Outcomes of traumatic brain injury patients with acute epidural and subdural hematoma who underwent burr hole surgery: A two-year study at Kilimanjaro Christian Medical Centre, Tanzania
Background: Traumatic brain injury is a leading cause of mortality and morbidity in Africa. Craniotomy is the surgical standard for acute extra-axial hematomas that is not realistic in LMIC due to deficient human and operative resources. Burr hole surgery may be an alternative in resource-limited se...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
|
| Series: | World Neurosurgery: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590139723001060 |
| _version_ | 1827355847043317760 |
|---|---|
| author | Sengua Koipapi Blandina T. Mmbaga Kondo Chilonga David Msuya Happiness Rabiel Mugisha Nkoronko Sarah Urasa Vivian Saria Samuel Chugulu |
| author_facet | Sengua Koipapi Blandina T. Mmbaga Kondo Chilonga David Msuya Happiness Rabiel Mugisha Nkoronko Sarah Urasa Vivian Saria Samuel Chugulu |
| author_sort | Sengua Koipapi |
| collection | DOAJ |
| description | Background: Traumatic brain injury is a leading cause of mortality and morbidity in Africa. Craniotomy is the surgical standard for acute extra-axial hematomas that is not realistic in LMIC due to deficient human and operative resources. Burr hole surgery may be an alternative in resource-limited settings. This study aimed at determining outcomes and factors associated with burr hole surgery as definitive management of traumatic extra-axial hematomas. Methods: Hospital-based cross-sectional study of patients with acute traumatic extra-axial hematomas who underwent burr hole surgery. Data were extracted from the patient's medical records after confirmation of the surgery and CT scan findings. The data were entered to SPSS 25 for analysis where a bivariate analysis was done. Results: 156 participants were enrolled; 149 (95.5 %) were males. The mean age of the participants was 35.33 (SD 15.37) years. The mean arrival GCS was 11.76 ± 3.59. Most participants had mild, followed by severe then moderate (55.8 %, 24.4 %, and 19.9 % respectively) TBI. 118 (75.6 %) participants had good outcomes and the overall in-hospital mortality was 18.6 %. 109 (69.9 %) had epidural hematomas mostly (21 %) in the parietal lobe. 30 (19.2 %) had brain herniation syndromes. Poor outcomes were associated with age above 50 years, severe TBI, motor response <4, abnormal pupil size, other injuries, ICU admission, SDH, midline shift >10 mm, cerebral edema, and brain herniation syndromes. Surgical site infection and hemostasis by packing were associated with a long length of hospital stay. Conclusion: Burr hole surgery is still a safe, effective, and simple life-saving procedure in patients with acute hematomas in resource-constrained areas. |
| first_indexed | 2024-03-08T04:49:16Z |
| format | Article |
| id | doaj.art-07b6d8bdfc9f452faa79227fdc004308 |
| institution | Directory Open Access Journal |
| issn | 2590-1397 |
| language | English |
| last_indexed | 2024-03-08T04:49:16Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Neurosurgery: X |
| spelling | doaj.art-07b6d8bdfc9f452faa79227fdc0043082024-02-08T05:15:57ZengElsevierWorld Neurosurgery: X2590-13972024-01-0121100257Outcomes of traumatic brain injury patients with acute epidural and subdural hematoma who underwent burr hole surgery: A two-year study at Kilimanjaro Christian Medical Centre, TanzaniaSengua Koipapi0Blandina T. Mmbaga1Kondo Chilonga2David Msuya3Happiness Rabiel4Mugisha Nkoronko5Sarah Urasa6Vivian Saria7Samuel Chugulu8Kilimanjaro Christian Medical University College, P.O Box 2240, Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi, Tanzania; Corresponding author. P.O.Box 3010, Moshi, Kilimanjaro, Tanzania.Kilimanjaro Christian Medical University College, P.O Box 2240, Moshi, Tanzania; Kilimanjaro Clinical Research Institute, P.O Box 3010, Moshi, TanzaniaKilimanjaro Christian Medical University College, P.O Box 2240, Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi, TanzaniaKilimanjaro Christian Medical University College, P.O Box 2240, Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi, TanzaniaKilimanjaro Christian Medical University College, P.O Box 2240, Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi, TanzaniaDepartment of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi, TanzaniaKilimanjaro Christian Medical University College, P.O Box 2240, Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi, TanzaniaKilimanjaro Christian Medical University College, P.O Box 2240, Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi, TanzaniaKilimanjaro Christian Medical University College, P.O Box 2240, Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi, TanzaniaBackground: Traumatic brain injury is a leading cause of mortality and morbidity in Africa. Craniotomy is the surgical standard for acute extra-axial hematomas that is not realistic in LMIC due to deficient human and operative resources. Burr hole surgery may be an alternative in resource-limited