ABSTRACT
Certain features of head-injured patients admitted to the Chang Gung Memorial Hospital in Taiwan during the period 1977 to 1987 were reviewed. The most common causes of injury were motorcycle accidents (56.3%) and street accidents with pedestrian injury (29.47%). The age groups with the greatest incidence of injury were aged 16-20 years, 21-25 years, and 25-30 years. The pedestrian group involving the highest incidence of injury was less than 10 years of age. Overall mortality was 17.26%. The injured pedestrian group had the highest mortality (19.1%). Initial clinical assessment was recorded using the Glasgow Coma Scale. Head-injured patients with a GCS less than 8 had a mortality in the injured pedestrian group of 46%, whereas the mortality rate in the motorcycle accident group was 41%. Additional features studied were time of occurrence of injury and pattern of injury. Information gathered from this study would suggest the need to establish a Head Injury Prevention Program in Taiwan. This of course implies major cooperation among the providers of health care delivery, the medical profession, legislators, and the government at all levels.
Subject(s)
Craniocerebral Trauma , Adolescent , Adult , Aged , Child , Child, Preschool , Craniocerebral Trauma/epidemiology , Craniocerebral Trauma/pathology , Female , Humans , Male , Middle Aged , Taiwan/epidemiologyABSTRACT
The role of the emergency extracranial-intracranial bypass in the management of the stroke-in-evolution is controversial. A case is presented in which the patient's fluctuating clinical picture was influenced by hemodynamic factors. The site of occlusion was inaccessible and an emergency extracranial-intracranial bypass was made to restore cerebral blood flow. The patient made a dramatic recovery after the operation. An emergency extracranial-intracranial bypass may be indicated in carefully selected cases.
