Role of CT(Computed Tomography) in Head Injury

Background: Head injury is considered as a major health problem that is a frequent cause of death and disability and makes considerable demands on health services. CT remains essential for detecting lesions that require immediate neurosurgical intervention as well as those that require in-hospital observation and medical management.Objectives: To evaluate the computed tomography findings in patients sustaining head injury and to emphasize the importance of computed tomography scan in head injury.Methodology: The study was conducted for the period of one year .It comprised a total number of eighty patients presenting to the emergency room(ER) with head injury and were evaluated by CT scan of head using siemens somatom dual slice spiral CT machine.Results: the study showed overall male to female ratio as 2.6:1. Head injury was most common in 31-50years of age group. Road traffic accidents (RTA) was the commonest mode of injury seen in 65% of patients. Loss of consciousness followed by vomiting and seizures were the common clinical presentations in head trauma patients respectively. According to Glasgow coma scale( GCS), most of the patients (68.8%)sustained mild head injury( GCS13-15). Most common abnormal CT findings were skull fractures 39(48.8%), extradural hematoma 31 ( 38.8%), subdural hematoma 21(26.2%) ,contusions 21(26.2%), subarachnoid hemorrhage14 ( 17.5%) and pneumocephalous 13 (16.2%) respectively. Linear skull fracture was the commonest among all other skull fractures. Patients sustaining severe head injury were mostly due to RTA (77%). The highest mortality was seen in patients with severe head injury (GCS 3-8). 5% also had cervical spine injury.Conclusion: CT is the most comprehensive diagnostic modality for accurate localization of the site of injury in craniocerebral trauma. The early and timely diagnosis of the precise lesion by CT not only had the substantial impact over instituting appropriate treatment and timely surgical intervention but also helped in predicting the ultimate outcome.Journal of Manmohan Memorial Institute of Health Sciences Vol. 2 2016 p.45-52

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A Prospective Clinical Study of Depressed Skull Fractures with Special Reference to Its Management

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/230 ◽

2021 ◽

Vol 8 (18) ◽

pp. 1195-1200

Author(s):

Dhruba Jyoti Kurmi ◽

Kunal Deka ◽

Jishan Ahmed

Keyword(s):

Head Injury ◽

Hospital Stay ◽

Road Traffic ◽

Head Injuries ◽

Skull Fracture ◽

Prospective Clinical Study ◽

Skull Fractures ◽

Female Ratio ◽

Wide Range ◽

Gcs Score

BACKGROUND Depressed skull fractures (DSFs) cause wide range of injuries to the cranium and underlying structures, which influence the morbidity, mortality, and prognosis of the patient. This study was done to obtain a baseline clinical data regarding the management of such patients in Eastern part of our country. METHODS This prospective study was conducted in Assam Medical College and Hospital, Dibrugarh, from June 2016 to May 2017. Patients with depressed skull fractures fulfilling inclusion and exclusion criteria were included. After initial clinical evaluation, patients were put in conservative and surgical treatment groups. Surgical procedures were performed as per indication and intra-operative findings were recorded. All the patients were evaluated with regard to clinical findings, treatment provided, complications, outcome and other clinical variables during the hospital stay and follow up period. RESULTS A total of 65 patients out of the 1274 patients admitted for head injury were taken up for this study. Most patients were in the age group of 20 - 40 years. Male to female ratio was 5.5:1. The commonest mode of injury was road traffic accident followed by assault and others. Most common presenting symptom was brief loss of consciousness followed by post traumatic amnesia, ENT bleeding, seizures etc. Most commonly involved bone was frontal bone and most were compound fractures. At the time of presentation, 58.5 % of patients had Glasgow Coma Scale (GCS) score of 13 - 15, 33.8 % patients had a GCS score of 9 - 12 and 7.7 % had a GCS score of 3 - 8. Surgical intervention was required in 25 patients and rest received conservative treatment. Two patients expired during hospital stay. At the end of 3 months 78.46 % patients had good recovery, 6.1 % had moderate disability and 6.1 % patients had severe disability. CONCLUSIONS DSFs carry specific clinical features and problems which require individualised attention and care. These types of head injuries can be managed with good outcome in a peripheral government centre run by a single neurosurgeon. KEYWORDS Head Injury, Traumatic Brain Injury, Depressed Skull Fracture

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Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

Indian Journal of Neurotrauma ◽

10.1055/s-0040-1718780 ◽

2021 ◽

Author(s):

Sukriti Das ◽

Bipin Chaurasia ◽

Dipankar Ghosh ◽

Asit Chandra Sarker

Keyword(s):

Head Injury ◽

Road Traffic ◽

Head Injuries ◽

Skull Fracture ◽

Tertiary Care ◽

Acute Subdural Hematoma ◽

Care Hospital ◽

Female Ratio ◽

Mortality And Morbidity ◽

The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

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A study of correlation of degree of midline shift on computed tomography scan and Glasgow coma scale in patients of acute traumatic head injury

