Factors Affecting Traumatic Brain Injury Outcome Among Patients Treated for Head Injury at Surgical Side, in Nekemte Referral Hospital, Oromia, Ethiopia.

Background Traumatic brain injury is an expanding major public health problem and the leading cause of death of the young and productive part of the world’s population. Research is mainly done in high-income countries where only a small proportion of the worldwide fatalities occur. Only few studies have examined prognostic factors of traumatic brain injury outcome in developing countries including Ethiopia. This study was aimed at defining the peculiar demographic and other associated factors of traumatic brain injury (TBI) outcome among patients treated for head injury at Nekemte Referral Hospital. Objective The main purpose of this study was to describe the magnitude of TBI outcome and assess factors associated with unfavourable outcome of TBI among patients treated for head injury at the surgical side in Nekemte Referral Hospital from July 8, 2016 to July 7, 2018. Methods A retrospective cross-sectional document review was conducted among TBI patients treated for head injury from July 8, 2016 to July 7, 2018 at Nekemte Referral Hospital. Data were collected using a pre-tested data collection format. Data analysis was done using SPSS version 20. Descriptive statistics were computed and association between the dependent and independent variables were assessed by using logistic regression. Odds ratios with 95% confidence interval were computed. Significant association was declared when the p value was <0.05. Results In this study, out of 378 cases 95 (25.1%) were discharged with unfavourable outcome of which 37(9.8%) were neurologic deficits and 58 were deaths giving overall mortality rate of 15.3%. Patient age>60years (AOR: 15.13; 95%CI: 3.575-64.028), time interval from injury to treatment (AOR: 16.054; 95%CI: 5.832-44.194), low GCS (AOR: 18.224; 95%CI: 4.167, 79.695), conservative management (AOR: 20.774; 95%CI: 6.106-70.681), pupils abnormality (AOR: 9.078; 95%CI: AOR: 2.996-27.509) were associated with unfavourable outcome. Conclusions A quarter of patients treated for TBI at Nekemte Referral Hospital are discharged with unfavourable outcomes. Old age, delayed presentation to the hospital, low GCS, conservative management, and pupillary abnormality increase the odds of unfavourable outcome. Timely management of TBI before patients develop secondary brain injury and use of surgical intervention based on CT scan diagnosis will reduce the occurrence of unfavourable outcome.

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Pediatric Minor Head Injury and Concussion

10.2310/tywc.4415 ◽

2018 ◽

Author(s):

Chad Scarboro ◽

Simone Lawson

Keyword(s):

Computed Tomography ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Mild Traumatic Brain Injury ◽

Head Injuries ◽

Normal Activity ◽

Secondary Brain Injury ◽

Wide Range ◽

Serious Injuries

Head injury is one of the most common reasons children present to the emergency department (ED) and the leading cause of pediatric death and disability. Head injuries can range from having no neurologic deficits to death. Management in the ED centers on determining if there is a serious brain injury and preventing secondary brain injury. In most cases of mild traumatic brain injury, serious injuries can be ruled out based on the history of the injury, associated symptoms, and clinical assessment. Concussion is a common presentation of head injury and encompasses a wide range of symptoms. Computed tomography should be used judiciously, and extensive research has led to algorithms to aid in this decision. Prior to discharge from the ED, parents will often have questions about when their child may resume normal activity. This is a decision that most often will involve the patient’s primary care provider or a concussion specialist as the ED provider is unable to follow progression or resolution of symptoms. However, the ED provider should be able to provide anticipatory guidance. Key words: computed tomography, concussion, head injury, mild traumatic brain injury, traumatic brain injury

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Differencial Diagnosis of Hypovolemia and Cushing‘s Response in Traumatic Brain Injury Patients, Using Hemodynamic Assessment Methods, to Prevent Secondary Brain Damage

Sveikatos mokslai ◽

10.5200/sm-hs.2015.035 ◽

2015 ◽

Vol 25 (2) ◽

pp. 83-86

Author(s):

