Management of Chronic Subdural Hematoma in Adults at the Renaissance University Hospital Center in Ndjamena (Chad)
Mots-clés :
hematoma, headRésumé
Introduction: A chronic subdural hematoma (CSDH) is a collection of old blood between the dura mater and the cranial arachnoid. It is a commonly encountered condition in neurosurgery. The goal of the study was to describe the epidemiological, clinical, paraclinical, therapeutic, and evolutionary aspects of CSDH. Methodology: This was a prospective observational and descriptive study conducted over a 22-month period. Any patient presenting with CSDH on a cerebral CT scan and consenting to take part in the study was included. Results: CSDH accounted for 17% of cranial conditions hospitalized and 46.05% of intracranial hematomas. The patients' mean age was 56 +/- 17.6 years, with 42.8% ranging from 61 to 80 years. In 85.7% of cases, head trauma was the cause of the CSDH. High blood pressure was identified as a risk factor in 37.1% of the cases. COVID-19 was associated with two cases of CSDH. 17.1% of patients were dehydrated. Anemia was found in 65.7% of cases. In 57.1% of cases, the hematoma was located in the left hemispheric region. Surgery was performed in 85.7% of the cases. In 91.4% of cases, the post-therapeutic outcome was favorable. The overall mortality rate was 8.6%. Conclusion: In our practice, CSDH is a relatively common but underdiagnosed condition. The prognosis is favorable if treated early.
Références
Guénot M. Hématome sous dural chronique : de la clinique au traitement. La lettre du neurologue. mars 2003; 7(3):89‑92.
Cuny E, Roche P-H, Moreau J-J, Vignes B JR, C B, K. Neurochirurgie. 1ère. Paris: Elsevier Masson SAS; 2016. 145-6.
Doleagbenou A.K, Ahanogbe H.K, Kpelao E.S, Beketi A.K, Egu K. Bilan de 24 mois d’activités neurochirurgicales au Centre Hospitalier Universitaire Régional Lomé commune (Togo). Africain Journal of Neurochirurgies sciences. 2019; 38(1):3-10.
Dongmo L, Juimo A.G, Eloundou N.J, Njamnshi A.K, Avdeeva V, Tiyou C. Hématome sous dural chronique au Cameroun. Aspects cliniques, radiologiques et thérapeutiques. A propos de 43 cas. Méd Afr. Noire. 1999; 46 (3)
Ekouele M.H.B, Boukassa L, Ngackosso OB, Otiobanda GF, Matali E, Moyikoua R, et al. Hématomes sous-duraux chroniques. Ann. Univ. M NGOUABI. 2016; 16(1):19‑26.
Minna R, Pauli H, Heini H, Paula H, Garant L.I, Tero N et al. Chronic subdural hematoma-incidence, complications and financial impact. Acta Neurochirurgica. 2020; 162: 2033-43.
Bankole O.B, Yusuf A.S, Kanu O.O, Efosa U, Nadi M.N, Arigbabu S.O. Chronic subdural haematoma: Clinical presentation, surgical treatment and outcome at the Lagos University teaching Hospital. African Journal of Neurological Sciences. 2011; 30(1), 10-17
Djintcheu V.P, Esiene A, Yamgoue T, Tchaleu B, Minkande J. Traitement chirurgical et devenir de 195 cas d’hématomes sous duraux non aigus à l’hôpital central de Yaoundé : Nécessité d’un point de repère pour les 2 trous de trépan ; African Journal of Neurological Sciences. 2011; 30(2): 21-27.
Adachi A, Higuchi Y, Fujikawa A, Machida T, Sueyoshi S, et al. Risk Factors in Chronic Subdural Hematoma: Comparison of Irrigation with Artificial Cerebrospinal Fluid and Normal Saline in a Cohort Analysis. PLoS ONE 9(8) 2014: e103703. doi:10.1371/journal.pone.0103703
Miguel Gélabert Gonzalez et al., Chronic subdural heamatoma: Surgical treatment and outcome in 1000 cases. Clinical Neurology and Neurochurgery 3 April 2005; 107: 223-9
Ayele A, Kuma A, Kifelew S, Tafesse A, Tirsit A. Hématome sous dural chronique bilatéral secondaire à une ponction lombaire. African Journal of Neurological Sciences. 2020; 39(5).
Liliang PC, Tsai YD, Liang CL, Lee TC, Chen HJ. Subdural haematoma in young and extremely aged adults: a comparative study of two age groups. Injury, Int J. Care Injured. 2002: 33(4): 345-348.
Mwanyombet L.O, Lada, Loembe P. Traitement des hématomes sous duraux chroniques à Libreville : Revue de 102 cas. African Journal of Neurochirurgie Science. 2011; 30(2):29.
Emerson B, Bodelson M, Larsson EM, Rommer B. Spontaneous intracranial hypotension resulting in coma: case report. Neurochurgery. 2013; 59(1): E204.
Jomli R., Zgueb Y., Nacef F., Douki S.. Hématome sous dural chronique et decompensation psychotique. L’Encephale. 2012 ; 38(1) : 356-9.
Broalet E., Haidara A., N’Dori Oka D., Topka A. Complications de la chirurgie de l’hématome sous dural chronique de l’adulte. Rev. Col. Odonto-stomatol. Afr. Chir. Maxilo-fac. 2011; 18(3): 53-7.
Markwalder TM, Steinsieger KF. Classification clinique des hématomes sous-duraux. J Neurosurg 1981; 55: 390- 6.
Okada Y, Akai T, Okamoto K, Iida T, Takata H, Iizuka H. A comparative study of the treatment of chronic subdural haematoma: burr hole drainage versus burr hole irrigation. Surg Neurol. 2002; 57(6): 405-9
Bakhti S. Les hématomes sous duraux chroniques de l’adulte : proposition d’un protocole de prise en charge 2012 ; 236-249.
Dran G, Bertheir F, Fontaine D, Rasenrarijao D, Paquis P. Efficacité de la corticothérapie dans le traitement adjuvant des hématomes sous-duraux chroniques. Etude rétrospective sur 198 cas. Science Direct. 2007; 6: 277-82.
Hamilton MG, Frizzel JB, Tranmer BI. Chronic subdural hematoma: the role for craniotomy reevaluated. Neurosurgery1993; 3(3): 67-72.89.
Mori K, Maeda M. Risk factors for the occurence of chronic subdural haematoma after neurosurgical procedures. Acta Neurochir (Wien); 2003: 145(7): 533-540.
Sambasivan M. An overview of chronic subdural hematoma: Experience with 2300 cases. Surg Neurol 1997; 47(1): 418-422.
Pancalet P. Formes cliniques et facteurs pronostics de l’hématome sous dural chronique de l’adulte. Neurochirurgie; 2001: 47(5): 469-72.
Téléchargements
Publiée
Comment citer
Numéro
Rubrique
Licence
(c) Tous droits réservés East African Journal of Neurological Sciences 2023
Ce travail est disponible sous licence Creative Commons Attribution - Pas d'Utilisation Commerciale - Pas de Modification 4.0 International.
