Pediatric intracranial suppurations: Prognosis and schooling of operated patients in Cameroon

Abstract

Introduction:
Studies on the outcome of operated children for intracranial suppurations remain almost non-existent in sub-Saharan Africa, especially those concerning their schooling.
Objective:
The aim of this study was to evaluate the prognosis of children operated on for intracranial suppurations and their education.
Methodology:
The study was retrospective, multicenter and cross-sectional from january 1, 2010 to december 31, 2019. From the medical records, we assessed the diagnosis, treatment and prognosis of patients below the age of 17 years who had been operated upon for intracranial suppuration in Neurosurgery Units in Yaoundé and Douala. The patients and/or their families were contacted to respond to a questionnaire about their academic progress or for the patients to be examined.
Results:
A total of 33 patients were included. There were 24 boys (72.7%) and 9 girls (27.3%). The mean age was 9.75 ± 4.59 years, 7 (21.2%) were below the age of 6 years. Twenty-seven (27) children were in school and 6 out of school. The main clinical presentations were: fever [31 cases (93.9%)], headache 24 cases (72.7%), altered consciousness 19 cases (57.6%) and convulsions 12 cases (36, 4%). The culture was positive in 13 cases (39,3%). Empyemas were found in 17 cases (51.5%), and abscesses in 13 cases (39.4%). The mortality rate was 15.1% and 18 (58.1%) patients were cured without sequelae. The main sequela was epilepsy in 7 cases (22.6). Education was normal in patients who recovered without sequelae, although all the survivors had resumed their studies.
Conclusion:
The prognosis of patients operated upon for intracranial suppurations is satisfactory in our setting. The main sequella was epilepsy. The schooling of these children remains almost normal for most of the survivors.