Traumatic intracranial haemorrhage in Cameroon: Clinical features, treatment options and outcome

Abstract

Traumatic intracranial haemorrhage (t-ICH) is major medical and surgical emergency. Road traffic accident related traumatic brain injury remains the main aetiology. Brain CT scan has contributed to early diagnosis and rapid management. The aim of this study was to describe clinical features, treatment options and outcome of t-ICH in a referral hospital in Cameroon.We retrospectively studied the medical records of patients admitted for t-ICH at the Douala General Hospital from January 1st, 2009 to December 31st, 2018. Data collected included: demographic, diagnostic, treatment, and outcome in the hospital. The traumatic brain injury severity was defined based on the Glasgow coma scale (GCS). Data analysis was performed using EPI Info 3.5.4. Logistic regression was done to identify predictive factors of mortality. The level of significance was set at p < 0.05.Among the 2368 files reviewed, we found 413 (17.4%) cases of t-ICH including 219 complete files. The most affected age group was 27 to 36 years. Male patients represented 83.6%. Road traffic accident was the commonest cause (74.9%). Initial loss of consciousness was found in 69.41% of patients. 17.8% of patients presented with severe traumatic brain injury. The commonest lesion were subdural and epidural hematomas. Surgical treatment was performed in 56.6% of cases. In-hospital mortality rate was 17.35%, and age ≥ 63 years and Glasgow ≤ 8 were the predictive factors of death.Traumatic intracranial haemorrhage provide significant mortality in this study. Road traffic accident is the leading cause, more affecting young adults. Older age and severe traumatic brain injury are predictors of in-hospital mortality. Multicentre studies are need to provide accurate data on traumatic intracranial haemorrhage in Cameroon.

Keywords

• Traumatic brain injury
• Intracranial haemorrhage
• Subdural hematoma
• Epidural hematoma
• Douala
• Cameroon