberi SH, Scobie WG. Skull fractures in children: a population study. Emerg Med J. 1996 Nov 1;13(6):386–9.
- Doléagbénou AK, Ahanogbé HK, Kpélao E, Békéti KA, Egu K. Aspects Épidémiologiques et Prise en Charge Neurochirurgicale des Traumatismes Cranioencéphaliques de l’Adulte au Centre Hospitalier Universitaire Sylvanus Olympio de Lomé. Health Sci Dis [Internet]. 2019 Oct 14 [cited 2021 Aug 31];20(6). Available from: http://hsd-fmsb.org/index.php/hsd/article/view/1648
- Lloyd DA, Carty H, Patterson M, Butcher CK, Roe D. Predictive value of skull radiography for intracranial injury in children with blunt head injury. The Lancet. 1997 Mar 22;349(9055):821–4.
- Trabold F, Meyer P, Orliaguet G. Les traumatismes crâniens du nourrisson et du petit enfant : prise en charge initiale1Travail présenté aux XXIIIes Journées de l’Association de neuroanesthésie-réanimation de langue française, Lille 29-30 novembre 2001. Ann Fr Anesth Réanimation. 2002 Feb 1;21(2):141–7.
- Pillai S, Praharaj SS, Mohanty A, Kolluri VRS. Prognostic Factors in Children with Severe Diffuse Brain Injuries: A Study of 74 Patients. Pediatr Neurosurg. 2001;34(2):98–103.
- Fujii T, Moriel G, Kramer DR, Attenello F, Zada G. Prognostic factors of early outcome and discharge status in patients undergoing surgical intervention following traumatic intracranial hemorrhage. J Clin Neurosci Off J Neurosurg Soc Australas. 2016 Sep;31:152–6.
References
Mathé J-F, Richard I, Rome J. Santé publique et traumatismes crâniens graves. Aspects épidémiologiques et financiers, structures et filières de soins. Ann Fr Anesth Réanimation. 2005 Jun 1;24(6):688–94.
Assiry KA, Abdulmutali HA, Alqahtani AA, Alyahya AA, Elawad ME. Traumatic Head Injuries in Children: Experience from Asir, KSA.
Qureshi JS, Ohm R, Rajala H, Mabedi C, Sadr-Azodi O, Andrén-Sandberg Å, et al. Head injury triage in a sub Saharan African urban population. Int J Surg. 2013 Apr 1;11(3):265–9.
Udoh DO, Adeyemo AA. Traumatic brain injuries in children: A hospital-based study in Nigeria. Afr J Paediatr Surg. 2013 Jan 4;10(2):154.
Ekouele Mbaki H, Moyen E, Mieret J, Ngackosso O, Moyen G. Article Original Traumatismes Crâniens de l’Enfant: Aspects Épidémiologiques et Prise en Charge au Centre Hospitalier Universitaire de Brazzaville. 2018 Apr 2;
Skull fractures in children: a population study. | Emergency Medicine Journal [Internet]. [cited 2021 Aug 23]. Available from: https://emj.bmj.com/content/13/6/386.short
Shahrokh Yousefzadeh C, Sara R, Leila K, Zahra S. Epidemiology of pediatric head trauma in Guilan. 2012;19–22.
Chong S-L, Chew SY, Feng JXY, Teo PYL, Chin ST, Liu N, et al. A prospective surveillance of paediatric head injuries in Singapore: a dual-centre study. BMJ Open. 2016 Feb 1;6(2):e010618.
Abdelgadir J, Punchak M, Smith ER, Tarnasky A, Muhindo A, Nickenig Vissoci JR, et al. Pediatric traumatic brain injury at Mbarara Regional Referral Hospital, Uganda. J Clin Neurosci. 2018 Jan 1;47:79–83.
Pd A, Sl B, Na C, Rm C, He du C, B G, et al. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Chapter 5. Indications for intracranial pressure monitoring in pediatric patients with severe traumatic brain injury. Pediatr Crit Care Med J Soc Crit Care Med World Fed Pediatr Intensive Crit Care Soc. 2003 Jul 1;4(3 Suppl):S19-24.
Hode L , Sogbo DHO, Hounnou MG, Houessou GF, Voyeme A.K.A, Chobli M. Prise en charge des traumatismes cranioencéphaliques chez les enfants à Cotonou. AJNS 2016; 35(1): 55-65
Agrawal A, Agrawal CS, Kumar A, Lewis O, Malla G, Khatiwada R, et al. Epidemiology and management of paediatric head injury in eastern Nepal. Afr J Paediatr Surg AJPS. 2008 Jun;5(1):15–8.
Satapathy MC, Dash D, Mishra SS, Tripathy SR, Nath PC, Jena SP. Spectrum and outcome of traumatic brain injury in children <15 years: A tertiary level experience in India. Int J Crit Illn Inj Sci. 2016 Mar;6(1):16–20.
Esmaeil F, Mahdi M, Samin B, Atoosa B, Sadat MA, Javad M. A SEVEN-YEAR STUDY ON HEAD INJURY IN INFANTS: THE CHANGING PATTERN. 2015 Jan 1;20(0):9–9.
Johnstone AJ, Zuberi SH, Scobie WG. Skull fractures in children: a population study. Emerg Med J. 1996 Nov 1;13(6):386–9.
Doléagbénou AK, Ahanogbé HK, Kpélao E, Békéti KA, Egu K. Aspects Épidémiologiques et Prise en Charge Neurochirurgicale des Traumatismes Cranioencéphaliques de l’Adulte au Centre Hospitalier Universitaire Sylvanus Olympio de Lomé. Health Sci Dis [Internet]. 2019 Oct 14 [cited 2021 Aug 31];20(6). Available from: http://hsd-fmsb.org/index.php/hsd/article/view/1648
Lloyd DA, Carty H, Patterson M, Butcher CK, Roe D. Predictive value of skull radiography for intracranial injury in children with blunt head injury. The Lancet. 1997 Mar 22;349(9055):821–4.
Trabold F, Meyer P, Orliaguet G. Les traumatismes crâniens du nourrisson et du petit enfant : prise en charge initiale1Travail présenté aux XXIIIes Journées de l’Association de neuroanesthésie-réanimation de langue française, Lille 29-30 novembre 2001. Ann Fr Anesth Réanimation. 2002 Feb 1;21(2):141–7.
Pillai S, Praharaj SS, Mohanty A, Kolluri VRS. Prognostic Factors in Children with Severe Diffuse Brain Injuries: A Study of 74 Patients. Pediatr Neurosurg. 2001;34(2):98–103.
Fujii T, Moriel G, Kramer DR, Attenello F, Zada G. Prognostic factors of early outcome and discharge status in patients undergoing surgical intervention following traumatic intracranial hemorrhage. J Clin Neurosci Off J Neurosurg Soc Australas. 2016 Sep;31:152–6.