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Intracranial suppurations in the African child: a severe but preventable complication

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Abstract

Introduction

Intracranial suppurations (ICS) are collections of pus of infectious origin in the skull. The authors present their experience.

Patients and method

All children operated for ICS at the Central Hospital of Yaoundé from January 2000 to December 2008 were retrospectively included.

Results

Thirty-five patients were recruited: 26 (74.29 %) males and 9 (25.71 %) females. These represent 82.9 % of all ICS operated in our institution. ICS represented 14.3 % of intracranial space-occupying lesions. The mean age was 8.34 years. They presented with headaches (80.77 %), altered consciousness (20 %), convulsions (76 %), vomiting (20 %), unilateral motor deficit (69.23 %), speech disorders (12 %), and fever (89.29 %). Bergman’s triad (51.86 %) was frequent. The primary infection was: meningitis, eight cases (22.85 %); sinusitis, six cases (17.14 %); head trauma, five cases (14.28 %); otitis media, one case (2.85 %); suppurations of the face, three cases (8.56 %); cardiopathy, one case (2.85 %); and craniotomy, one case (2.85 %). In seven cases (20 %), the origin was unknown. The lesions were empyema in 23 cases (65.71 %), cerebral abscess in 8 cases (22.85 %) and pyoventriculitis in 2 cases (5.72 %). The surgical procedures were burr holes (88.89 % of empyemas) and trepano-puncture–aspiration (75 % of abscesses). The mortality (21.42 %) and morbidity (42.85 %) were recorded.

Conclusion

ICS are frequent but preventable (early treatment of the primary infection) pathologies of childhood in developing countries. Burr hole drainage (empyemas) and puncture–aspiration (abscesses) are simple, safe, and effective techniques.

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Authors and Affiliations

  1. Neurosurgery unit, Central Hospital of Yaounde, PO Box: 87, Messa, Yaounde, Cameroon

    V. P. Djientcheu, Y. N. Kamga, F. Bello & T. Y. Yamgoue

  2. Pediatric surgery unit, HGOPY, Yaoundé, Cameroon

    T. F. Mouafo

  3. Anesthesiology unit, Central Hospital of Yaounde, Yaoundé, Cameroon

    A. Esiene

  4. Neuropediatric unit, HGOPY, Yaoundé, Cameroon

    S. Nguefack & E. Mbonda

  5. Radiology unit, Central Hospital of Yaounde, Yaoundé, Cameroon

    Z. C. Ongolo

Authors
  1. V. P. Djientcheu
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  2. T. F. Mouafo
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  3. A. Esiene
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  4. Y. N. Kamga
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  5. S. Nguefack
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  6. F. Bello
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  7. T. Y. Yamgoue
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  8. Z. C. Ongolo
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  9. E. Mbonda
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Correspondence to V. P. Djientcheu.

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Djientcheu, V.P., Mouafo, T.F., Esiene, A. et al. Intracranial suppurations in the African child: a severe but preventable complication. Childs Nerv Syst 29, 119–123 (2013). https://doi.org/10.1007/s00381-012-1930-6

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  • DOI: https://doi.org/10.1007/s00381-012-1930-6

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