Some peculiar lesions of traumatic brain injuries encountered in our practice with brief discussion-imaging manuscript

The advent of neuroimaging like computed tomography and magnetic resonance imaging has facilitated the diagnosis of traumatic brain injuries. Emphasizing certain diagnostic features of some peculiar traumatic brain injuries. The following lesions of traumatic brain injuries were pictorially depicted, namely Tension pneumocephalus, Blow out orbit, Bilateral subacute subdural haematomata, Acute-onchronic subdural haematoma, Middle cranial fossa acute epidural haematoma, Traumatic basal ganglial haematoma and Acute intra-ventricular haematoma. Mount Fuji sign is typical of tension pneumocephalus while herniation of extra-ocular muscles into the maxillary sinus is diagnostic of blowout orbit. Rabbit ear appearance is observable in bilateral subacute subdural haematomata

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

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

Patterns of Spinal Injury in a New Neurosurgical Centre: A 2-Year Prospective Study

Background: Spinal injury is a major cause of morbidity and mortality worldwide. Road traffic accident is the main aetiologic factor; affecting mostly the male gender in the 15 - 40-year age group. The aim of this study was to establish our local hospital patterns of spinal injury and compare them with published reports. Methods and Patients: A prospective study of all spinal injury patients treated in our service in the two-year period; April 21; 2006 - April 20; 2008 was undertaken. Data collection was done using a structured proforma from the time of admission into our service to the time of discharge; and subsequent follow-up in the few cases that kept to their appointment. Data was then collated and simple data analysis done. Results: Spinal injury was diagnosed in 62 of our 826 patients; mostly males; aged 15-40years 28 (45.2); and road traffic accident was the main aetiologic factor with an unusually high case incidence from motorcycles. There were neurological deficits in 49(79) and cervical cord injuries were the most common. Evaluation of the injuries was mostly with plain radiography; and treatment was non-operative in all cases. omplete cord injuries remained without improvement; and complications were mostly pressure ulcers; with no incident of deep venous thrombosis. Mortality was 13(21). Conclusion: Spinal injury was an important indication for neurosurgical consultations in our service. Complete cord injuries were more common than incomplete injuries contrary to other previous reports; and the case incidence from motorcycles was remarkably high