Giedrė Zinkevičiūtė Žarskienė ◽

Diana Bilskienė ◽

Andrius Macas

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Vegetative State ◽

Public Health Problem ◽

Morbidity And Mortality ◽

Infusion Therapy ◽

Secondary Brain Injury ◽

Major Public Health Problem ◽

Hemodynamic Assessment ◽

Cord Injury

Traumatic brain injury is the leading cause of death and further cause of disability and a major public health problem. Although the severity of the injury depends directly on the primary brain injury, secondary brain injury deteriorates the outcomes. The main causes of secondary ischemic injury include hypotension (systolic blood pressure 90mmHg) and hypoxaemia (PaO260mmHg), which are directly associated with increase of morbidity and mortality due to severe traumatic brain injury. Hypoxia and hypotension during decompresive craniotomy are independently associated with significant increaeses in vegetative state development and higher frequency of disability. Intraoperative period, including immediate anaesthesia during urgent craniotomy, is a critical moment for these patients. Their intraoperative hypotension can be caused by various factors, such as blood loss due other traumatic injuries, direct pulmonary or heart disorders, sympathetic tone lesions (spinal cord injury and neurogenic shock), potent anesthetic medicaments action or current hypovolemia and inadequate infusion therapy. How to solve this situation? Usually we choose a larger infusion therapy and vasoactive drugs. Is it realy a best solution for the patient? Severe brain trauma and related complications are the most common morbidity and mortality causes in young and middle-aged people. The initial injury we can not influence, but to avoid the major secondary brain injury risks, especially such as hypotension and hypoxia, are required. Only quick and accurate diagnosis, secondary risk factors prevention and immediate treatment may improve the outcomes.

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Epidemiology of Traumatic Brain Injury in Neurosurgery Department of Tertiary Referral Hospital at North Sumatera, Indonesia

Medicinus ◽

10.19166/med.v7i5.2471 ◽

2020 ◽

Vol 7 (5) ◽

pp. 146

Author(s):

Steven Tandean ◽

Jeffrey Japardi ◽

Fini Kollins ◽

Michael Lumintang Loe

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Mortality Rate ◽

Length Of Stay ◽

Traffic Accident ◽

Severe Head Injury ◽

Referral Hospital ◽

Tertiary Referral ◽

Tertiary Referral Hospital

Introduction : Traumatic brain injury (TBI) is the most common problem that caused morbidity and mortality in the world. Epidemiology information of TBI is very important in understanding the causes and the risk factors of TBI, so that effective programs can be designed to prevent injury. This study purposed to provide overview of TBI pattern in tertiary referral hospital at North Sumatera with focus on epidemiological data of TBI pattern. Methods : The design of this study is a retrospective, and it is done in general hospital H. Adam Malik from June-December 2018 with sample from all patient with traumatic brain injury that admited in hospital. All medical records with diagnosis traumatic brain injury will be assessed for several variables as age, gender, etiology, severity, length of stay and outcome. Results : During the period of study, 118 patients with traumatic brain injury were admitted in neurosurgery ward. The highest TBI cases was occurs in male patients with range age between 18-35 years old, and caused by traffic accident. Most patients admitted to Emergency department with GCS 13-15 and epidural hematoma was the most common lesion found in head CT scan. Length of stay in this research mostly between 1-5 days, and the mortality rate is about 16.9%, which is dominated by severe head injury. Conclusions : Head injury mostly found in male with productive age, and traffic accident be the most common caused. Severe head injury still have quite high mortality rate.

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CONSERVATIVE MANAGEMENT OF SIGNIFICANT EXTRA-DURAL HAEMATOMA : CASES AND LITERATURE REVIEW

10.36106/paripex/3701403 ◽

2019 ◽

pp. 1-3

Author(s):

