Acute Management of Traumatic Intracranial Hematomas in Brazzaville City, Congo: A Study of 115 Cases From 2016 to 2021

Background and Aim: Traumatic brain injuries (TBI) are a significant global public health concern due to their impact on morbidity, mortality, and the economy. This study aims to describe the management of traumatic intracranial hematoma (TICH) during the acute phase in a neurosurgical environment at the Brazzaville University Hospital Center. Methods and Materials/Patients: This descriptive study was conducted for 6 years, from 2016 to 2021 in the Department of Multipurpose Surgery of the University Hospital Center of Brazzaville City, Congo. The research included all patients hospitalized for TICH; we used a comprehensive sampling method. The variables studied were socio-demographic, clinical, radiological, therapeutic, and outcome-related. Results: A total of 130 subjects were identified as having TICH in the acute phase, representing a frequency of 12.4%. In the 115 cases retained, 78 cases (67.8%) had an epidural hematoma (EDH), 24 cases (20.9%) had an acute subdural hematoma (ASDH) and 13 cases (11.3%) had intracerebral hematoma (ICeH). The median age was 30 years and the sex ratio of 56.5. The trauma was caused by a road traffic accident (RTA) in 93.9% of the cases. The mean Glasgow coma scale (GCS) on admission was 13±1. Surgery was performed in 31 patients, 29 cases for EDH and the remaining two for ASDH. Craniotomy with flap replacement was the technique employed in all patients undergoing surgery. The median interval between the occurrence of trauma and surgical intervention was 36 hours. The evolution was favorable in 110 patients (95.7%), and death occurred in three patients (2.6%). The postoperative mortality rate in our series was 6.4%. Conclusion: One out of four patients (27%) with TICH requires surgery. The latter is carried out within more than 24 hours, in a context of insufficient social coverage (health insurance).