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Interest of Transcranial Doppler (TCD) in Emergency in Traumatic Brain Injury Patients at Gabriel Touré University Hospital, Bamako, Mali

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Open Journal of Emergency Medicine 2024年第3期12卷 114-121页

作者： Abdoulhamidou Almeimoune Moustapha Mangane Madane Thierno Diop Mahamadoun Coulibaly Amadou Gamby Dramane Sanogo Alfousseini Soumare Adama Coulibaly Ababacar Salaha harouna sangaré Diango Djibo Mahamane Department of Intensive Care Anesthesia and Emergency Medicine CHU Gabriel Toure Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technology of Bamako Bamako Mali Department of Intensive Care Anesthesia CHU Luxembourg Luxembourg City Luxembourg

Introduction: Transcranial Doppler is a simple, non-invasive and inexpensive examination which allows the assessment of cerebral perfusion. In countries with limited resources, which do not have a means of monitoring intracranial pressure, this examination offers hope of survival for patients with traumatic brain injury. This study was designed to investigate the incidence of early cerebral circulation abnormalities after traumatic brain injury using transcranial Doppler (TCD). Methodology: A descriptive and analytical study was conducted over one year, including patients with traumatic brain injury and an initial Glasgow Coma Scale (GCS) score of less than 15. Non-inclusion criteria: Stroke, brain tumor, cerebral abscess. Exclusion criteria: Inadequate insonation window. Results: Out of 854 traumatic brain injury patients admitted to the emergency department, 112 were included in the study. The average age was 30.14 years, with a sex ratio of 4.1. Initially, 83.5% had moderate traumatic brain injury, and 12.1% had severe traumatic brain injury. Brain CT scans were performed in 95.7% of the patients. Edematous-hemorrhagic contusion was observed in 95% of the patients. On initial TCD, the pulsatility index in the middle cerebral artery was greater than 1.3 in 49.4% of the patients. Diastolic velocity was less than 20 cm/s in 46.4% of cases, and mean velocity was greater than 150 cm/s in 8.7% of cases. In this group, low diastolic velocity indicated cerebral hypoperfusion suggestive of intracranial hypertension. When the pulsatility index was greater than 1.9, no patient had a normal diastolic velocity. Among patients with severe traumatic brain injury, 61.5% had an abnormal pulsatility index compared to 42.3% of patients with moderate traumatic brain injury. Conclusion: TCD is a simple tool for analyzing intracerebral hemodynamics.

关键词： Traumatic Brain Injury TCD Neuroresuscitation Sub-Saharan Africa

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Blows and Voluntary Wounds of the Emergency Unite in Gabriel Toure Teaching Hospital in Bamako

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Surgical Science 2018年第9期9卷 334-343页

作者： Mangané Moustapha Diop Thierno Madane Almeimoune Abdoul Hamidou Keita Soumaila Dembelé Aladji Seydou Youssouf Sogoba Konaté Madiassa Koita Siriman Traoré Amadou Issa Amadou Badimi Siaka Abdoulaye Kanté Diallo Sadio sangaré harouna Dembelé Bakary Tientigui Togo Adegné Diango Djibo Mahamane Department of Anesthesiology and ICU H&#244 pital Gabriel Touré Bamako Mali Department of General Surgery H&#244 pital du Point G Bamako Mali Department of Anesthesiology H&#244 pital IOTA Bamako Mali Department of Neurosurgery H&#244 pital Gabriel Touré Bamako Mali Department of General Surgery H&#244 pital Gabriel Touré Bamako Mali Department of Anesthesiology and ICU H&#244 pital Mère-Enfant Bamako Mali Department of Pediatric Surgery H&#244 pital Gabriel Touré Bamako Mali

Introduction: Voluntary assault and injuries are acts that damage the physical and psychological integrity of a human being. WHO in its global report on violence and health estimates that in 2000, 1.6 million people worldwide died as a result of self-harm, interpersonal or collective violence, resulting in an overall rate adjusted by age of 28.8 per 100,000 population. Because of the seriousness of this phenomenon and the heavy socio-economic and health consequences that they generate, it seemed important to us to undertake this study, which aimed to study the deliberate injuries in the emergency unite of the Gabriel Touré Teaching Hospital in Bamako. Material and methods: This was a descriptive and cross-sectional study with a prospective study from September 1st, 2016 to August 31st, 12 months, covering 295 patients, including any patient received for voluntary injury consultation with a workable medical record and/or a full investigation record with or without requisition. Our data were collected on individual survey cards and subsequently analyzed with Word, Excel, IBM SPSS Statistics 22 software. Results: The majority of victims of assault and bodily injury were male with 83.1%;with a sex ratio of 4.9, the 18 to 28 age group was the most concerned with 163 cases of the 295 cases in our study, 55.2%. The extremes were 6 and 100 years old with an ectype at 11.08. The most affected ethnic group was Bambara with 38.6% (n = 114) followed by Fulani with 15.6% (n = 46). Students were the most affected at 24.7% (n = 73), followed by traders at 10%. The victims coming from outside Bamako are the most predominant with 22.4% (n = 66) followed by those of commune IV of Bamako 15.6% (n = 46). In 92.2% of the cases the mechanism was direct with n = 272. Of the lesions recorded in our study, wounds came first with 53.2% of cases. Radiography was the most used imaging at 44.7% (n = 89) followed by computed tomography at 34.7% (n = 69). The hemoperitoneum objectified by abdomin

关键词： Blows Wounds EU Gabriel Touré University Hospital

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