scholarly journals Aetiology of Traumatic Brain Injury in Bauchi, North East Nigeria

Author(s):  
Ogunleye Olabisi Oluwagbeiga ◽  
Ibrahim Shaphat Shuaibu ◽  
Obanife Henry Olayere

Background: Trauma is the leading cause of death among teens and youth in the developing countries. Head injury accounts for nearly onethird of all trauma deaths and is the leading cause of disability and economic loss. The aim was to study the aetiological pattern of head injury and to highlight the burden of the aetiological factors in our setting. Materials and method: A prospective study on patients admitted with traumatic brain injury at Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, a tertiary hospital located in North-eastern Nigeria with neurosurgical services being rendered to her primary and referred patients. Data were collected using structured proforma and were analysed using SPSS version 20 software. Descriptive statistics expressed in mean, frequency and percentages. Results: Five hundred and thirty-seven patients were recruited into the study.

2019 ◽  
pp. 443-448
Author(s):  
Vibhushankar Parashar ◽  
Vivek Kumar Kankane ◽  
Gaurav Jaiswal ◽  
Tarun Kumar Gupta

Introduction. Traumatic brain injury is a leading cause of death and disability among children, adolescents. Therefore, analysing outcome predictors and initiating preventive policies may contribute to decreased incidence and better prognosis. Aim. Aim to describe the epidemiologic characteristics, mechanism of injury, radiological findings and also to analyse the determinants of outcome that could help to provide better critical care and also to establish effective preventive policies. Material and Methods. We conducted a prospective study including patients ?18 years admitted to our Neuro-intensive care unit at R.N.T. Medical College ,Udaipur, Rajasthan, India from September 2016 to June 2018.Factors including age, gender ,mode of injury, Glasgow coma score(GCS) at admission ,pupillary size-reaction, radiological findings and their relation to outcome was assessed .Patients were divided into mild, moderate and severe head injury according to GCS. Outcome of patients was assessed by Glasgow outcome scale. For statical Analysis used Chisquare test. Statistical Analysis was carried out using Stata 11.0(College station, Texas, USA) Results. The study comprised of 84 paediatric patients. 44.4%of patients were within 1–5-year age group. The most common cause for trauma was falls and traffic accidents. Patients with mild, moderate and severe head injury were 38.1%, 47.6%and 14.3% respectively. Poor outcome predictors included severity of head injury, pupil size and reaction, midline shift on CT. Conclusion. This study emphasizes increased burden of paediatric brain injury with assessment of predicting factors for more effective critical care of patients and emerging need for effective fall and traffic accidents prevention strategies.


2018 ◽  
Vol 6 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Prakash Kafle ◽  
Mohan Raj Sharma ◽  
Sushil K Shilpakar ◽  
Gopal Sedain ◽  
Amit Pradhanang ◽  
...  

Introduction : Traumatic brain injury (TBI) is one of the major cause of severe disability and death world wide.The mortality rate in these patients largely depends on initial severity of trauma. In TBI, initial level of consciousness is most important prognostic indicator. The commonest scale is the Glasgow Coma Scale (GCS). Despite its widespread use, the GCS has some significant limitations, including variations in inter rater reliability and predictive validity. In order to overcome deficiencies of the GCS, an alternative scale called FOUR (Full Outline of Unresponsiveness score) has been developed and validated in several neurosurgical centers in North America. This study was an attempt to validate this score in Nepalese Setting.  This study was carried out in the Department of Neurosurgery at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. The main objective ofthe study was to compare the FOUR with GCS in predicting outcome in patients with Traumatic brain injury.MATERIAL AND METHODS: Patients with moderate to severe head injury aged 2: 16 years admitted in the Department ofNeurosurgery were eligible to participate in the study.The GCS and FOUR score were measured at the earliest possible time during admission by the single observer. Glasgow Outcome Scale (GOS) was measured at discharge and at 3 months follow up. Mortality was used as the primary outcome measure.RESULTS: Total  of 122 patients were included in the study. The mean age of the study population was 38.7 ± 18 years. Mean GCS score among survivors was higher than that among non-survivors which was statistically significant (10.9 ± 2 vs. 6 ± 1.12 (p <0.001). Similarly mean FOUR score among survivors was significantly higher than that among non-survivors ( 12. 8±2.49 vs. 6.08 ± 1.72 (p< 0.001). The cut off point for GCS and FOUR score were ≤ 7and ≤ 8 respectively. The area under ROC curve for GCS for prediction of mortality was 0.975 (95% CI; 0.947-1.000; p<0.001) and for FOUR score was 0.981 (95% CI; 0.960-1.000; p<0.001) suggesting good discrimination ability ofboth models.The overall sensitivity, specificity, positive predictive value and negative predictive values of GCS were 91.67%, 91.82%, 55% and 99% respectively while that for FOUR score were 100%, 91.82%, 57.1 % and 100%respectively.CONCLUSION: The outcome measurement of FOUR score was comparable with the GCS in traumatic brain injury and both the scores correlated well.Journal of Universal College of Medical SciencesVol. 6, No. 1, 2018, Page: 32-39 


