%0 Journal Article
%T The Exploratory Burr Hole: Indication and Results at One Departmental Hospital of Benin
%A Holden O. Fatigba
%A Alexandre S. Allod¨¦
%A Kofi-M. Savi de Tov¨¦
%A Emile D. Mensah
%A Adrien M. Hodonou
%A Jijoho Padonou
%J ISRN Surgery
%D 2013
%R 10.1155/2013/453907
%X Objective. The aim of this study was to describe the indications and results of exploratory burr hole performed at the Departmental Teaching Hospital of Borgou (Benin). Methods. It was a retrospective study performed from January 2008 to February 2011. It concerned patients with a closed traumatic brain injury (TBI) in which an exploratory burr hole was performed. The selection criteria were unilateral mydriasis associated with neurological deficits on the opposite side or the occurrence of a decreased consciousness associated with the appearance of a motor deficit after a lucid interval. Results. Amongst the 74 patients operated, 23 (31%) underwent an exploratory burr hole for which the average age was 24.8 ˇŔ 17.3 years. Sex ratio male/female was 3.6. TBI was due to road traffic accident (56.5%), a fall (26.1%), and an assault (17.4%). It was severe (47.8%), moderate (39.1%), and mild (13.1%). Mydriasis was observed in 69.6% of cases as well as neurological deficit in all patients. A lesion was observed in 15 (65.2%) cases. Conclusion. The exploratory burr hole seemed as an old practice, still no longer performed in full practice in Benin, and is a diagnosis and therapeutic approach. Better technical conditions would allow more relevant therapeutic options. 1. Introduction Brain CT-scan and magnetic resonance imaging (MRI) had made a huge impact on diagnosis and surgical management of traumatic brain injuries [1]. Such practice is well codified and wide spread in developed countries [2, 3]. In Benin and many African countries those means of medical image still lacking. When they are in place it is either their high cost or restricted number and sometimes the fact that they are only located in big towns made them inaccessible to patients as well as to practitioners. Nevertheless TBI remains a frequent affectation in our country [4]. Even though exploratory burr hole practice is very old and abandoned or extremely limited in a modern management of TBI [3, 5¨C7], it is still current in countries with poor healthcare system [8¨C10]. The purpose of this study was to report the indications and outcomes of exploratory burr hole performed in patients with closed TBI without brain CT-scan in one underequipped hospital in Benin. 2. Materials and Methods It was a retrospective study performed between January 2008 and June 2011, at the Departmental Teaching Hospital of Borgou (Benin). This health centre is the only referral hospital in the Northern Benin. The study concerned patients who underwent an exploratory burr hole after one TBI. The hospital is located at
%U http://www.hindawi.com/journals/isrn.surgery/2013/453907/