TITLE:
Intracranial Suppurations in Togo: Etiologies and Treatment
AUTHORS:
Essossinam Kpélao, Messan H. Ahanogbé, Komi Egu, Agbéko K. Doléagbénou, Kader Moumouni, Assila Komlanvi, Kossi K. Ségbédji, Solim Bakondé, Dzidoula Lawson, Abaltou Bawoubad, Abdoulaye Hima-Maïga, Katanga A. Békéti
KEYWORDS:
Intracranial Abscess, Empyema, Togo
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.13 No.1,
January
9,
2023
ABSTRACT: Objective: Intracranial suppurations are a cosmopolitan pathology whose prevalence depend
of the region of the world. They are mostly caused by otolaryngological infections.
Despite the progress, they remain serious diseases in Africa. The objective of this
study was to report the epidemiology, clinical and etiological aspects of intracranial
suppurations in Togo. Method: This was a retrospective and descriptive study
carried out from January 1, 2012 to December 31, 2020 including all cases of intracranial
suppuration treated in the neurosurgery unit of Sylvanus Olympio university hospital
in Lomé. The evolution was evaluated at discharge, at 3 and 6 months after. Results: We collected 185 cases of intracranial suppuration. The average age of the patients
was 12.6 years with a male predominance (72.4%). The main clinical signs were the
infectious syndrome (92.4%), intracranial high pressure (51.4%), focal deficit (38.4%)
and seizures (20.5%). An otolaryngological infections history was noted within 3
months in 72.4%. The brain CT scan noted a predominance of empyema (63.8%) mostly
subdural (64.4%). Radiological sinusitis was found in 57.3%. We identified etiology
in 69.2% predominated by otolaryngological causes. Patients received medical and
surgical treatment in 77.3%. The bacteriology was positive only in 7 cases. The
mortality rate was 15.1%, mostly no operated cases (78.6%). At 6 months 84% recovered
without sequelae. The predictive prognostic factors for mortality were: coma (p 0.001),
absence of surgical treatment (p 0.02). Conclusion: Intracranial suppuration remains frequent in our country, mainly due to otolaryngological
pathologies. The clinical presentation is not always specific and Bergman’s triad
is rarely complete. The results of treatment are good if it is early.