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Management of Penetrating Cranioencephalic Trauma Caused by Sharp Metal Objects—Therapeutic and Evolutionary Aspects: 12 Cases at the Renaissance University Hospital in N’Djamena

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Open Journal of Modern Neurosurgery 2024年第2期14卷 170-178页

作者： goumantar félicien toudjingar Li-Iyane Olivier Ouambi Yannick Canton Kessely Donal Djasdé Mahouli fata Vounki Momar Codé Ba Neurosurgery Unit of Center Hospitalier Universitaire la Renaissance N&#8217Djamena Chad Neurosurgery Unit of CHU la Ré f&#233rence Nationale N&#8217Djamena Chad Neurosurgery Department of Centre Hospitalier National Universitaire de fann Dakar Senegal

Introduction: Cranioencephalic trauma caused by bladed weapons is rare, and that caused by sharp objects is exceptional. The aim of our study was to describe the clinical, therapeutic and evolutionary aspects. Materials and method: This was a descriptive and analytical study over a 48-month period at CHU la Renaissance from January 1, 2018 to December 31, 2021, concerning patients admitted for penetrating cranioencephalic trauma by pointed object. Results: Twelve cases, all male, of penetrating cranioencephalic sharp-force trauma were identified. The mean age was 34 ± 7 years, with extremes of 11 and 60 years. farmers and herders accounted for 31% and 25% of cases respectively. The average admission time was 47 hours. Brawls were the circumstances of occurrence in 81.2% of cases. Knives (33%), arrows (25%) and iron bars (16.6%) were the objects used. Altered consciousness was present in 43.8% of cases, and focal deficit in 50%. Scannographic lesions were fracture and/or embarrhment (12 cases), intra-parenchymal haematomas (6 cases) and presence of object in place (4 cases). Surgery was performed in 11 patients. Postoperative outcome was favorable in 9 patients. After 12 months, 2 patients were declared unfit. Conclusion: Penetrating head injuries caused by sharp objects are common in Chad. Urgent surgery can prevent disabling after-effects.

关键词： Penetrating Trauma Skull Encephalon Sharp Object Surgery Patient Outcome

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The Management of Lumbosciatic Disc Related Disease at Renaissance University Teaching Hospital of N’Djamena-Chad: About 156 Cases

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Open Journal of Modern Neurosurgery 2023年第1期13卷 25-32页

作者： goumantar felicien toudjingar Yannick Canton Kessely Ngaoussandjim Ndom-Assal Olivier Ouambi Donald Djasde Mahouli fata Vounki Alio Hamit Mahamat Momar Code Ba Department of Neurosurgery La Renaissance University Hospital N’Djamena Chad Department of Neurosurgery Reference Nationale University Hospital Center N’Djamena Chad Department of Neurosurgery Fann University Hospital Center Dakar Senegal

Introduction: Low back disc disease (LSD) is a neurosurgical condition with significant socioeconomic repercussions. The objective of this study was to determine the frequency and report the modalities of management. Methodology: This study on lumbosciatic disc disease was carried out in the neurosurgery department of the University Hospital Center (CHU), la Renaissance in N’Djamena. It covered a period of 12 months (from September 2019 to August 2020). A descriptive and an analytical approach were used. The variables studied were epidemiology, clinic, radiology and therapy. Results: the results showed that LSD represented 14.7% of the reasons for consultation in neurosurgery. The average age was 45.8, and to some extent, it ranges between 18 and 76. Lifting was the main reason behind lumbosciatic disc disease with 35.9% of cases, followed by a sedentary life style which represents 30.8%. Lumbosciatica L5 was noted in 49.4%. Obesity and overweight were significant risk factors (P = 0.02) reported in 59% of cases. Motor and sensory deficits were observed in 14.8% and 17.3% of cases, respectively. CT of the lumbar spine was performed in 91% and MRI in 28.9%. The L4-L5 disc herniation represented 74.3% of cases, with a lateral location in 44.2% and L5 radicular impingement in 30.8%. Conservative treatment was instituted in 87.2% and surgical treatment in 12.8% of cases. Conclusion: LSD is caused by a sedentary lifestyle, physical work and overweight. Surgery deals with complicated cases and cases not responding to conservative treatment.

关键词： Lumbosciatica Herniated Disc Surgical Treatment Conservative Treatment Chad

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