Nonsurgical Management of the Brain’s Trauma in the University Hospital of Brazzaville

The aim of this study was to evaluate the medical management of traumatic brain injury. We performed a retrospective and descriptive study during the period from 1st January 2014 to 31st December 2015 (24 months), into the surgical department of the University Hospital of Brazzaville. 167 cases of non-operated traumatized brain have been identified. The average age was 29.84 years. The sex ratio was 8.82. Accidents on public roads were responsible for injury in 88.2% of the cases. 46.71% of patients had a moderate traumatic brain injury while 10.18% had a severe traumatic brain injury. Radiological evaluation was highlighted for the brain contusion in 52.09% of the cases. Tracheal intubation and ventilation were completed only in 6 out of the 17 cases of severe traumatic brain injury. Prevention of post-traumatic seizure was performed with the use of phenobarbital or sodium valproate. Mannitol was used for its osmotic properties. The outcome was favorable in 55.68% of the cases. The most common complications were pulmonary infections, persistent neurological disorders, urinary infection and hyponatremia. Mortality was recorded at 13.77%. Nonsurgical management of traumatic brain injury involves an expansion of the ventilatory assistance indication at all severe traumatic brain injuries, the fight against infectious complications and ionic monitoring.