Traumatic Brain Injury in the Accident and Emergency Department of a Tertiary Hospital in Nigeria

Background: Traumatic brain injury is a major public health problem in Nigeria; as it could be associated with long term and life long deficits. Unlike other parts of the world; in our country; motorcycles are possibly the main cause of this injury. Unfortunately; we do not have a national epidemiological data base yet. This study was aimed at defining the peculiar demographic and associated risk factors in traumatic brain injury among our patients; as part of a multi-institutional data pool for a future meta-analysis to generate the national data base. Methods: This was a 24-month retrospective study of all head injury patients who met the criteria for traumatic brain injury in the Accident and Emergency Department of a tertiary health institution. Data were collected from the emergency cards and case notes; then collated and analyzed using the descriptive statistics on SPSS 13; with the p value taken as 0.05. Results: A total of 9;444 patients were attended to during the 24 months; 510 (5.4) of them met the inclusion criteria for the study. This translated to a presentation rate of 5.3 cases per week and an incidence rate of 2;710 per 100;000 per year. Males accounted for 404 (79.2) of the cases. The peak age incidence (31.2) was in the 20 - 30 year age group. Traders constituted the highest occupational group 125 (24.5). Most (58.8) of the cases resulted from motorcycle accident. There were 28 deaths giving a mortality rate of 5.5or 148 deaths per 100;000 per year. Conclusion: The risk factors were the male gender; motorcycle riding; illiteracy; trading; extremes of age and active daytime period of 12:01 - 18:00hours. The incidence rate was much higher than in the developed countries; but could reduce with the use of crash helmets; seat belts; speed limits and safety/protective vehicular devices; with better road rehabilitation

Traumatisme cranioencephalique a l'hopital Gabriel Toure

Objectif : etait d'evaluer la morbidite et la mortalite liee au traumatisme cranioencephalique. Patients et methodes : Il s'agissait d'une etude descriptive portant sur des patients admis consecutivement pour traumatisme cranioencephalique aux urgences chirurgicales de l'hopital Gabriel Toure de Bamako de janvier 2004 a aout 2004. Etaient inclus tous les patients victimes de traumatisme cranioencephalique avec ou sans autres lesions associees. Un P 0;05 etait considere comme significatif. Resultats : Sur une periode de huit (8) mois 324 patients ont ete admis pour traumatisme cranioencephalique. Les patients de sexe masculin etaient de 243 soit 75avec un sex-ratio de 3;1. La population scolaire et universitaire representaient 79 des professions soit 24;4. Le traumatisme cranien survenait dans 268 cas soit 82;80des cas dans un contexte d'accident de la voie publique. Ces accidents concernaient les pietons dans 42des cas (auto pietons ou moto pieton). Le taux de morbidite etait de 11.Conclusion : Les lesions intracerebrales sont des lesions majoritairement rencontrees au cours du traumatisme cranioencephalique. Le fait d'etre pieton dans un contexte d'accident semble rendre vulnerable au traumatisme cranioencephalique

Aetiological Patterns and Management Outcome of Paediatric Head Trauma: One-Year Prospective Study

Trauma is themost common cause of paediatric deaths. In75of paediatric trauma deaths; head injury is responsible; and most are from falls. Recent reports from Nigeria; however; appear to indicate a predominance of road traffic accidents; instead of falls. To evaluate the aetiology of paediatric head trauma; management protocols and outcome from our Centre; in order to acquire a baseline data base and recommendmeasures to reduce childhood trauma. Aprospective study of all paediatric head trauma cases presenting toNnamdiAzikiwe University Teaching Hospital; Nnewi; for 12months from April 21; 2006 to April 20; 2007; was done and collated data subsequently analyzed. The paediatric age group was taken as =15years; and grading of head injurywaswith theGlasgowComa Scale (3 15) and themodified scale for non-verbal children;while outcome wasmeasuredwith the Glasgow Outcome Scale (1 5). Out of 334 patients treated within the period of study; 210 were head trauma cases. Of these; 52 were paediatric head trauma; representing 24.8of all head trauma cases; and 19.2(10 of 52) of them were aged 0- 2years. About 62(32 of 52) were males. Falls and RTA were each responsible in 25(48.1) cases. Mild head injury occurred in 31(59.6); and 49(94.2) patients were evaluated by plain radiography. Treatment was conservative in 39(75) cases;with satisfactory outcome in 36(69.2); and amortality rate of 15.4. Road traffic injury; mostly from motorcycles; has become the major cause of morbidity and mortality amongst the paediatric age group; especially the male gender; and outcome from management is mostly satisfactory