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Management of spontaneous intracerebral haemorrhage (sICH) at the University Hospital of Brazzaville (CONGO)

Neuroscience & Medicine 2024年第1期15卷 23-38页

作者： Ekouele Mbaki Hugues Brieux Ngoma Niangui Léocia Exaucée Diatewa Josué Euberma Boukaka Kala Rel Gerald Ngackosso Olivier Brice Mpandzou Ghislain Armel Boukassa Léon Ossou-Nguiet Paul Macaire Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo Multipurpose Surgery Department University Hospital Center of Brazzaville Brazzaville Republic of the Congo Neurology Department University Hospital Center of Brazzaville Brazzaville Republic of the Congo

spontaneous intracerebral haemorrhage (sICH) is characterised by bleeding within the brain parenchyma, without any accompanying vascular malformation, parenchymal abnormality or coagulation disorder. The study aimed to depict the management of sICH at the University Hospital of Brazzaville (UHB). It was an observational, descriptive, and cross-sectional analysis. Data collection was conducted retrospectively, covering the period from January 1, 2020 to August 31, 2022, spanning two years and eight months. The study examined socio-demographic, diagnostic, therapeutic, and evolutionary variables. We included 274 cases. We observed 160 men (58.4%) and 114 women (41.6%), resulting in a sex ratio of 1.4. The mean age was 55.3 ± 11.4 years, with ages ranging from 31 to 93 years. The detection of sICH was typically a result of experiencing motor deficits (59.5%) or disorders of consciousness (37.2%). The weightiness of one half of the body was the most common reason for seeking medical advice. Hematoma was capsulo-lenticular in 159 cases (58%) and capsulo-thalamic in 63 cases (23%). Hematomas were 30 ml in 112 cases (40.9%), and associated with hydrocephalus in 11.7% of cases. Conservative medical treatment was administered in 257 cases (94.2%) while surgical treatment was performed in 16 cases (5.8%). The surgical techniques used were external ventricular drainage (EVD) in 2 cases, ventriculo-peritoneal shunt in 5 cases, and hematoma evacuation in 10 cases. Death occurred before the 7th day of hospitalisation in 73 cases (57.8%) and after in 46 cases (42.2%). The median time to death was four days (Q1 = 2 days;Q3 = 7 days), with extremes of 0 and 216 days. .

关键词： spontaneous intracerebral haemorrhage Management Brazzaville

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spontaneous intracerebral Hemorrhage: Epidemiology, Clinical Profile and Short-Term Outcome in a Tertiary Hospital in Sub-Saharan Africa

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World Journal of Neuroscience 2020年第3期10卷 141-154页

作者： Jacques Doumbe Khadidja Abdouramani Daniel Massi Gams Chia Mark Ayeah Caroline Kenmegne Yacouba Njankouo Mapoure Department of Clinical Sciences University of Douala Douala Cameroon Department of Epidemiology School of Public Health University of Ghana Accra Ghana Department of Clinical Sciences University of Buea Buea Cameroon Neurological Unit Douala General Hospital Douala Cameroon

Background: Data on spontaneous intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were to determine the prevalence of SICH, describe the clinical profile, aetiology and evaluate the prognosis (fatality case, functional outcome) of patients in a tertiary health care hospital in Cameroon. Methods: This was a hospital-based retrospective cohort which included patients with SICH and followed up for 6 months after stroke. Subarachnoid haemorrhage, cerebral venous thrombosis with bleeding or bleeding related with ischemic or brain tumour were excluded. Predictive factors were obtained using multiple logistic regression and survival by Kaplan Meier method. Results: The prevalence of SICH was 37% with male predominance (64.0%), a mean age of 55.6 ± 11.8 years. Deep coma was found in 30.3% on admission. The basal ganglion was the most frequent location of haemorrhage (85.1%) while intraventricular blood effusion, mass effect, cerebral oedema and herniation occurred in 31.4%, 25.7%, 8.8% and 5.0% respectively. Hypertension (57.5%) was the most common aetiology. The mean length of hospitalization was 9.0 ± 7.7 days and chest infection (30.7%) was the most frequent complication. The cumulative case fatality rate after 24 hours (day 1), during admission, month 1 and month 3 was 9.6%, 39.9%, 46.0%, 59.8% respectively. On multivariate analysis, GCS -month survival was 37.8%. Conclusion: About one-third of stroke patient were haemorrhagic. Hypertension is the leading CV

关键词： spontaneous intracerebral haemorrhage Epidemiology Prognosis Africa

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