International Surgery Journal ◽

10.18203/2349-2902.isj20213998 ◽

2021 ◽

Vol 8 (10) ◽

pp. 3075

Author(s):

A. K. Chaurasia ◽

Lalit Dhurve ◽

Rajneesh Gour ◽

Rajpal Kori ◽

Avias K. Ahmad

Keyword(s):

Computed Tomography ◽

Head Injury ◽

Glasgow Coma Scale ◽

Severe Head Injury ◽

Road Traffic ◽

Midline Shift ◽

Traumatic Head Injury ◽

Cross Sectional ◽

Common Cause ◽

Coma Scale

Background: Traumatic brain injury is one of most common cause of death in road traffic accident. Most of these classified as mild injury, with approximately 20% classified as moderate to severe. Approximate 50% of the 150,000 trauma deaths every year are caused by head injury.Methods: A prospective cross-sectional study was conducted on 150 patients with a head injury admitted in the Hamidia hospital, Bhopal. The assessment of the severity of head injury using Glasgow coma scale (GCS) at the time of admission, follow up on 5 days and 15 days respectively. The collected data were transformed into variables, coded and entered in Microsoft excel. Data were analyzed and statistically evaluated using statistical package for the social sciences (SPSS)-PC-21 version.Results: Out of 150, a total of 115 patients had no midline shift while 35 patients were having midline shift. Severe head injury patients (GCS 3-8) were having more morbidity and mortality. Moderate head injury (GCS 9-13) was associated with good prognosis and low mortality. A greater degree of midline shift of (more than 5 mm) is indicated severe head injury and is significantly associated with morbid outcome and higher mortality.Conclusions: In our study, road traffic accidents is the most common cause of head injury, with males being affected more than females. The degree of midline shift on computed tomography (CT) scan head in patients with head injuries was found to be significantly associated with high mortality and morbidity.

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Secular Trend, Seasonal Variation, Epidemiological Pattern, and Outcome of Traumatic Head Injuries Due to Road Traffic Accidents in Aseer, Saudi Arabia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126623 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6623

Author(s):

Mubarak Ali Algahtany

Keyword(s):

Saudi Arabia ◽

Seasonal Variation ◽

Head Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Skull Fracture ◽

Road Traffic Accidents ◽

Female Ratio ◽

Common Diagnosis ◽

Traumatic Head

Road traffic accidents (RTAs) are a leading cause of traumatic head injury (THI) and are regarded as a public health problem in Saudi Arabia. This hospital-based retrospective study aims to provide data on the frequency, type, and distribution of RTA-related THIs over the past decade; demonstrate their time trend and seasonality; and decipher age and sex differences in RTA-related THIs and their outcome. The results showed a decline in the number of RTA-related THIs between 2010 and 2019. The patients had a mean age of 26.16 ± 16.27 years, and the male-to-female ratio was 10.8:1. Head injury with multiple lesions was the most common diagnosis, followed by cerebral contusion and skull fracture (32.1%, 12.9%, and 11.2%, respectively). Subdural hematoma (SDH) and skull fracture were significantly more common in patients aged ≥60 years (standard residual > 1.96), and significantly less common in those aged ≤17 years (standard residual < 1.96), compared to other age groups. Males experienced significantly more SDHs than females (standard residual = −2.8, p = 0.029). The length of hospital stay was positively correlated with age (Spearman’s rho = 0.057, p = 0.046). No seasonal variation was found.

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An Analysis of Aetiology, Pattern and Outcome of Head Injury in Trauma Patients

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0903.05 ◽

2022 ◽

Vol 9 (3) ◽

pp. 16-21

Author(s):

Sudatta Waghmare ◽

ashish Aswar ◽

Hiranya Deka ◽

Aman Singh ◽

Arjav Nanavati ◽

...

Keyword(s):

Blood Pressure ◽

Head Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Tertiary Care ◽

Care Hospital ◽

Road Traffic Accidents ◽

Major Health Problem ◽

Female Ratio ◽

Associated Injury

Abstract Background: Head injury is considered as a major health problem in developed and developing nations. Analysis of etiology, patterns, and outcome of head injury in trauma patient is essential for understanding and planning for better management. Materials and Methods: The prospective observational study carried out among patients who presented with head injury at the tertiary care hospital, Mumbai from July 2015 to July 2017. Demographic details recorded were age, sex, blood pressure on arrival, Glasgow Coma Scale (GCS) score, the interval between injury and admission, associated injury, co-morbidities, hospital stay, and outcome. Results: The age group at which maximum patients of head injury were admitted was 18-29 years (31%) followed by 40-49 years (21%). Eighty one percent patients were males and 19% patients were females, the male to female ratio being 4:1. Road traffic accidents (36% cases) were the commonest cause leading to acute head injury followed by accidental fall (21% cases). 47% patients presented with mild head injury according to GCS. Conclusion: Head injuries mainly caused by vehicular accidents and affect mainly the young men. Road traffic accidents were the commonest mode of head injury, but railway accident had the worst outcome in our study. Factors associated with outcome were Pre-hospital delay, GCS on arrival, Blood pressure on arrival, Associated injury, Need for ventilator support, CT scan findings.

