• A R Aguèmon, J L Padonou, S R Yévègnon, P C Hounkpè, S Madougou, A K Djagnikpo, and D Atchadé.
• Service polyvalent d'anesthésie-réanimation, centre national hospitalier et universitaire HK MAGA 06 BP 416 Akpakpa-PK3, Cotonou, Bénin. aguemon_c@yahoo.fr
• Ann Fr Anesth Reanim. 2005 Jan 1; 24 (1): 36-9.

ObjectiveTo study in Cotonou (Benin) in tropical environment, the specific problems of severe head injury.Study DesignFive years retrospective study in Cotonou University National and Teaching Hospital.Patients And MethodsAll patients admitted with severe head injury between January 1998 and December 2002 were included. The following parameters were studied: age, sex, traumatism cause, temperature, blood pressure, Glasgow coma scale.ResultsTwo Hundred thirty six patients (mean age 32 +/- 18 years) essentially men, were admitted. The cause of the injury was road traffic accidents in 86% of cases. Prehospital medicalisation was achieved in only 9% of cases. A head CT-scan was performed in 5% of the cases. Respiratory resuscitation essentially used the association intubation and oxygenation (59%), 19% of the patients were ventilated and 21% were sedated. Mortality was closely related to the initial Glasgow coma scale score (GCS): GCS 3-4 = 97%; GCS 5-6 = 72% GCS 7-8 = 36%. Overall mortality was 70%.ConclusionSevere head injury is a major cause of morbidity and mortality in developing countries. Limited access to highly specialised care explain a high mortality rate. An active policy of prevention from administrative authorities and a greater effectiveness of medical management may improve outcome.

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