The authors report on their experience in the medical and surgical management of three cases of penetrating craniocerebral injuries caused by a nail. In all three cases, it was an aggression. Two of the three patients...The authors report on their experience in the medical and surgical management of three cases of penetrating craniocerebral injuries caused by a nail. In all three cases, it was an aggression. Two of the three patients were male. The cranial locations affected were respectively left parietal, right temporal and right frontal. The Glasgow coma score (GCS) was between 9 and 13. None of the patients had a motor deficit. A plain skull radiographs was performed for each patient. All patients underwent surgery and all received antibiotic therapy and tetanus vaccination. In two cases, post-operative outcome was simple. Recovery was complete without sequelae. The patient with a GCS of 9 died the day after surgery.展开更多
<strong>Introduction.</strong> Penetrating craniocerebral wounds (PCCWs) are a particular lesion in the category of traumatic brain injury (TBI). The objective of this study was to describe the management ...<strong>Introduction.</strong> Penetrating craniocerebral wounds (PCCWs) are a particular lesion in the category of traumatic brain injury (TBI). The objective of this study was to describe the management of these lesions, and to identify signifiant risk factors associated with mortality in patients with a PCCW. <strong>Methods.</strong> It was a transversal, descriptive and analytical study performed in Departmental Teaching Hospital of Borgou and Alibori in Benin. From January 1, 2015 to June 30, 2020, patients with a PCCW were retained. Risk factors of mortality and morbidity associated to etiological, clinical and surgical parameters were assessed using the chi-square test. p value < 0.05 was considered to be statistically significant. <strong>Results.</strong> During the study period, 1267 cases of traumatic brain injuries (TBI) were admitted. Of these patients, 77 (6.1%) cases of PCCW were retained. These patients were divided into 66 (85.7%) male and 11 (14.3%) female. The mean age of the patients was 22.6 ± 14.8 years (range from 2 years to 70 years). The circumstances of occurrence were a traffic accident in 42 (54.5%) cases, an assault in 33 cases (42.9%) and a fall 2 (2.6%). The PCCW was unilateral in 71 cases (92.2%). A brain CT-scan was performed in 60 (77.9%) patients. Surgery was performed in 69 (89.6%) patients. Post-operative outcomes were simple in 59 (85.5%) cases. GCS, pupillary abnormalities, motor deficit were a statistically significant risk factor associated with death or sequels (p < 0.0001).<strong> Conclusion.</strong> The identification of risk factors of mortality or sequels is a major step for an efficient management of PCCWs and a reduction of morbidity and mortality. Whatever strategies are adopted, prevention must remain a priority.展开更多
文摘The authors report on their experience in the medical and surgical management of three cases of penetrating craniocerebral injuries caused by a nail. In all three cases, it was an aggression. Two of the three patients were male. The cranial locations affected were respectively left parietal, right temporal and right frontal. The Glasgow coma score (GCS) was between 9 and 13. None of the patients had a motor deficit. A plain skull radiographs was performed for each patient. All patients underwent surgery and all received antibiotic therapy and tetanus vaccination. In two cases, post-operative outcome was simple. Recovery was complete without sequelae. The patient with a GCS of 9 died the day after surgery.
文摘<strong>Introduction.</strong> Penetrating craniocerebral wounds (PCCWs) are a particular lesion in the category of traumatic brain injury (TBI). The objective of this study was to describe the management of these lesions, and to identify signifiant risk factors associated with mortality in patients with a PCCW. <strong>Methods.</strong> It was a transversal, descriptive and analytical study performed in Departmental Teaching Hospital of Borgou and Alibori in Benin. From January 1, 2015 to June 30, 2020, patients with a PCCW were retained. Risk factors of mortality and morbidity associated to etiological, clinical and surgical parameters were assessed using the chi-square test. p value < 0.05 was considered to be statistically significant. <strong>Results.</strong> During the study period, 1267 cases of traumatic brain injuries (TBI) were admitted. Of these patients, 77 (6.1%) cases of PCCW were retained. These patients were divided into 66 (85.7%) male and 11 (14.3%) female. The mean age of the patients was 22.6 ± 14.8 years (range from 2 years to 70 years). The circumstances of occurrence were a traffic accident in 42 (54.5%) cases, an assault in 33 cases (42.9%) and a fall 2 (2.6%). The PCCW was unilateral in 71 cases (92.2%). A brain CT-scan was performed in 60 (77.9%) patients. Surgery was performed in 69 (89.6%) patients. Post-operative outcomes were simple in 59 (85.5%) cases. GCS, pupillary abnormalities, motor deficit were a statistically significant risk factor associated with death or sequels (p < 0.0001).<strong> Conclusion.</strong> The identification of risk factors of mortality or sequels is a major step for an efficient management of PCCWs and a reduction of morbidity and mortality. Whatever strategies are adopted, prevention must remain a priority.
