Management of severe head injury patients

ABSTRACT

Severe head injuries [Glasgow Coma Score less than or equal to 7] is associated with high mortality and morbidity which can be improved by early energetic therapy. We are presenting a study of 481 head injury patients admitted in our department during the period 1991 to 1993. Forty percent [193 patients] of them had severe head injuries [GCS 7 or below]. Majority of them were the victims of road traffic accidents [RTA] 60%, the next common cause of trauma was fall from height 28%. They were between the ages of 1 month to 80 years. Despite aggressive surgical treatment and intensive care 80% patients died. In the age groups of 16 to 60 years and 60 to 80 years the mortality rate was 77% and 82% respectively. In the younger group of patients upto 15 years the mortality rate was 49%. Fifty-one percent of patients were treated surgically. We are recommending more efficient system of prehospital services, controlling ventilation, haemodynamics and avoiding any increased intra cranial pressure and speedy and safe transportation of these patients to specialised neurosurgical centers by the peripheral hospitals