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Decompressive Craniectomy at the National Hospital of Niamey: Prospective Study of the Epidemioclinical Profil, Indications, Surgical Techniques, and Results in a Context of Limited Resources

Article scientifique 2024 Anglais

Résumé

Abstract Background: Decompressive craniectomy (DC) is a neurosurgical technique that is receiving renewed interest because of the resurgence of head injuries worldwide. Our aim was to analyze the quality of management and prognosis of patients who underwent this surgery in the context of limited resources. Methods: This was a prospective, longitudinal, descriptive, and analytical study following STROBE, lasting 36 months (October 2020 to October 2023) at the National Hospital of Niamey in patients who had undergone DC. A p value ≤ 0.05 was considered to indicate statistical significance. Results: During our study, we collected 74 cases of DC. The mean age was 32.04 years (10 to 75 years), and there was a male predominance (91.89%). DC was performed mainly following head trauma (95.95%; 71/74), the main cause of which was road traffic accidents (76%; 54/71). On admission, most patients presented with altered consciousness (95.95%) and pupillary abnormalities (62.16%). The average time to complete the brain scan was 31.28 hours, with parenchymal contusion being the most common lesion (90.54%). The majority of patients (94.59%) underwent decompressive hemicraniectomy. Postoperative complications occurred in 71.62% of all patients, 33.78% (25/74) of whom died. Among survivors, 55.10% had neurological sequelae at the last consultation (27/49). The main factors associated with the risk of death and morbidity were a Glasgow Coma Scale (GCS) ≤ 8, pupillary abnormality on admission, presence of signs of brain engagement, and a long admission delay. Conclusions: Our study showed that the impact of limited resources on our care is low. However, it is crucial to develop judgment criteria that are adaptable to our realities.

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Hamma, O., Kelani, A., Ango, S., Hissene, T., Mobarak, S., Tounga, Y., Assoumane, I., Dechambenoit, G. (2024). Decompressive Craniectomy at the National Hospital of Niamey: Prospective Study of the Epidemioclinical Profil, Indications, Surgical Techniques, and Results in a Context of Limited Resources. https://doi.org/10.21203/rs.3.rs-4178683/v1

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Ousmane Issoufou Hamma Aminath Kelani Souleymane Mahamadou Ango Tidjani Mahamat Hissene Salifou Mahamane Mobarak Yahouza Boka Tounga Ibrahim Issa Assoumane Gilbert Dechambenoit

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