title: Surgical management of head trauma: problems, results, and perspectives at the departmental teaching hospital of Borgou, Benin.
abstract: OBJECTIVE
  The purpose of this study was to report our neurosurgical experience with traumatic brain injury (TBI) at a departmental teaching hospital in Benin.
  
  
  METHODS
  This was a descriptive study performed from January 2008 to June 2010. It concerned patients who received surgical treatment after a brain trauma. Conditions for surgical care were based on imaging data or exclusively on clinical symptoms (disorders of consciousness associated with focal signs).
  
  
  RESULTS
  Sixty-two patients underwent surgical management during the study period. They accounted for 5% of the TBI cases hospitalized. There were 56 (90.3%) men and 6 (9.7%) women. The average age of patients was 26.38 ± 14.76 years. The main cause of injury was road traffic accident (80.6%). The mean time of admission to the surgical room was 27.59 ± 20.71 hours. The indication for surgery was based on clinical data in 17 (27.4%) patients, clinical and x-ray data in 27 (43.6%) patients, and computed tomography scan data in 18 (29%) patients. A burr-hole exploration was performed in 17 (27.4%) patients. Repair of depressive fracture or cerebral wound and evacuation of hematoma were mainly performed (75.8%). Complete recovery was observed in 34 (54.9%) patients. Sequels were observed in 10 (16.1%) patients. The postoperative mortality was 29% (n = 18). This mortality was 76.5% among 17 patients for whom burr-hole exploration was performed (P = 0.00000).
  
  
  CONCLUSIONS
  Surgical treatment of TBI is a common activity in our practice, despite the difficulties. Good imaging and enhanced prevention could improve care and reduce TBI severity.
authors: Unit of Neurosurgery, Medicine School of Parakou University, University of Parakou, Borgou, Republic of Benin. Electronic address: ftg_holden@yahoo.fr.
authors: Holden O
authors: HO
authors: Fatigba
authors: Mensa K
authors: MK
authors: Savi de Tove
authors: Blaise A
authors: BA
authors: Tchaou
authors: Emile
authors: E
authors: Mensah
authors: Allexandre S
authors: AS
authors: Allode
authors: Jijoho
authors: J
authors: Padonou
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001541:Benin / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D056424:Decompressive Craniectomy; D005260:Female; D015600:Glasgow Coma Scale; D006407:Hematoma, Epidural, Cranial / Q000601:surgery; D006408:Hematoma, Subdural / Q000601:surgery; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009493:Neurosurgery / Q000706:statistics & numerical data; D019635:Neurosurgical Procedures; D012887:Skull Fractures / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult