Firearm-related injuries are deadly but avoidable. The case of Kivu, a region in the Eastern Democratic Republic of Congo (DRC), is alarming. Decades of unresolved regional conflicts birthed armed groups that have massacred inhabitants and injured several children. This regional instability has also created barriers to seeking and obtaining timely care, decreasing the survival rate. This region's lack of data on paediatric fatal and nonfatal firearm injuries (F&NFFIs) needs studying. Thus, we aim to determine the prevalence and evaluate the outcomes of paediatric F&NFFIs in Kivu. We included all F&NFFI paediatric patients (≤18 years), admitted at our institution between 2017 and 2020. We extracted data from patient records. Next, we assessed the relationship between determinants of paediatric outcomes using the Chi-square test and the student's t-test. Confounders were identified using cox regression. This study included 101 paediatric patients, mostly male (63.4%), with an average age of 15.9 years residing 164.4 km on average from the hospital. On average, they were admitted 2.9 days post-injury, with the most affected anatomical regions being lower limbs (53.5%) and upper limbs (18.8%). The mean length of stay was 52.9 days, and the mortality rate was 4.0%. Also, injury complications increased the mean length of stay and mortality rate. In addition, mortality was correlated with circulatory failure and anaemia. Paediatric F&NFFIs in Eastern DRC is a preventable tragedy. Mortality is increased by injury complications and correlates with some biological factors. Prevention strategies should be developed to protect children and appropriate measures should be established to improve rates of prehospital care and early hospital presentation to lower mortality and improve paediatric outcomes.

Traumatic brain injury (TBI) data in Africa remain limited, underscoring the need for a robust neurotrauma registry. This study evaluates the availability, implementation, and challenges of the Neurotrauma Registry in Africa (NEUTRIA) and provides recommendations for developing a continent-wide TBI registry. An e-survey was distributed via Google Forms to neurosurgeons and neurosurgical trainees across Africa from November 1 to December 10, 2024. From the 54 African countries, 81.5% (n = 44) responded. Ninety-seven responses were recorded for 91 (93.8%) inclusion from 39 (72.2%) African countries. Statistical analysis was performed using JAMOVI 3.2.0. Neurosurgical centers were unevenly distributed, with 47.3% of respondents reporting 3-5 centers across 21 countries. Most centers (75.8%) served public and private systems, while 22.0% were exclusively public. Paper-based registries for TBI and traumatic spinal cord injury were used in 79.1% of centers, while 46.2% employed electronic systems, with Excel being the most common platform. Seven countries (Tanzania, Mozambique, Egypt, Rwanda, Cameroon, Zambia, and Uganda) had national registries, each with variable patient volumes. Key challenges included administrative burdens, material and staffing shortages, time constraints, and limited awareness about the registry's importance. Financial support from governments and nongovernment organizations was crucial for implementing national registries and improving data collection and neurotrauma care across the continent. This study highlights the uneven distribution of neurotrauma care and African registries. Although progress is evident, significant barriers hinder widespread implementation. Expanding financial support and addressing systemic challenges is critical for advancing data collection and improving neurotrauma care continent-wide.

Key Clinical Message: Arrow injuries have not disappeared in our environment despite the advances in the development of warfare tools in the world. All regions of the body can be the target of these arrows and in particular the cephalic region whose gravity will depend on the structures reached. With the development of modern weapons of war, arrow wounds have become rare in developed countries, but they are still common in developing countries, including Niger. These injuries are often serious and life‐threatening when they are in the head and neck region, due to the presence of major vessels and vital organs in these areas of the body. Extraction of these arrows is usually difficult due to the proximity of major vital structures. Unskilled extraction can aggravate the injury or result in unintentional damage to vital structures with imminent risk of death. We present the case of a patient with a homemade arrow to the head in the left periorbital region that we successfully extracted at the National Hospital in Niamey. Our objective is to highlight the experience with this patient and review some reports in the literature.

Background: Epidural hematoma constitutes a common condition in neuro-traumatology. If its acute form is well known, the chronic one remains less described. Objective: This study aimed to evaluate the epidemiology, clinical presentations, management, and outcomes of chronic epidural hematoma. Methodology: Systematic searches of PubMed, Google Scholar, and ScienceDirect were performed from a database searching for all studies reporting chronic epidural hematoma. Pooled statistics were calculated using measures of central tendency and spread. The rank correlation test and the regression test, using the standard error of the observed outcomes as predictor, are used to check for funnel plot asymmetry. Results: A total of 3009 studies were identified, of which 95 were included with 359 patients. Chronic epidural hematoma (CEDH) was more common at the intracranial level than spinal level (91.9% vs 8.1%). The average age of onset was 37.2 ± 4.83 years. The common cause found was trauma (n = 279; 77.72%) with 271 (97.1%) cases for the head and 8 (2.9%) cases for the spine. The mean delay between the trauma and the first symptoms was 13.32 ± 1.73 days in intracranial level and 16.38 ± 2.49 days in spinal level. CT scan constituted the main diagnosis tool. The lesion was predominantly located in the temporal region at the intracranial level and lumbar region at the spinal level. Craniotomy and laminectomy constituted the most reported treatment option, respectively, at the intracranial and spinal level. The outcome was commonly uneventful. Correlation and regression tests for publication bias assessment show no significant funnel plot asymmetry with high p value (p = 0.8458 and p = 0.9596, respectively). Conclusion: CEDH was commonly related to trauma. Its treatment was mostly surgical at both sites.

Spinal tuberculosis is the most common form of extrapulmonary tuberculosis. While cervical involvement, known as cervical Pott's disease, has traditionally been considered rare, its incidence is increasing. However, comprehensive data on its clinical presentation, diagnostic methods, treatment options, and outcomes remain limited. This review consolidates evidence on cervical spine tuberculosis, offering insights into its epidemiology, therapeutic strategies, and outcomes. A systematic search of PubMed/MEDLINE and Google Scholar was conducted following PRISMA guidelines to identify studies related to cervical spine tuberculosis. Quantitative data were analyzed using Jamovi 2.3.0. The pooled mean age was 23.6 years (95% CI: 18.3-29.0), with 54.6% of patients being male. Prior pulmonary tuberculosis and exposure were reported in 52% and 26% of cases, respectively. Common symptoms included cervical pain (69.5%), radicular pain (31%), motor-sensory deficits (46.2%), and fever (50.1%). MRI findings showed epidural/paravertebral abscesses with cord involvement in 72.9% of cases. Lesions affected a single vertebral level in 42.8% of cases, predominantly in the upper cervical spine (52.7%). Surgical intervention was performed in 71.9% of patients, using anterior (60.4%), posterior (44.1%), or combined approaches (18.2%). Bone fusion was achieved in 4.1 months. Surgery-related mortality was 1.0%. Cervical spine tuberculosis, though rare, is a severe extrapulmonary form with a rising incidence. The condition leads to neurological impairments and spinal deformities, with symptoms including cervical pain, motor-sensory deficits, and fever. A combination of medical and surgical treatment can result in favorable neurological outcomes. Future research should focus on developing protocols and evaluating outcomes to improve management.