settings. This study aimed at determining outcomes and factors associated with burr hole surgery as definitive management of traumatic extra-axial hematomas. Methods: Hospital-based cross-sectional study of patients with acute traumatic extra-axial hematomas who underwent burr hole surgery. Data were extracted from the patient's medical records after confirmation of the surgery and CT scan findings. The data were entered to SPSS 25 for analysis where a bivariate analysis was done. Results: 156 participants were enrolled; 149 (95.5 %) were males. The mean age of the participants was 35.33 (SD 15.37) years. The mean arrival GCS was 11.76 ± 3.59. Most participants had mild, followed by severe then moderate (55.8 %, 24.4 %, and 19.9 % respectively) TBI. 118 (75.6 %) participants had good outcomes and the overall in-hospital mortality was 18.6 %. 109 (69.9 %) had epidural hematomas mostly (21 %) in the parietal lobe. 30 (19.2 %) had brain herniation syndromes. Poor outcomes were associated with age above 50 years, severe TBI, motor response <4, abnormal pupil size, other injuries, ICU admission, SDH, midline shift >10 mm, cerebral edema, and brain herniation syndromes. Surgical site infection and hemostasis by packing were associated with a long length of hospital stay. Conclusion: Burr hole surgery is still a safe, effective, and simple life-saving procedure in patients with acute hematomas in resource-constrained areas.http://www.sciencedirect.com/science/article/pii/S2590139723001060TBITrephinationBurr holeExtra-axial hematomaGlasgow outcome scaleLow resource settings |
| spellingShingle | Sengua Koipapi Blandina T. Mmbaga Kondo Chilonga David Msuya Happiness Rabiel Mugisha Nkoronko Sarah Urasa Vivian Saria Samuel Chugulu Outcomes of traumatic brain injury patients with acute epidural and subdural hematoma who underwent burr hole surgery: A two-year study at Kilimanjaro Christian Medical Centre, Tanzania World Neurosurgery: X TBI Trephination Burr hole Extra-axial hematoma Glasgow outcome scale Low resource settings |
| title | Outcomes of traumatic brain injury patients with acute epidural and subdural hematoma who underwent burr hole surgery: A two-year study at Kilimanjaro Christian Medical Centre, Tanzania |
| title_full | Outcomes of traumatic brain injury patients with acute epidural and subdural hematoma who underwent burr hole surgery: A two-year study at Kilimanjaro Christian Medical Centre, Tanzania |
| title_fullStr | Outcomes of traumatic brain injury patients with acute epidural and subdural hematoma who underwent burr hole surgery: A two-year study at Kilimanjaro Christian Medical Centre, Tanzania |
| title_full_unstemmed | Outcomes of traumatic brain injury patients with acute epidural and subdural hematoma who underwent burr hole surgery: A two-year study at Kilimanjaro Christian Medical Centre, Tanzania |
| title_short | Outcomes of traumatic brain injury patients with acute epidural and subdural hematoma who underwent burr hole surgery: A two-year study at Kilimanjaro Christian Medical Centre, Tanzania |
| title_sort | outcomes of traumatic brain injury patients with acute epidural and subdural hematoma who underwent burr hole surgery a two year study at kilimanjaro christian medical centre tanzania |
| topic | TBI Trephination Burr hole Extra-axial hematoma Glasgow outcome scale Low resource settings |
| url | http://www.sciencedirect.com/science/article/pii/S2590139723001060 |
| work_keys_str_mv | AT senguakoipapi outcomesoftraumaticbraininjurypatientswithacuteepiduralandsubduralhematomawhounderwentburrholesurgeryatwoyearstudyatkilimanjarochristianmedicalcentretanzania AT blandinatmmbaga outcomesoftraumaticbraininjurypatientswithacuteepiduralandsubduralhematomawhounderwentburrholesurgeryatwoyearstudyatkilimanjarochristianmedicalcentretanzania AT kondochilonga outcomesoftraumaticbraininjurypatientswithacuteepiduralandsubduralhematomawhounderwentburrholesurgeryatwoyearstudyatkilimanjarochristianmedicalcentretanzania AT davidmsuya outcomesoftraumaticbraininjurypatientswithacuteepiduralandsubduralhematomawhounderwentburrholesurgeryatwoyearstudyatkilimanjarochristianmedicalcentretanzania AT happinessrabiel outcomesoftraumaticbraininjurypatientswithacuteepiduralandsubduralhematomawhounderwentburrholesurgeryatwoyearstudyatkilimanjarochristianmedicalcentretanzania AT mugishankoronko outcomesoftraumaticbraininjurypatientswithacuteepiduralandsubduralhematomawhounderwentburrholesurgeryatwoyearstudyatkilimanjarochristianmedicalcentretanzania AT sarahurasa outcomesoftraumaticbraininjurypatientswithacuteepiduralandsubduralhematomawhounderwentburrholesurgeryatwoyearstudyatkilimanjarochristianmedicalcentretanzania AT viviansaria outcomesoftraumaticbraininjurypatientswithacuteepiduralandsubduralhematomawhounderwentburrholesurgeryatwoyearstudyatkilimanjarochristianmedicalcentretanzania AT samuelchugulu outcomesoftraumaticbraininjurypatientswithacuteepiduralandsubduralhematomawhounderwentburrholesurgeryatwoyearstudyatkilimanjarochristianmedicalcentretanzania |