The burden of motorcycle-related neurotrauma in South-East Nigeria

Abstract

Neurotrauma or cranio-spinal trauma is the most common pathology in multiple injuries, causing significant morbidity and mortality. Majority of cases result from road traffic accidents. In one of Nigeria’s centres for neurosurgery, we evaluated our local etiological patterns to ascertain the impact of motorcycles, the most commonly used mode of intra-city transportation, on neurotrauma. This is a retrospective study of all consecutive neurotrauma patients presenting in our unit in the first 30 months after the commencement of neurosurgical services. The data were collected for each patient with a structured proforma, and were analyzed. A total of 1055 neurosurgical cases were attended to in our service in the period under study, out of which 138 had congenital anomalies and 917 had acquired diseases. Among the acquired cases, 785 had trauma but only 748 (95.3%) of them had complete re-cords, with 658 (88%) cases of head injury, 61 (8.1%) cases of spinal injury, and 29 (3.9%) concomitant head and spinal injuries. These are distributed thus: road traffic accidents 537 (71.8%), falls 120 (16.0%), assaults 47 (6.3%), missiles 20 (2.7%), falling objects 11 (1.5%), deceleration/acceleration injuries 7 (0.9%), sports/recreational activities 3 (0.4%) and birth trauma 3 (0.4%). Majority were males 569 (76.1%), and in the 15-40year age group 376 (50.3%). Of the 537 cases of road accidents, those related to motorcycles were 367 (68.3%), motor vehicles 169 (31.5%) and bicycle 1 (0.2%); and none of the motorcycle cases wore a protective helmet at the time of the accident. Most of the cases were treated conservatively 559 (74.7%), and the mortality rate from all neurotrauma cases was 17.7%. Neurotrauma is the major reason for neurosurgical consultations in our service, affecting mostly the young male age group, and most cases result from motorcycle accidents caused by the poor compliance with traffic regulations. There is an urgent need to stringently control the use of motorcycles to reduce the morbidity and mortality amongst Nigerian youths. Key words: Head, injury, spinal, road, traffic, accidents.