ABSTRACT
OBJECTIVE: To determine the severity factors in severe traumatic brain injuries. METHODS: A prospective descriptive study of severe head injuries admitted to the emergency department at Ibn Tofail Hospital at the University Hospital of Marrakech over a period of six months from May to October 2015. The following data was collected: circumstances, clinical, biology, radiology, treatment and evolution. RESULTS: One hundred and nineteen patients with severe traumatic brain injury were collected (101 males, 84,9%). The mean age was 37,73±15,7 years. Road accidents were the most common cause representing 84%. The median Glasgow coma scale (GCS) was 7±3. We noted 36 cases (30,3%) of anisocoria, 32 cases (26,9%) of bilateral mydriasis and 72 cases (60,5%) of hypoxia. Cerebral contusions (66,1%) and meningeal hemorrhage (66,6%) were the most frequent lesions on CT. Forty-seven patients (42%) had stage VI Marshall lesions. Twenty-four patients (20.1%) required a neurosurgical intervention, 12 extradural hematoma evacuations and 10 craniocerebral wounds. Mortality was 64.7% (77 deaths), the main cause was neurological (64,9%). In the latter group, we observed more frequently an older age (P=0.00001), a management delay (P=0.011), a low initial GCS (P=0.000001), a bilateral nonreactive mydriasis (P=0.0001), a hypoxia (P=0.0002), a subarachnoid hemorrhage (P=0.008), a high Marshall score (P=0.017) and an anemia (P=0.046). CONCLUSION: Head trauma is a public health problem. The victims are young, and the sequelae are frequently disabling. Several parameters are associated with a poorer prognosis including age, neurological state and the initial delay in management.
Subject(s)
Brain Injuries, Traumatic , Aged , Brain Injuries, Traumatic/diagnosis , Brain Injuries, Traumatic/epidemiology , Glasgow Coma Scale , Humans , Infant, Newborn , Male , Prognosis , Prospective Studies , Retrospective Studies , Treatment OutcomeABSTRACT
Primary epidural hydatid cyst of the spinal canal without bone involvement is very rare. The authors report the case of a 35 year old man presenting with lower cauda equina compression. MRI showed a cystic lesion with signal characteristics similar to cerebrospinal fluid. Surgical exploration through a midline posterior approach was used which confirmed the hydatid nature of the cyst. There was no bone lesion. Histological examination confirmed the diagnosis. Hydatid cyst should be suspected in case of cystic lesion causing cord compression or cauda equina syndrome.
