EPIDEMIOLOGY, TREATMENT STRATEGY & OUTCOME IN PATIENTS WITH TRAUMATIC BASIFRONTAL CONTUSION- A RETROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA

Abstract

Background: Frontal contusions especially basifrontal region is quite common brain injury following road trafc accidents. The management of these basifrontal contusions depends upon various factors and appropriate management is important as these patients can deteriorate anytime during the hospital stay. The aim of this study is to analyze the epidemiology of basifrontal contus Objective: ions in head injury and assess the outcome following conservative vs. surgical treatment and to identify risk factors involving poor outcome in patients with traumatic basifrontal contusions. This study is a retrospective study from January 2022 to December 2022 conduc Material & methods: ted in institute of neurosurgery , madras medical college. Total 310 patients with CT ndings of basifrontal contusion admitted between jan 2022- dec 2022 were studied. Results: Initial surgical decompression was done in 50 patients of which 10 patients having contusion volume >50cm3 and 40 patients having contusion volume > 35cm3< 50cm3 . 10 patients were seen having increase in contusion volume & were undergone delayed surgical intervention after 48 hours. Of 310 patients treated , 74 patients died of which 38 deaths were in post operative period and 10 death in patients who were managed conservatively , 26 deaths in those patients whose admission GCS was 3. Seven patients died due to rapid deterioration within 24 hours of admission having GCS 9 to 13 with contusion volume 20cm3 – 35cm3. Three patients died after 7 days with GCS 13-15 who were conservatively managed with contusion volume < 20 cm3. Both sudden & delayed deterioration complicated the clinical course of this disease with both increased mortality & morbidity in bilateral lesions. Basifrontal contusion remains a Conclusion: challenge for the treating neurosurgeon when compared to contusions of other areas of brain as the basifrontal region is a silent area of brain and it is difcult to interrupt the quantum of injury and to elicit the features of increased intracranial pressure. Early surgical intervention might be appropriate in patients with contusion volume >35cm3 with GCS <9. Close observation with hourly GCS monitoring is essential in patients who are managed conservatively.