Contribution of Computed Tomography in the management of headache in adults in Sub-Saharan Africa.

Abstract

Objective: To determine the etiology of headache in sub-Saharan Africa.

Patients and methods: a prospective study of six months duration carried out at the military hospital of Abidjan. It included all patients who underwent a Cranioencephalic CT for headache. The CT scans were performed in spontaneous contrast, supplemented according to the context by another complementary acquisition after iodinated contrast medium injection. The epidemiological and clinical data were obtained from the patients’ examination interview.

Results: The total number of our patients was 129. The sex ratio was 0.92. The average age was 44 years. The associated signs were: motor deficit (30.2%) and fever (11%). In 58.8% of cases there were no associated signs. In 17 cases there was a notion of combined hormonal taking, 20 cases of hypertension and 10 cases of trauma. CT revealed in 46.2% of cases a cause for headache. These etiologies were dominated by stroke (24%), followed by sinusitis (9.3%), abscesses and encephalitis (7.8%) and trauma (5.4%).

Conclusion: In sub-Saharan Africa headache is frequently explored in neuroradiology, particularly in subjects of about 44 years and most often females. This is a serious symptom for which CT revealed in 46.2% of cases an underlying cause dominated by decreasing order of frequency: stroke, sinusitis and brain abscess.

Keywords: cranioencephalic CT, headache, Sub-Saharan Africa.