1. Cerebral Abcess and Intracranial Empyemas in Children (Francais)
- Author
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Dominique N'dri Oka, V Bazeze, Varlet, Eb Guillao-Lasme, E. Broalet, Serge Eholie, and Guy
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Pus collection ,French ,medicine.disease ,Empyema ,language.human_language ,Brain herniation ,Surgery ,Neurology ,medicine ,language ,Neurology (clinical) ,University teaching ,Neurosurgical department ,Abscess ,business ,Hemophilus - Abstract
Abces et Empyemes Intracraniens chez l\'Enfant Resume Introduction Les abces et empyemes sont des lesions intracrâniennes frequentes chez l\'enfant. Objectif Les auteurs rapportent et etudient les aspects cliniques, paracliniques et therapeutiques de ces suppurations intracrâniennes observees a Abidjan. Methode Une etude retrospective est effectuee dans le service de neurochirurgie du CHU de Yopougon sur une periode de 5 ans (decembre 1993 a decembre 1998). Cette etude a porte sur 34 observations cliniques dont l\'âge variait entre 7 mois et 15 ans. Resultats Les empyemes sous-duraux representaient 44,1 %, les abces 20,5 % et les deux lesions etaient associees dans 17,6 % des cas. Les germes isoles chez 12 patients etaient : Cocci Gram positif (3 cas), Enterobacteries (2 cas), Streptocoque (2 cas), Hemophilus (2 cas) flore mixte aeroanaerobie (1 cas) et une association pseudomonas acinetobacter (1 cas). La principale porte d\'entree etait une infection ORL. L\'evolution a ete favorable chez 32 patients avec des sequelles retrouvees dans 8 cas. Nous avons enregistre deux (2) cas de deces dont l\'un a l\'arrivee et l\'autre un jour apes l\'intervention, imputables a un engagement cerebral consecutif a l\'hypertension intracrânienne. Il n\'y a pas eu de recidive de la suppuration. Conclusion Les empyemes sous-duraux sont les plus frequentes de ces suppurations intracrâniennes chez l\'enfant. A travers cette etude, les auteurs argumentent en faveur de l\'utilisation de la trephine ou du trou de trepan pour evacuer ces collections suppurees intracrâniennes. Ils insistent sur la prophylaxie qui passe par le traitement des infections ORL, dentaires, meningees et le parage correct des plaies crânio-encephaliques. Background Abcess and empyemas are frequent intracranial lesions in children. Objective The s report the clinical, radiological bacteriological and therapeutical aspects of these intracranial suppurations observed in Abidjan. Methods A retrospective analysis has been conducted in the neurosurgical department of university teaching hospital of Yopougon over a 5 years period (December\' 93 to december\' 98). The study was based on 34 clinical observations on patients whom age ranges between 7 months and 15 years. Results The s report 34 cases of abscesses and intracranial empyemas of the cases in children. Subdural empyemas represented 44,1 % of the cases, abcess 20,5 % and the two lesions were associated in 17,6 %. Bacteriological agents isolated on 12 patients were gram positif cocci (3 cases) heamophilus (2 cases) flora mixed (2 cases) and a combination of pseudomonas acinetobacter (1 case). The predisposing factors were ENT diseases. Two patients died, the first day soon after admission, and the second one day after surgery. And in both cases because of brain herniation secondary to severe raised intracranial pressure. We observed no recurrence of pus collection. Neurological sequelae was observed in 8 cases. Conclusion Intracranial subdural empyemas are most common form of intracranial suppurations seen in children in our unit. This study emphasizes the importance of treating theses intracranial sepsis through a burrhole. The s stress the interest of eradication of primary source of the sepsis and the appropriate treatment of head trauma. Keywords: Africa, Child, Cerebral abscess, Intracranial empyema, Abces cerebral, Afrique, Empyeme intracrânien, Enfant. Af J Neuro Sci: 2002 21(1)
- Published
- 2002