Dilraj Kadlas ◽

Meghna Kinjalk

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Ct Scan ◽

Conservative Management ◽

Road Traffic Accident ◽

Traffic Accident ◽

Road Traffic ◽

History Of

OBJECTIVE: Study of natural history of significant extra dural haematoma resolution. BACKGROUND: Traumatic brain injury is one of the leading causes of death. There are various modes of injury like road traffic accident, assault, fall and others.The traumatic brain injury can range from scalp laceration to intracranial haemorrhage.The line of management is decided upon considering several factors like age, co morbidities, Glasgow coma scale neurodeficiency,CT scan findings,other associated injury. CASE REPORT: A 24-year-old gentleman sustained head injury following road traffic accident. CT scan (head) was suggestive of extradural haematoma.Patient was subjected to decompressive craniotomy and evacuation of extra dural haematoma. On 2nd post-operative day, CT Scan (head) was done which was suggestive of right frontal and right posterior parietal extra dural haematoma. The relatives did not give consent for surgery .Conservative management was done. Patient improved and haematoma resolved. A 42 year old male presented to the emergency with history of head injury . CT Scan was suggestive of extra dural haematoma. Conservative management was done as surgery was refused by the relatives.Patient was monitored.Patient was asymptomatic after discharge and during follow up period. CONCLUSION:We report two unusual cases of extradural haematoma with a good outcome and uneventful follow up period.

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CT Scan importance in the first eight hours of head injury

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20182446 ◽

2018 ◽

Vol 5 (4) ◽

pp. 766

Author(s):

Mohammed Alfageeh ◽

Moneerah Bahran ◽

Sultan Albargi ◽

Ibrahim Althomali ◽

Adnan Alzahrani ◽

...

Keyword(s):

Public Health ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Public Health Problem ◽

Neurological Deficits ◽

Major Public Health Problem ◽

Adults And Children ◽

The Brain

Traumatic brain injury following head injury is a major public health problem that can result in significant long-term morbidity and mortality among adults and children worldwide. Emergency brain imaging is necessary for individuals subjected to traumatic brain injury to early detect treatable conditions. Prompt neurosurgical management of treatable conditions can prevent further damage and secondary neurological deficits. This will subsequently improve the outcome and reduce long-term disability. Computed Tomography (CT) of the brain is the investigation of choice for assessment of patients with head injury due to its availability, advantages, and sensitivity for multiple lesions following head trauma. This article will review and discuss the importance of CT imaging in evaluating patients with traumatic brain injury, its advantages, limitations, and prognostic values.

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Clinical profile and outcome of traumatic brain injury in children: record-based descriptive study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20213800 ◽

2021 ◽

Vol 8 (10) ◽

pp. 4950

Author(s):

Lekha Bhupendra Rathod ◽

Umakant G. Shidam ◽

Ruchir Kesaria ◽

Sanket Mohata ◽

Prashant Lakhe ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Medical Records ◽

Tertiary Care ◽

Public Health Problem ◽

Clinical Aspects ◽

Common Symptom ◽

Major Public Health Problem ◽

Paediatric Patients

Background: Paediatric head injury is considered to be a major public health problem and is often associated with significant morbidity and mortality in severe cases. The present study aimed to explore the demographics, mechanism of injury and clinical aspects of injury in children in a peripheral hospital attached to tertiary care centre.Methods: Electronic medical records of all paediatric patients aged ≤12 years with traumatic brain injury admitted during one-year period from January to December 2018 were reviewed. Epidemiological and clinical data of paediatric patients with traumatic brain injury (TBI) were analysed using SPSS version 20.Results: The medical records of 203 paediatric patients with TBI were analysed. The majority of the injury occurred in patients belonging to age-group 1-6 years. The number of male children outnumbered (58.1%) that of female children (41.9%). Fall from height was the most common mode of injury, followed by fall from a staircase. As per the Glasgow coma scale, 4% patients had severe head injury. Vomiting and headache was the most common symptom at admission (50.2%), a subdural hematoma was the most common lesion seen on computed tomography scans; frontal bone was the most common site of skull bone injury. Cutaneous injuries associated with contused lacerated wounds were the most common external injuries, 92.1% completely recovered with conservative management.Conclusions: Increasing incidence of paediatric trauma suggests the need for supervision during play and identification of environmental risk factors for such injuries. Parental advice and supervision is recommended to prevent accidental falls.

