Craniocerebral Gunshot Injuries in Chad: A Study of 44 Cases.

BACKGROUND: Firearm head injuries cause great public health concern because of their severity. They are life-threatening due to intracranial lesions and sepsis risks. This prospective study evaluates the management of craniocerebral wounds in Chad. METHODS: This is an observational study conducted over a period of 65 months with 44 patients with a ballistic craniocerebral wound (BCW), of which only 7.18% were assessed by neurosurgeons with gunshot wound. RESULTS: The mean age was 30.57 ± 13 years (range:2-60 years). The 21-30 age group was the most affected (31.8%). The sex ratio was 21. A total of 63.6% of cases involved military personnel. The average admission time was 24.95 ± 12 hours (range: 1-72 hours). Explosive device attacks represented 29.5% of cases, of which 53.3% occurred in civilian practice. Point-blank shooting was reported in 70.5% of cases. The entry hole of the projectile was frontal in 40.9%. Intracranial sequestration of the projectile was found in 56.8%. Association of upper limb trauma was found in 9.1% of cases. Brain scans were performed in 95.5% of cases. Surgical treatment was undertaken in 68.18% of cases. The recovery process was marked by brain abscess in 6.8% of cases. Seven deaths were recorded. CONCLUSIONS: This study shows that BCW is frequent and mainly affects young male individuals in Chad. Many of the cases were related to improvised explosive device attacks, especially in civilian practice (70.5%). The delay in diagnostic and therapeutic management favors the high rate of sequelae.

[Arteria lusoria causing dyspnea: about a case]. / Arteria lusoria dyspnéisante: à propos d'un cas.

Arteria lusoria or retroesophageal right subclavian artery is the most common aortic arch malformation, accounting for 0.5-2.5% of cases. It can be detected in patients with symptoms including airway and/or esophageal compression such as dyspnea or dysphagia or even recurrent respiratory infections; but it is mostly asymptomatic, as reported by several authors. We here report the case of a 44-year-old female patient treated in our emergency room due to respiratory distress syndrome associated with arteria lusoria. This is a rare cause of dyspnea which should be suspected in patients with dyspnea not responding to medical treatment. Asymptomatic patients undergo medical treatment associated with simple surveillance. Surgery is necessary when it becomes symptomatic or when it is associated with Kommerell diverticulum (KD).