Nonsurgical Management of the Brain’s Trauma in the University Hospital of Brazzaville

Abstract

The aim of this study was to evaluate the medical management of traumatic brain injury. We performed a retrospective and descriptive study during the period from 1 st January 2014 to 31 st December 2015 (24 months), into the surgical department of the University Hospital of Brazzaville. 167 cases of non-operated traumatized brain have been identified. The average age was 29.84 years. The sex ratio was 8.82. Accidents on public roads were responsible for injury in 88.2% of the cases. 46.71% of patients had a moderate traumatic brain injury while 10.18% had a severe traumatic brain injury. Radiological evaluation was highlighted for the brain contusion in 52.09% of the cases. Tracheal intubation and ventilation were completed only in 6 out of the 17 cases of severe traumatic brain injury. Prevention of post-traumatic seizure was performed with the use of phenobarbital or sodium valproate. Mannitol was used for its osmotic properties. The outcome was favorable in 55.68% of the cases. The most common complications were pulmonary infections, persistent neurological disorders, urinary infection and hyponatremia. Mortality was recorded at 13.77%. Nonsurgical management of traumatic brain injury involves an expansion of the ventilatory assistance indication at all severe traumatic brain injuries, the fight against infectious complications and ionic monitoring.