Background: Acute subdural hematoma is one of the frequent complications of severe head trauma, it is a neurosurgical emergency. The aim of this study is to determine and evaluate the outcome of patients operated by craniotomy versus decompressive craniectomy. Methods: This is a retrospective and analytical study over two years from January 01, 2019 to December 31, 2020. Results: 73 patients were included in the study including 63 men and 10 women with a sex ratio of 6.3. The average age was 37.84 years old. The traffic accident was the most common in 47.95% of cases. Of the 73 patients, 54 under went decompressive craniectomy and 19 had craniotomy. The predominant initial Glasgow score in the decompressive craniectomy was less than 8 and in the craniotomy between 13-15. The mean hematoma thickness was 9.54 mm for the decompressive craniectomy and 11.07 mm for the craniotomy. The mean deviation from the midline of the decompressive craniectomy was 7.25 mm and 7.21 mm for the craniotomy. The mortality rate found in décompressive craniectomy was 46.30% and 52.63% for craniotomy. Conclusions: There is no consensus in the literature on the surgical technique, so the management of acute subdural hematoma depends on the expertise of the neurosurgeon on a case-by-case. In order to determine a surgical strategy, a prospective study is necessary.
We reported the case of an elderly child who was admitted to the neurosurgery department of the CHU-HJRA for headaches and vomiting. It is a child with obstructive hydrocephalus of tumor origin to whom a shunt ventriculoperitoneal has been placed. He had secondary a hydrocephalus by obstruction of the ventricular catheter secondary to a membrane causing dysfunction of the shunt system discovered during endoscopic surgery
Thoracolumbar spine injury is a frequent and serious lesion with functional prognosis. The objective of this study was to determine the epidemiological-clinical profile and the therapeutic aspects of thoracic and lumbar spine injuries in Madagascar. This was a retrospective, single centered 3-years study of 98 cases of thoracic and/or lumbar spine trauma hospitalized and managed in the neurosurgery department at Joseph Ravoahangy Andrianavalona Antananarivo Madagascar University Hospital center. During the targeted period, 98 trauma cases were studied, of which 24.39% of the traumatized were between 21 and 30 years old with a clear male predominance of 80.48% (sex ratio 4.1). Etiology is dominated by a drop in 36.72% of cases. It was part of a polytrauma that included head trauma in 58.53%. Clinically, 39.02% of the patients were tetraplegic and the standard radiograph represented the requested radiological tool in 82.92%. The mortality rate was 21.95%. Thoracic and lumbar spine injuries are serious and several Frankel A type neurological deficits are usually irreversible despite rapid management
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