Author(s):  
Gopal Krishna ◽  
Varun Aggarwal ◽  
Ishwar Singh

Abstract Introduction Traumatic brain injury (TBI) affects the coagulation pathway in a distinct way than does extracranial trauma. The extent of coagulation abnormalities varies from bleeding diathesis to disseminated thrombosis. Design Prospective study. Methods The study included 50 patients of isolated TBI with cohorts of moderate (MHI) and severe head injury (SHI). Coagulopathy was graded according to the values of parameters in single laboratory. The incidence of coagulopathy according to the severity of TBI and correlation with disseminated intravascular coagulation (DIC) score, platelets, prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, and fibrinogen was observed. The comparison was also made between expired and discharged patients within each group. It also compared coagulation derailments with clinical presentation (Glasgow Coma Scale [GCS]) and outcome (Glasgow Outcome Scale [GOS]). Results Road traffic accident was the primary (72%) mode of injury. Fifty-two percent had MHI and rest had SHI. Eighty-four percent of cases were managed conservatively. The mean GCS was 12.23 and 5.75 in MHI and SHI, respectively. Sixty-two percent of MHI and 96% of the patients with SHI had coagulation abnormalities. On statistical analysis, DIC score (p < 0.001) strongly correlated with the severity of head injury and GOS. PT and APTT were also significantly associated with the severity of TBI. In patients with moderate TBI, D-dimer and platelet counts showed association with clinical outcome. Fibrinogen levels did not show any statistical significance. The mean platelet counts remained normal in both the groups of TBI. The mean GOS was 1.54 and 4.62 in SHI and MHI, respectively. Conclusion Coagulopathy is common in isolated TBI. The basic laboratory parameters are reliable predictors of coagulation abnormalities in TBI. Coagulopathy is directly associated with the severity of TBI, GCS, and poor outcome.


Cells ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 500
Author(s):  
William Brad Hubbard ◽  
Meenakshi Banerjee ◽  
Hemendra Vekaria ◽  
Kanakanagavalli Shravani Prakhya ◽  
Smita Joshi ◽  
...  

Traumatic brain injury (TBI) affects over 3 million individuals every year in the U.S. There is growing appreciation that TBI can produce systemic modifications, which are in part propagated through blood–brain barrier (BBB) dysfunction and blood–brain cell interactions. As such, platelets and leukocytes contribute to mechanisms of thromboinflammation after TBI. While these mechanisms have been investigated in experimental models of contusion brain injury, less is known regarding acute alterations following mild closed head injury. To investigate the role of platelet dynamics and bioenergetics after TBI, we employed two distinct, well-established models of TBI in mice: the controlled cortical impact (CCI) model of contusion brain injury and the closed head injury (CHI) model of mild diffuse brain injury. Hematology parameters, platelet-neutrophil aggregation, and platelet respirometry were assessed acutely after injury. CCI resulted in an early drop in blood leukocyte counts, while CHI increased blood leukocyte counts early after injury. Platelet-neutrophil aggregation was altered acutely after CCI compared to sham. Furthermore, platelet bioenergetic coupling efficiency was transiently reduced at 6 h and increased at 24 h post-CCI. After CHI, oxidative phosphorylation in intact platelets was reduced at 6 h and increased at 24 h compared to sham. Taken together, these data demonstrate that brain trauma initiates alterations in platelet-leukocyte dynamics and platelet metabolism, which may be time- and injury-dependent, providing evidence that platelets carry a peripheral signature of brain injury. The unique trend of platelet bioenergetics after two distinct types of TBI suggests the potential for utilization in prognosis.


