Ahanogbe K M H, Belo M, Beketi A K, Kpelao S, Doleagbenou K A
Service de neurochirurgie, CHU Sylvanus Olympio, Lomé, Togo.
Service de neurologie, CHU Sylvanus Olympio, Lomé, Togo.
Neurochirurgie. 2016 Dec;62(6):312-316. doi: 10.1016/j.neuchi.2016.06.008. Epub 2016 Nov 4.
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.
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.
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 %).
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.
在多哥创建神经外科之前，分析自发性蛛网膜下腔出血（SAH）的诊断和治疗策略以及治疗结果。
我们对2005年6月30日至2010年6月30日在洛美大学医院收集的蛛网膜下腔出血病例进行了系列研究。研究对象为15岁以上因蛛网膜下腔出血住院且经临床和/或影像学确诊的患者。
共发现35例SAH病例，占神经科急症的0.20%。平均年龄为48岁，范围在22至78岁之间，男女比例为F/H 1.33。意识障碍（48.57%）和头痛（42.85%）是主要的入院原因。17例患者（48.57%）患有高血压，14例（40%）有酗酒史。分别对9例患者（25.71%）进行了腰椎穿刺，对29例患者（82.86%）进行了CT扫描，其敏感性分别为百分之百和93.10%。诊断出4例颅内动脉瘤。平均住院时间为3.07±3.69天。治疗主要是对症治疗。死亡率为22.85%，8例患者（22.85%）出现严重残疾。
洛美地区SAH的情况似乎与文献报道不同。动脉瘤的诊断比例过低。需要改善医院设备并培训神经外科医生，以提高对这种疾病的管理水平。