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Scenario of Head Injury Patients in Tertiary Care Hospital of Nepal

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v18i1.2276 ◽

2020 ◽

Vol 18 (1) ◽

pp. 112-115

Author(s):

Subodh Sharma Paudel ◽

Ritesh Luitel ◽

Anushruti Bista ◽

Aashish Baniya ◽

Dibya Jyoti Panta ◽

...

Keyword(s):

Computed Tomography ◽

Head Injury ◽

Glasgow Coma Scale ◽

Head Trauma ◽

Road Traffic Accident ◽

Traffic Accident ◽

Severe Head Injury ◽

Road Traffic ◽

Care Hospital ◽

Coma Scale

Background: The aim of the study is to find out the age and sex distribution, modes of head injury and correlate Glasgow Coma Scale with Computed Tomography in patients with head trauma in our center.Methods: A cross-sectional study was performed among 113 patients of acute head trauma presenting to Emergency department of our hospital for three months. The severity of the head injury was assessed on admission by the Glasgow Coma Scale score and categorized as mild, moderate, or severe head injury. Non contrast head computed tomography was obtained. Results: The mean age of patients studied in this study was 35.53 year in males and 32.1 year in female with male to female ratio being 1.86:1. The most common causes of head injury were road-traffic accident 58 (51%), falls 42 (37%) and physical assault 13 (12%). In our present study, 67 (59.3%) of patients had mild head injury, 27 (23.9%) had moderate head injury and 19(16.8%) had severe head injury. Our study shows presence of multiple lesions with depressed bone fracture of skull bone was associated with lower Glasgow Coma Scale. Significant association between Glasgow Coma Scale and computed tomography finding was seen (p<0.001). Conclusions: Glasgow Coma Scale is strongly associated with computed tomography in patients with head injury. Road traffic accident is the commonest mode of injury. Most present with mild head injury.Keywords: Computed tomography; Glasgow coma scale; head injury

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Clinical spectrum of paediatric head injury

Romanian Neurosurgery ◽

10.33962/roneuro-2020-033 ◽

2020 ◽

pp. 220-225

Author(s):

Krishna Govind Lodha ◽

Tarun Kumar Gupta ◽

Gaurav Jaiswal ◽

Yogendra Singh

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Road Traffic ◽

Radiological Finding ◽

Paediatric Population ◽

Major Health Problem ◽

Female Ratio ◽

Paediatric Head Injury ◽

Fall From Height

Introduction: Traumatic Brain injury is considered as a major health problem which causes frequent deaths and disabilities in paediatric population with special concern to tribal regions of developing countries like India where etiology of traumatic brain injury in the paediatric population fall from height dominant over the road traffic accident as a major. Aim and objective: The aim is to analyse the epidemiology, mechanism, clinical presentation, severity and outcome of paediatric head injury in the tribal region of northern India that could help to make preventive policies to improve their care. Material methods: It is a prospective observational study of 345 children of up to 18 years of age admitted under Department of Neurosurgery from October 2017 to April 2019. Results: The study population comprised of 345 paediatric patients. Mean age was 9.25 years.36.81% patients were in 1-6-year age group and male to female ratio was 2.45. The most common cause for trauma was fall from height in 179(52%) cases followed by RTA in 141(41%) cases. The most common radiological finding was depressed skull fractures in 97(50%) cases. There was 35% mortality in severe head injury patients. Conclusion: This study through some light on the different scenario of head injury in Tribal regions of Developing country and will help to formulate effective strategies for prevention and better care of the patients.

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Risk Factors, Pattern and Outcome of Motorcycle-associated Head Injury in Sokoto: An Analysis of 184 Cases

Indian Journal of Neurotrauma ◽

10.1055/s-0040-1722553 ◽

2021 ◽

Author(s):

Henry Olayere Obanife ◽

Nasiru Jinjiri Ismail ◽

Ali Lasseini ◽

Bello B. Shehu ◽

Ega J. Otorkpa

Keyword(s):

Developing Countries ◽

Head Injury ◽

Road Traffic ◽

Negative Impact ◽

Cross Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Incidence And Mortality ◽

Male Female Ratio ◽

Significant Negative Impact

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Methods This is a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.

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