Acute head injuries managed in the intensive care unit of Al-Adan hospital, Kuwait

In a prospective study of acute head injuries in Kuwait, 53 patients with moderate to severe head injuries were managed in the Intensive Care Unit [ICU] of Al-Adan Hospital during a 6-month period in 1988. There were 50 male and 3 female patients. Children below the age of 15 years accounted for 38% of the patients. Patients below the age of 40 years accounted for 85%. Road traffic accidents [RTA] and falls from heights [FFH] were the two main causes of the injuries. Seventy percent of the patients sustained associated injuries involving the face, upper limbs and chest. The few abdominal injuries recorded were comparatively serious. Seventeen patients had severe head injuries with Glasgow Coma Scores [GCS] of between 3 and 8 upon admission. All other patients had GCS of 9-13 upon admission. Fifty-one percent had skull fractures. Skull fractures were associated with FFH more often than with RTA. In 54% of cases, a CT scan of the brain gave positive intracranial findings. Among these, 60% were various types of intracranial hematomas. There were 6 deaths among the 53 victims. Of the 47 survivors, 20 made good recoveries, 19 were moderately disabled, 7 were severely disabled and 1 person remained in a vegetative state

Intracranial pressure monitoring in head injury: its first use in Kuwait

The first clinical experience in Kuwait of the use of extradural fibre-optic sensors and Ladd equipment to monitor intracranial pressure [ICP] in head injury cases is described. Twenty patients with severe or moderately severe injuries were selected for monitoring from the head injury cases admitted to the Intensive-Care Unit of Al-Adan Hospital. The extradural device proved safe, simple, reliable and effective in assessing ICP response to hyperventilation, dehydration regime and head elevation which were used to reduce the high ICP accompanying brain oedema in such injuries