[Problematics of subarachnoid hemorrhage in developing countries: The case of Togo].
OBJECTIVE
To analyze the diagnostic and therapeutic strategies as well as the results of the treatment of spontaneous subarachnoid hemorrhage (SAH) in Togo, before creating a neurosurgery department.


METHODS
We conducted a case series of subarachnoid hemorrhage collected from 30 June 2005 to 30 June 2010 in the Universities Hospital of Lomé. It involved patients older than 15 years of age hospitalized for subarachnoid hemorrhage with clinical and/or radiation confirmation.


RESULTS
Thirty-five cases of SAH were found and corresponded to 0.20 % of neurological emergencies. The average age was 48 years with a range of 22 to 78 years with a sex-ratio F/H 1.33. The consciousness disorders (48.57 %) and headaches (42.85 %) were the main reasons for admission. Seventeen patients (48.57 %) had hypertension and 14 (40 %) were ethylic. Lumbar puncture performed in 9 patients (25.71 %) and CT scan in 29 patients (82.86 %), respectively, had a sensitivity of 100 % and 93.10 %. Four cases of intracranial aneurysm were diagnosed. The admission average was 3.07±3.69 days. The treatment was mainly symptomatic. Mortality was 22.85 % and severe disability was observed in 8 patients (22.85 %).


CONCLUSIONS
The profile of the SAH in Lomé appeared to differ from the literature. Too low a proportion of aneurysm is diagnosed. The equipment of Hospital and neurosurgeons training would be needed to improve the management of this pathology.
Service de neurochirurgie, CHU Sylvanus Olympio, Lomé, Togo. Electronic address: samsonahas@hotmail.com.
K M H
KM
Ahanogbe
Service de neurologie, CHU Sylvanus Olympio, Lomé, Togo.
M
M
Belo
Service de neurochirurgie, CHU Sylvanus Olympio, Lomé, Togo.
A K
AK
Beketi
Service de neurochirurgie, CHU Sylvanus Olympio, Lomé, Togo.
S
S
Kpelao
Service de neurochirurgie, CHU Sylvanus Olympio, Lomé, Togo.
K A
KA
Doleagbenou
D000328:Adult; D000368:Aged; D003906:Developing Countries; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D013129:Spinal Puncture / Q000379:methods; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D014037:Togo; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
AVC; Hémorragie sous-arachnoïdienne; Stroke; Subarachnoid hemorrhage; Togo