Épidémiologie, Présentation Clinique et Évolution des Hémorragies Spontanées du Tronc Cérébral au CHU Point G

ABSTRACTIntroduction.Stroke is a major public health problem in the world in terms of morbidity and mortality. According to Collomb, spontaneous hemorrhages of the brainstem represent between 2 to 16% of hemorrhagic strokes [1]. Spontaneous hemorrhages of the brainstem due to their location are often life-threatening for patients. The aim of this study is to determine the epidemiological, clinical and radiological aspects of spontaneous hemorrhages of brainstem. Patients and methods. This was a prospective and descriptive study from January 2016 to September 2018 of cases of spontaneous haemorrhages of the brainstem collected in the neurology department of Point G Teaching Hospital. Patients male or female were included in the study wich having presented a spontaneous hemorrhage in the brainstem certified by cerebral imaging. Cases of post-traumatic brainstem hemorrhage and cerebral or cerebellar hemorrhages with brainstem contamination were not included. Results. The frequency of brainstem haemorrhages was 5.2% of haemorrhagic strokes with a predominance of women (sex-ratio 1.5). The average age was 41.4 years with extremes of 27 and 52 years. High blood pressure (HBP) was the major cardiovascular risk factor in 90% of cases. The site of the hematoma was pons in 90% of cases. The outcome was favorable in all of ours patients. Conclusion. Spontaneous haemorrhage of brainstem is a serious and potentially fatal condition for which hospitalization in a neurovascular unit is required in the face of signs of seriousness (volume of bleeding, deep coma, cardio-respiratory distress, epilepticus state, etc.). The finesse of the neurological examination makes it possible to suspect the level of the lesion on the brainstem. Unlike ischemias, cerebral CT is very sensitive in detecting hemorrhages from TC. Observation of directives recommending symptomatic treatment combined with monitoring. Gave us a favorable outcome in all of our patients despite our limited resources.