Profile Of Head Injury Research Articles

Head injury care in a low- and middle-income country tertiary trauma center: epidemiology, systemic lacunae, and possible leads.

Although head injury (HI) from low- and middle-income countries (LMIC) heavily contributes to the global disease burden, studies are disproportionately less from this part of the world. Knowing the different epidemiological characteristics from high-income nations can target appropriate prevention strategies. This study aims to provide a comprehensive overview of the clinico-epidemiological data of HI patients, focusing on the existing challenges with possible solutions from a developing nation's perspective. This is a prospective, registry-based, observational study of HI in an Indian tertiary trauma-care center over 4years. Various clinico-epidemiological parameters, risk factors, and imaging spectrum were analyzed in a multivariate model to identify the challenges faced by LMIC and discuss pragmatic solutions. The study included a large-volume cohort of 14,888 patients. Notably, half of these patients belonged to mild HI, despite most were referred (90.3%) cases. Only one-third (30.8%) had severe HI. Less than a third reached us within 6h of injury. Road traffic accidents (RTA) accounted for most injuries (61.1%), especially in the young (70.9%). Higher age, males, RTA, helmet non-usage, drunken driving, systemic injuries, and specific imaging features had an independent association with injury severity. The study represents the much-needed, large-volume, epidemiological profile of HI from an LMIC, highlighting the suboptimal utilization of peripheral healthcare systems. Strengthening and integrating these facilities with the tertiary centers in a hub and enhanced spoke model, task sharing design, and efficient back-referrals promise effective neurotrauma care while avoiding overburden in the tertiary centers. Better implementation of road safety laws also has the potential to reduce the burden of HI.

Profile of Head Injuries: Prehospital Care, Diagnosis, and Severity in an Ethiopian Tertiary Hospital

Consistent data on head injury is lacking especially in the low- and middle-income countries. Our study tries to characterize patients with head injury at the emergency department of one of the few tertiary public hospitals giving neurosurgical care in the country. A retrospective cross-sectional study was performed from May 2015 to October 2015 in one of the neurosurgical teaching hospitals, Black Lion Specialized Hospital. All adult patients with head injury who visited the emergency department during the study period were included. Data on patients' sociodemographic, mechanism of trauma, clinical presentation, imaging findings, and presence of polytrauma were collected by a pretested questionnaire. The source of data was emergency department logbooks and patient charts. A total of 390 patients with head injury who visited the emergency department were included during the study period. There were 335 males (85.9%) and 55 females (14.1%) with the mean age (standard deviation) of 35.4 (15.6) years. Majority of patients came by taxi constituting 149 (38.2%) of all patients, whereas 147 patients (37.7%) used ambulance. Of 147 patients brought by ambulances, 133 (90.4%) were referred from other hospitals. The majority, 26 (45.6%), of patients who came directly to the emergency department used taxis. It is shown that the mode of arrival and origin of arrival are significantly related, P= 0.000. Mortality of severe head injury at the emergency department was 50.8%. Prehospital care coverage was low and ambulances were used mainly for interhospital transfers. Mortality of severe head injury at the emergency department is high and significantly associated with preventable causes like vital sign derangement.

Socio Demographic Profile of Head Injury among Medico Legal Autopsies Conducted in a Rural Medical College

Socio Demographic Profile of Head Injury among Medico Legal Autopsies Conducted in a Rural Medical College

Profile of head injuries in Road Traffic Accident cases with Ocular trauma in a rural tertiary care hospital

Background Road traffic accidents form a major part of accident and emergency care not only in cities but also in rural places. Improved affordability, changed socio economic conditions, personality and mind set of the younger generation, etc.. have influenced the behavioral pattern directly & indirectly. Access to accident and emergency care in rural India is still limited; especially with regards to management of head injuries. This research was conducted as an arm of a study of ocular injuries, as it was felt that there was a close inter relation between ocular injuries & head injuries, the outcome of this research may help in drawing attention to head injuries and better management of the same. Objectives • To study profile and pattern of head injuries in relation to eye injury presenting to Accident and Emergency services of a tertiary care hospital, wherein ophthalmology reference was sought. Head injuries include both injuries to the brain and those to other parts of the head, such as the scalp and skull. • It is also useful to study common ophthalmic manifestation in various types of head injury and to attempt a correlation between the neurological signs, ocular signs, GCS (Glassgow Coma Scale). • It was a non-interventional study to analyze correlation, if any, between Ocular trauma & head injuries. • This study aims to record incidence & various modes of injury which can cause serious eye involvement with mild head injury as well as serious head injury with minimal eye involvement. Materials & Methods 60 consecutive patients presenting to Ophthalmology outpatient department or accident and emergency department of PESIMSR, with ocular trauma from the period August 2013-April 2015 were included in the study. This was an added arm of the study of ocular injuries, approved by the hospital ethical review board. And it did not include any additional intervention or investigation. Results In our study 31 patients were associated with head injury along with associated ocular injury. Out of 31, 27 were males and only 4 were females. Out of 31, 21 were two wheelerdrivers, 2 were two wheeler passengers, 4 were four wheeler passengers, 4 were pedestrians.25 patients had mild head injury, 2 patients had moderate head injury, 4 patients had severe head injury. Out of 31, 6 patients had traumatic optic neuropathy. Invariably all patients of skull fracture were associated with periorbital edema/ecchymosis. Out of 31, 20 patients had Ocular Trauma Score (OTS)-100. OTS between 80-100-1 patient. 55-80-2 patients, 45-55-4patients. Conclusion Those with head injury other than skull fractures had intraocular findings rather than extra ocular involvement. Thus it signifies the importance of intraocular findings in relation to head injury. Language: en

The profile of head injuries and traumatic brain injury deaths in Kashmir

This study was conducted on patients of head injury admitted through Accident & Emergency Department of Sher-i-Kashmir Institute of Medical Sciences during the year 2004 to determine the number of head injury patients, nature of head injuries, condition at presentation, treatment given in hospital and the outcome of intervention. Traumatic brain injury (TBI) deaths were also studied retrospectively for a period of eight years (1996 to 2003).The traumatic brain injury deaths showed a steady increase in number from year 1996 to 2003 except for 1999 that showed decline in TBI deaths. TBI deaths were highest in age group of 21–30 years (18.8%), followed by 11–20 years age group (17.8%) and 31–40 years (14.3%). The TBI death was more common in males. Maximum number of traumatic brain injury deaths was from rural areas as compared to urban areas.To minimize the morbidity and mortality resulting from head injury there is a need for better maintenance of roads, improvement of road visibility and lighting, proper mechanical maintenance of automobile and other vehicles, rigid enforcement of traffic rules, compulsory wearing of crash helmets by motor cyclist and scooterists and shoulder belt in cars and imparting compulsory road safety education to school children from primary education level. Moreover, appropriate medical care facilities (including trauma centres) need to be established at district level, sub-divisional and block levels to provide prompt and quality care to head injury patients