Résumé

Introduction: The International Labor Organization (ILO) reports that approximately 270 million workers worldwide experience occupational accidents each year, leading to 2.2 million fatalities. While these global statistics are well-documented, data on occupational accidents in Comoros remain limited. Key contributing factors to workplace injuries include equipment failures, human error, inadequate hazard awareness, insufficient training, and non-compliance with safety regulations. This study presents a detailed case of a severe occupational traumatic brain injury (TBI) admitted to and managed at the Emergency Department of CHN El-Maarouf. Clinical case: A 34-year-old male, employed as a telecommunication engineer specializing in radio relay systems, sustained a severe occupational injury while working at an elevated height. His duties frequently required him to operate on transmission towers, and he had undergone formal safety training, including the use of personal protective equipment (PPE). The incident occurred during routine maintenance on a radio transmission tower, when the patient fell from a height exceeding 15 meters. He was transported to CHN El-Maarouf’s emergency department in a private vehicle, exhibiting signs of traumatic brain injury, including a temporary loss of consciousness lasting approximately 15 minutes and multiple episodes of vomiting. Upon admission, the patient was fully conscious with a Glasgow Coma Scale (GCS) score of 15/15. A thorough physical examination revealed a significant hemorrhagic frontal scalp wound, suggesting a high-impact cranial injury. Urgent cranial computed tomography (CT) imaging was performed, revealing a comminuted depressed frontal skull fracture with intracerebral bone fragments, a contusional hemorrhagic edema, and the presence of pneumocephalus. Given the severity of the injury, immediate surgical intervention was indicated. The patient underwent extensive wound debridement, removal of intracerebral bone fragments, and cranioplasty with bone reconstruction using a metallic plate. The postoperative period was closely monitored, and the patient demonstrated a favorable recovery trajectory, with no observed neurological deficits. He was discharged on the third postoperative day with instructions for close outpatient follow-up. Conclusion: Severe occupational accidents, particularly those involving traumatic brain injuries, pose a growing public health challenge, especially in high-altitude work environments. Comprehensive safety training and emergency preparedness protocols are essential for mitigating risks and improving survival outcomes. This case highlights the critical importance of rapid medical intervention, advanced imaging, and timely neurosurgical management in optimizing patient recovery and prognosis.

Mot-clés :

Occupational Accidents, Traumatic Brain Injury, Comoros, Safety