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Background & Aim: Chronic subdural hematoma (CSDH) is a common neurosurgical pathology. The objective of this study was to describe the epidemiology of this pathology and the results in treating it combined from three hospital centers in Benin. Methods & Materials/Patients: From September 2010 to September 2013 a multi-center, retrospective and descriptive study was conducted in three hospital centers in Benin. Inventory was taken of all patients in whom CSDH was diagnosed. Patients were evaluated according to Markwalder classification. All patients received a brain scan. The variables studied include demographic and clinical characteristics, therapeutic modalities and post-operative followup. Results: 104 consecutive patients with CSDH were included in the study. The mean age was 49.66, but ranged from six months to 87 years. The M:F sex ratio was 5.11/1. Prior cranial trauma had occurred in 81 patients (77%). Preoperative neurological Grades 1 or 2 were observed in 56.4% of cases. Surgical treatment was given to 100 patients (96.15%). Events surrounding the surgery were straightforward and results satisfactory in 94% of cases. No relapses were observed. The morbidity was 4% and the mortality among surgical patients was 3%. Conclusion: CSDH is frequently treated in the country of Benin. The mean age of patients is lower than that observed in global literature, and patients are predominantly male. Regardless of the patient condition upon hospital admission, post-operative results compare favorably with the literature.

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Introduction. 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. Methods. 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. Results. 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). Conclusion. 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.

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.