Craniocerebral Gunshot Injuries in Chad: A Study of 44 Cases

Area of Science:

• Neurosurgery
• Trauma Surgery
• Public Health

Background:

• Firearm head injuries represent a significant public health challenge due to their severity and potential for life-threatening intracranial lesions and sepsis.
• This study focuses on the management of craniocerebral wounds in Chad, a region where such injuries pose a considerable threat.

Purpose of the Study:

• To evaluate the management strategies and outcomes of patients with ballistic craniocerebral wounds (BCW) in Chad.
• To identify demographic, injury-related, and treatment factors influencing the prognosis of BCW.

Main Methods:

• A prospective, observational study was conducted over 65 months, analyzing data from 44 patients with BCW.
• Patient data included demographics, injury mechanisms, clinical presentation, diagnostic procedures (brain scans), and surgical interventions.

Main Results:

• The majority of patients were young males (mean age 30.57 years), with military personnel constituting 63.6%.
• Explosive device attacks accounted for 29.5% of cases, often in civilian settings, and point-blank shootings were frequent (70.5%).
• Delayed admission (average 24.95 hours), surgical treatment (68.18%), and complications like brain abscess (6.8%) were noted, with seven recorded deaths.

Conclusions:

• Ballistic craniocerebral wounds are prevalent in Chad, predominantly affecting young males, with improvised explosive devices being a common cause, particularly in civilian cases.
• Significant delays in diagnostic and therapeutic management were observed, contributing to a high rate of sequelae and mortality.