摘要
Objective: Intracranial suppurations are a cosmopolitan pathology whose prevalence depend of the region of the world. They are mostly caused by otolaryngological infections. Despite the progress, they remain serious diseases in Africa. The objective of this study was to report the epidemiology, clinical and etiological aspects of intracranial suppurations in Togo. Method: This was a retrospective and descriptive study carried out from January 1, 2012 to December 31, 2020 including all cases of intracranial suppuration treated in the neurosurgery unit of Sylvanus Olympio university hospital in Lomé. The evolution was evaluated at discharge, at 3 and 6 months after. Results: We collected 185 cases of intracranial suppuration. The average age of the patients was 12.6 years with a male predominance (72.4%). The main clinical signs were the infectious syndrome (92.4%), intracranial high pressure (51.4%), focal deficit (38.4%) and seizures (20.5%). An otolaryngological infections history was noted within 3 months in 72.4%. The brain CT scan noted a predominance of empyema (63.8%) mostly subdural (64.4%). Radiological sinusitis was found in 57.3%. We identified etiology in 69.2% predominated by otolaryngological causes. Patients received medical and surgical treatment in 77.3%. The bacteriology was positive only in 7 cases. The mortality rate was 15.1%, mostly no operated cases (78.6%). At 6 months 84% recovered without sequelae. The predictive prognostic factors for mortality were: coma (p 0.001), absence of surgical treatment (p 0.02). Conclusion: Intracranial suppuration remains frequent in our country, mainly due to otolaryngological pathologies. The clinical presentation is not always specific and Bergman’s triad is rarely complete. The results of treatment are good if it is early.
Objective: Intracranial suppurations are a cosmopolitan pathology whose prevalence depend of the region of the world. They are mostly caused by otolaryngological infections. Despite the progress, they remain serious diseases in Africa. The objective of this study was to report the epidemiology, clinical and etiological aspects of intracranial suppurations in Togo. Method: This was a retrospective and descriptive study carried out from January 1, 2012 to December 31, 2020 including all cases of intracranial suppuration treated in the neurosurgery unit of Sylvanus Olympio university hospital in Lomé. The evolution was evaluated at discharge, at 3 and 6 months after. Results: We collected 185 cases of intracranial suppuration. The average age of the patients was 12.6 years with a male predominance (72.4%). The main clinical signs were the infectious syndrome (92.4%), intracranial high pressure (51.4%), focal deficit (38.4%) and seizures (20.5%). An otolaryngological infections history was noted within 3 months in 72.4%. The brain CT scan noted a predominance of empyema (63.8%) mostly subdural (64.4%). Radiological sinusitis was found in 57.3%. We identified etiology in 69.2% predominated by otolaryngological causes. Patients received medical and surgical treatment in 77.3%. The bacteriology was positive only in 7 cases. The mortality rate was 15.1%, mostly no operated cases (78.6%). At 6 months 84% recovered without sequelae. The predictive prognostic factors for mortality were: coma (p 0.001), absence of surgical treatment (p 0.02). Conclusion: Intracranial suppuration remains frequent in our country, mainly due to otolaryngological pathologies. The clinical presentation is not always specific and Bergman’s triad is rarely complete. The results of treatment are good if it is early.
