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ABSTRACT
Introduction. Subarachnoid Hemorrhages (SAH) secondary to ruptured aneurysm (RA) are frequent and severe pathologies. Methods. From January 1st 2016 to December 31st 2020, all consecutive spontaneous SAH cases admitted in the teaching hospitals of Yaounde were analyzed. Results. During the study period, 774 stroke cases were registered, including 90 cases of SAH (11.63) with a sex ratio of 1/1.5. The median age was 49 years [range: 17 – 72. The patients were admitted to the internal medicine unit (48), the neurosurgery unit (37) and the intensive care unit (15). The classification was WFNS I (47.9), WFNS II (27.1), WFNS III (10.4), WFNS IV (10.4) and WFNS V (4.2). Positive diagnosis was made by CT scan (85.4), MRI (14.6) and lumbar puncture combined to CT scan (10.4). The delay was 24hrs (33%), 24-48hrs (17), after 72hrs (50); Fischer modified score was Grade I (29.2), Grade II (25), Grade III (22.9). The main etiology found was ruptured aneurysms (76) and arteriovenous malformation (10). Treatment consisted of microsurgical clipping of aneurysms and external CSF diversion; the other patients were treated medically. Conclusion. The high loss of patients from the admission to the neurosurgical consultation of SAH is common in Yaounde. It was due probably to disorientation of the patients, underdiagnosis and lack of endovascular equipment, the reinforcement of knowledge for a better screening and orientation of SAH to the right services and the right specialties in our environment is needed.


RÉSUMÉ
Introduction. Les hémorragies sous-arachnoïdiennes (HSA) secondaires à une rupture d’anévrisme sont des pathologies fréquentes et graves. Méthodes. Du 1er janvier 2016 au 31 décembre 2020, tous les cas spontanés consécutifs d’HSA admis dans les hôpitaux universitaires de Yaoundé ont été analysés. Résultats. Durant cette période, 774 cas d’AVC furent enregistrés, dont 90 cas d’HSA (11, 63 %) avec un sex ratio de 1/1, 5. L’âge médian était de 49 ans [de 17 – 72ans]. Les patients étaient admis en médecine interne (48%), en neurochirurgie (37%) et aux soins intensifs (15%). La classification était WFNS I (47, 9%), WFNS II (27, 1%), WFNS III (10, 4%), WFNS IV (10, 4%) et WFNS V (4, 2%). Un diagnostic positif a été posé par tomodensitométrie (85, 4 %), IRM (14, 6 %) et ponction lombaire combinée à la tomodensitométrie (10, 4 %). Le délai était de 24 heures (33%), de 24-48 heures (17 %) , après 72 heures (50 %); Le score modifié de Fischer était grade I (29,2 %), grade II (25 %) , grade III (22,9 %). L’étiologie principale était une rupture d’anévrismes (76 %) et une malformation artérioveineuse (10 %). Le clippage microchirurgical des anévrysmes et la derivation ventriculaire externe du LCR étaient les principaux traitements, les autres patients étant traités médicalement. Conclusion. La perte élevée de patients de l’admission à la consultation neurochirurgicale de l’HSA est fréquente à Yaoundé . Les raisons probables sont la mauvaise orientation des patients, le retard de diagnostic et l’absence de technologies pour la voie endovasculaire. Le renforcement des connaissances pour un meilleur dépistage et une meilleure orientation de l’HSA vers les bonnes spécialités dans notre environnement est nécessaire.

Keywords

subarachnoid hemorrhages, aneurysm, Yaounde, Cameroon hémorragie sous- arachnoïdienne, anévrysme, Yaoundé, Cameroun

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Author Biographies

VDP Djientcheu , Faculty of medicine and biomedical sciences, university of Yaounde I

NEUROCHIRURGIE

GA Douanla , 2 Yaounde general hospital

Neurochirurgie

NO Haman , Faculty of medicine and biomedical sciences, university of Yaounde I

Neurochirurgie

TO Ndome , Yaounde general hospital

Neurochirurgie

How to Cite
Djientcheu , V., Douanla , G., Haman , N., Bello , F., Ndome , T., Nguifo , F., Batamack , Y., Silatsa , D., Bijevé , M., & Potho , T. (2022). The Efficacy of Screening and Treatment of Ruptured Aneurysm in Sub-Saharan African Countries: Case of Yaounde, Cameroon . HEALTH SCIENCES AND DISEASE, 23(3). https://doi.org/10.5281/hsd.v23i3.3477
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