Management of Pediatric Traumatic Brain Injuries at The Regional Hospital of Ziguinchor (Senegal)

ABSTRACT Objectives. The purpose of our study was to describe the diagnostic, therapeutic, evolutive and prognostic features of children’s traumatic brain injury (TBI) at Ziguinchor Regional Hospital. Methods. This cross sectional retrospective study was based on 77 children age 6 months up to 16 years, suffering from traumatic brain injury admitted to our unit over a one-year period (from April 1, 2019 to March 31, 2020). Diagnostic, therapeutic, dynamic and prognostic aspects were evaluated. Results. Out of 147 children who were casualties of road traffic accident during our study period, 77 (52.38%) had a TBI. The average age was 8.96 years. The sex ratio was 3.27 boys to one girl. Street accidents (53.25%) followed by falls (35.06%) were the most common causes. Forty-seven patients (61.04%) were admitted within 4 hours of trauma. The Glasgow Coma Scale was less than or equal to 8 in 9 cases (11.69%), lied between 9 and 13 in 18 cases (23.38%) and between 14 and 15 in 50 cases (64.94%). Motor deficit was noted in 7 cases (9.09%) and mydriasis in 5 cases (6.49%). Fractures of the arch (23.38%), followed by contusions (16.88%) were the most frequent lesions on brain CT scan. Eight patients (10.39%) underwent surgery. The evolution was favorable in 83.11% of cases. We recorded 10.39% of deaths and 3.89% of minor sequelae. Conclusion. TBI in children occur frequently in our context. The main etiology is road accidents. They must be managed as early as possible by a specialised team. RESUME Introduction. Le but de notre etude etait decrire les aspects diagnostiques, therapeutiques, evolutifs et pronostiques des traumatismes crânio-encephaliques (TCE) de l’enfant au centre hospitalier regional de Ziguinchor. Materiels et methodes. Il s’agissait d’une etude transversale retrospective portant sur 77 enfants âges de 6 mois a 16 ans admis dans notre structure pour TCE sur une periode d’un an (du 1er avril 2019 au 31 mars 2020). Les aspects diagnostiques, therapeutiques, evolutifs et pronostiques ont ete analyses. Resultats. Parmi 147 enfants victimes d’un accident avec traumatisme durant la periode d’etude, 77 (52,38%) ont presente un TCE. L’âge moyen etait de 8,96 ans. Le sex ratio etait de 3,27 en faveur des garcons. Les accidents de la voie publique (53,25%) suivis des chutes (35,06%) etaient les etiologies les plus frequentes. Quarante-sept (61,04%) patients ont ete admis dans les 4 heures suivant le traumatisme. Le score de Glasgow etait inferieur ou egal a 8 dans 9 (11,69%) cas, compris entre 9 et 13 dans 18 (23,38%) cas et entre 14 et 15 dans 50 (64,94%) cas. Un deficit moteur a ete note dans 7 (9,09%) cas et une mydriase dans 5 (6.49%) cas. Les fractures de la voute (23,38%), suivies des contusions (16,88%) constituaient les lesions les plus frequentes au scanner cerebral. Huit (10,39%) patients ont beneficie d’une intervention chirurgicale. L’evolution etait favorable dans 83,11% des cas. Nous avons enregistre 10,39% de deces et 3,89% de sequelles mineures. Conclusion. Les TCE de l’enfant sont frequentes dans notre contexte. L’etiologie reste dominee par les accidents de la voie publique. La prise en charge doit etre precoce avec des equipes specialisees.