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Epidemiological, Clinical and Radiological Characteristics of Patients with Head Trauma

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v2i1.49 ◽

2017 ◽

Vol 2 (1) ◽

pp. 7

Author(s):

Amir Moghadamahmadi ◽

Alireza Vakilian ◽

Habib Farahmand ◽

Athena Sharifi-Razav ◽

Farzad Tajik ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Ct Scan ◽

Head Trauma ◽

Clinical Symptoms ◽

Head Injuries ◽

Major Public Health Problem ◽

Brain Ct ◽

Brain Ct Scan

Introduction: Head injury has been recognized as a major public health problem and is a frequent cause of death and disability in young people and makes considerable demands on health services. Motor vehicle accidents are the major causes of traumatic brain injury (TBI) that its occurrence has been increasing in our country in recent years.Objective: We decided to study head injury in our region to evaluate the Epidemiological, clinical and radiological features of this health problem.Materials and methods: We reviewed 200 TBI-patients records in Ali ebn abitaleb hospital of Rafsanjan from November 2012 – September 2013. A Questionnaire including Age, Sex, Job, Cause of trauma, GCS, Brain CT Scan findings and clinical symptoms for every head trauma patient; was completed. Data were analyzed by SPSS software. We used Chi-square test and P-Value less than 0.05 was considered significant.Results: From the total of 200 patients, 73.5% were males and 26.5% were females. The most common age group was 20-24 years. Majority of patients were students. Traffic accidents were the major cause of injuries (64.5%) and 35.5% of them were motorcyclist. The most frequent finding of Brain CT scan was skull fracture and subdural hematoma. 25% of patient had severe head injury. In clinical symptoms in conscious patients, headache, nausea, vomiting and vertigo was common.Conclusion: This study showed that we should pay more attention to traumatic brain injury young patients who are the most active potential forces of our society. Traffic accident s are the major reason for head injuries. Pay attention to prevention of this accident can perform important role in decreasing of head injuries.

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Pediatric Minor Head Injury and Concussion

10.2310/em.4415 ◽

2016 ◽

Author(s):

Chad Scarboro ◽

Simone Lawson

Keyword(s):

Computed Tomography ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Mild Traumatic Brain Injury ◽

Head Injuries ◽

Normal Activity ◽

Secondary Brain Injury ◽

Wide Range ◽

Serious Injuries

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An Epidemiological Study of Traumatic Head Injury in a Tertiary Care Center in Kancheepuram, Tamil Nadu, India

Asian Journal of Medicine and Health ◽

10.9734/ajmah/2019/v16i130136 ◽

2019 ◽

pp. 1-5

Author(s):

K. Myl Kumaran ◽

Pragadeesh Raja ◽

M. Jasmine

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Tamil Nadu ◽

Road Traffic ◽

Tertiary Care ◽

Major Public Health Problem ◽

Traumatic Head Injury ◽

History Of ◽

Traumatic Head

Introduction: Traumatic brain injury is a major public health problem in India. The severity of a traumatic brain injury may range from mild to severe. The increase in economic growth in India coupled with rise in population, motorization and industrialization has contributed to a significant increase in TBI with each advancing year. India having the highest rate of head injury in the world. In India more than 100000 lives are lost every year with over 1 million suffering from serious head injury. Objectives: To assess the risk factors among for head injury cases and assess the outcome of the traumatic brain injury patients. Materials and Methods: A cross sectional Study conducted among all patients with traumatic head injury attending tertiary care centre and those admitted in intensive care unit with the history of traumatic head injury for the duration of one year (August 2016 to July 2017). Data was collected through questionnaire, hospital records and collected from patients. Data Collected was entered in MS office excel and analyzed in SPSS version 21. Results: Totally 295 cases were reported with history of traumatic brain injury, out of which 82.7% were males and 17.3% were females. Road traffic accidents was the most common cause for TBI 86.4%. Most of the patient was between the age group of 21-40 (51.5%). Most of the cases were from rural areas 55.3%. Based on GCS 49.5%, 28.5% and 22.0% patients had mild, moderate and severe injury respectively. 44.7% injuries occurred between the time period 04.00PM to 12.00AM. Conclusion: This study revealed that most traumatic head injury occur due to Road traffic accident stressing the urgent need to create awareness and conduct health education about prevention of traumatic head injury.

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