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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References
Alliez B, Ducolombier A, Gueye L (1992) Les suppurations collectées intracrâniennes: Etude de 64 observations anatomo-cliniques. Med Afr Noire 39:377–382
BA M C (2007) Les suppurations intracrâniennes à Dakar. Présenté au 1er congrès de la Société camerounaise de Neurochirurgie
Bahloul H, Benrhouma T, Snoussi N, Rekik A, Triki A (1985) Notre expérience de l’abcès cérébral chez l’enfant: à propos de 7 cas. Tunis Méd 63:425–429
Bissagnene E, Domoua K (1996) Situation actuelle des méningites, encéphalites infectieuses et suppurations intracrâniennes en zone tropicale africaine. Med Afr Noire 43:123
Bok A (1993) Subddural empyema, burr holes or craniotomy? A retrospective computerised tomography-era analysis of treatment in 90 cases. Neurochirurgie 78:574–578
Broalet E, N’dri Oka D, Eholie SP, Guillao-Lasme EB, Varlet G, Ba Zeze V (2002) Abcès et empyèmes intracrâniens observés chez l’enfant à Abidjan (Côte d’Ivoire). Afr J Neurol Sci 21:38–41
Buonaguro A, Colangelo M, Daniel B, Cantone G, Ambrosio A (1989) Neurological and behavioral sequelae in children operated for brain abscesses. Childs Nerv Syst 5:153–155
Dechambenoit G (1998) Empyèmes sous duraux: Plaidoyer pour l'utilisation de la tréphine ou le trou de trépan. Présenté au 13ème Congrès de l'Association Panafricaine des Sciences Neurologiques à Dakar.
Djindjian M, Decq P (1995) Abcès, empyèmes et spondylodiscites, In neurochirurgie DECQ P, KERAVEL Y ELLIPSES AUPELF/UREF: 592–598
Eyenga VC, Atangana R, Bahebeck J, Eloundou Ngah J, Etom E, Ondoa M et al (2007) Empyèmes sous-duraux et abcès cérébraux au Cameroun: aspects bactériologiques et pronostic en pédiatrie. Med AfrNoire 5402:69–72
Gueye M, Badiane SB, Sakho Y, Kone S, Ba MC, Kabre A (1991) Abcès du cerveau et empyèmes extra cérébraux. Dakar Med 36:82–87
Loembe PM, Ndong-Launay M, Mwanyombet-Ompounga L, Assengone-Zeh Y (1991) Diagnostic et traitement des empyèmes intracrâniens au Gabon. Med Mal Infect 10:657–659
Loembe PM, Okome-Kouakou M, Alliez B (1997) Les suppurations collectées intracrâniennes en milieu africain. Méd Trop 57:186–194
Loembe PM, Okome-Kouakou M, Idoudou-Antimi J, Mwanyombet-Ompounga L (1997) Quelle attitude adopter devant les empyèmes intracrâniens en l’absence de tomodensitométrie? Cah Santé 7(3):173
Merad A S (1999) Etude bactériologique des suppurations intracrâniennes dans la région d'Alger entre 1987 et 1996. Archives de l’Institut Pasteur d’Algérie 63
N’goan AM, N’gbesso RD, Amon-Tanoh F (1997) Echographie transfontanellaire dans les méningites purulentes de l’enfant à Abidjan (Côte d’Ivoire). Cah Santé 7:169–172
Wacky MPA, Canalis RF, Feuerman T (1990) Subdural empyema of otorhinological origin. J Laryngol Otol 104:118–122
Yen PT, Chan ST, Huang TS (1995) Brain abscess: with special reference to otolaryngologic sources of infection. Otolaryngol Head Neck Surg 113:15–22
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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