Author(s):  
Shrikant Govindrao Palekar ◽  
Manish Jaiswal ◽  
Mandar Patil ◽  
Vijay Malpathak

Abstract Background Clinicians treating patients with head injury often take decisions based on their assessment of prognosis. Assessment of prognosis could help communication with a patient and the family. One of the most widely used clinical tools for such prediction is the Glasgow coma scale (GCS); however, the tool has a limitation with regard to its use in patients who are under sedation, are intubated, or under the influence of alcohol or psychoactive drugs. CT scan findings such as status of basal cistern, midline shift, associated traumatic subarachnoid hemorrhage (SAH), and intraventricular hemorrhage are useful indicators in predicting outcome and also considered as valid options for prognostication of the patients with traumatic brain injury (TBI), especially in emergency setting. Materials and Methods 108 patients of head injury were assessed at admission with clinical examination, history, and CT scan of brain. CT findings were classified according to type of lesion and midline shift correlated to GCS score at admission. All the subjects in this study were managed with an identical treatment protocol. Outcome of these patients were assessed on GCS score at discharge. Result Among patients with severe GCS, 51% had midline shift. The degree of midline shift in CT head was a statistically significant determinant of outcome (p = 0.023). Seventeen out of 48 patients (35.4%) with midline shift had poor outcome as compared with 8 out of 60 patients (13.3%) with no midline shift. Conclusion In patients with TBI, the degree of midline shift on CT scan was significantly related to the severity of head injury and resulted in poor clinical outcome.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rani Matuk ◽  
Mandy Pereira ◽  
Janette Baird ◽  
Mark Dooner ◽  
Yan Cheng ◽  
...  

AbstractTraumatic brain injury (TBI) is of significant concern in the realm of high impact contact sports, including mixed martial arts (MMA). Extracellular vesicles (EVs) travel between the brain and oral cavity and may be isolated from salivary samples as a noninvasive biomarker of TBI. Salivary EVs may highlight acute neurocognitive or neuropathological changes, which may be particularly useful as a biomarker in high impact sports. Pre and post-fight samples of saliva were isolated from 8 MMA fighters and 7 from controls. Real-time PCR of salivary EVs was done using the TaqMan Human Inflammatory array. Gene expression profiles were compared pre-fight to post-fight as well as pre-fight to controls. Largest signals were noted for fighters sustaining a loss by technical knockout (higher impact mechanism of injury) or a full match culminating in referee decision (longer length of fight), while smaller signals were noted for fighters winning by joint or choke submission (lower impact mechanism as well as less time). A correlation was observed between absolute gene information signals and fight related markers of head injury severity. Gene expression was also significantly different in MMA fighters pre-fight compared to controls. Our findings suggest that salivary EVs as a potential biomarker in the acute period following head injury to identify injury severity and can help elucidate pathophysiological processes involved in TBI.


2016 ◽  
Vol 12 (2) ◽  
pp. 63-66
Author(s):  
Bal G Karmacharya ◽  
Brijesh Sathian

The objective of this study was to review the demographics, causes injury, severity, treatment and outcome of traumatic brain injuries in victims of the April 2015 earthquake who were admitted in Manipal Teaching Hospital, Pokhara. A total of 37 patients was admitted under Neurosurgery Services. Collapse of buildings was the commonest cause of head injury. The majority of them had mild head injury. Associated injuries to other parts of the body were present in 40.54% patients.Nepal Journal of Neuroscience 12:63-66, 2015


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