Study of Traumatic Head Injuries Using Computed Tomography

Samih Kajoak, Hamid Osman, Caroline E. Ayad, Alamin Musa, Mohammed Yousef, Nahla L Faizo, Bushra Abdel Malik

 
International Journal of Biomedicine. 2021;11(1):82-86.
DOI: 10.21103/Article11(1)_OA14
Originally published March 5, 2021

Abstract: 

The aim of this retrospective research was to study traumatic head injury (THI) using CT scan and to classify the types of head trauma fractures and types of hemorrhages.
Methods and Results:  The current study included 53 THI patients (43/81.1%) males and 10/18.9% females) with positive and negative CT scan findings. A complete clinical history and patients’ data were taken from CT reports, which included age, gender, type of trauma, associated injury, and CT findings with their percentages. The study was carried out in Taif city in King Abdelaziz Hospital and King Faisal Hospital.
The distribution of various etiologies of THI has shown that the most common etiology was road traffic accident (RTA) (45.3%). The typical age for THI was between 21 to 30 years old (26.4%). The typical age for RTA was the age group of 11-20 years (33.3%), for falls – the age groups of 0-10 years (33.3%) and over 60 years of age (33.3%). The frequency of various CT findings of THI was as follows: intracranial hemorrhage (56.6%), fracture (39.6%), pneumocephalus (22.6%), contusion (22.6%), foreign body (11.3%), and proptosis (3.8%).  The distribution of fracture cases, according to their types, was as follows: a linear fracture (76.2%), comminuted fracture (23.8%), basilar fracture (14.3%), and depressed fracture (9.5%). The frontal bone was the most affected site with fractures (30.7%). 
Conclusion: CT is an appropriate clinical modality used in the management of THI patients in the emergency department. CT has the advantage of being fast, safe, available, sensitive to most acute post-traumatic injuries, accurate in identifying the head abnormalities such as fractures and hemorrhage during the first 24 hours after injury, which is beneficial in the early assessment, therapy planning, monitoring, and long-term patient care.

Keywords: 
computed tomography• traumatic head injury• road traffic accident
References: 
  1. Johnson KM. The hazards of stopping a brain in motion: evaluation and classification of traumatic brain injury. Virtual Mentor. 2008 Aug 1;10(8):516-20. doi: 10.1001/virtualmentor.2008.10.8.cprl1-0808.
  2. Ghebrehiwet M, Quan LH, Andebirhan T. The profile of CT scan findings in acute head trauma in Orotta Hospital, Asmara, Eritrea. JEMA. 2009;4:5-8.
  3. Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008 Aug;7(8):728-41. doi: 10.1016/S1474-4422(08)70164-9. 
  4. Georges A, Booker JG. Traumatic Brain Injury. 2020 Nov 19. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29083790.
  5. Zimmerman RA, Bilaniuk LT, Gennarelli T, Bruce D, Dolinskas C, Uzzell B. Cranial computed tomography in diagnosis and management of acute head trauma. AJR Am J Roentgenol. 1978 Jul;131(1):27-34. doi: 10.2214/ajr.131.1.27.
  6. Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation. 2007;22(5):341-53.
  7. Asaleye CM, Famurewa OC, Komolafe EO, Komolafe MA, Amusa YB. The pattern of Computerized Topographic findings in moderate and severe head injuries in ILE- IFE, Nigeria. West Afr J Radiol. 2005;12:8–13.
  8. Sosin DM, Sniezek JE, Waxweiler RJ. Trends in death associated with traumatic brain injury, 1979 through 1992. Success and failure. JAMA. 1995 Jun 14;273(22):1778-80. 
  9. Sternbach GL. The Glasgow coma scale. J Emerg Med. 2000 Jul;19(1):67-71. doi: 10.1016/s0736-4679(00)00182-7. PMID: 10863122.
  10. Majdan M, Mauritz W, Brazinova A, Rusnak M, Leitgeb J, Janciak I, Wilbacher I. Severity and outcome of traumatic brain injuries (TBI) with different causes of injury. Brain Inj. 2011;25(9):797-805. doi: 10.3109/02699052.2011.581642. 
  11.  Edelman RR, Hesselink JR, Zlatkin MB, Crues JV., III . Clinical Magnetic Resonance Imaging. New York, NY: Elsevier; 2005. 
  12. Bordignon KC, Arruda WO. CT scan findings in mild head trauma: a series of 2,000 patients. Arq Neuropsiquiatr. 2002 Jun;60(2-A):204-10. doi: 10.1590/s0004-282x2002000200004. 
  13. Agrawal A, Agrawal CS, Kumar A, Lewis O, Malla G, Khatiwada R, Rokaya P. Epidemiology and management of paediatric head injury in eastern Nepal. Afr J Paediatr Surg. 2008 Jan-Jun;5(1):15-8. doi: 10.4103/0189-6725.41630. 
  14. Norlund A, Marké LA, af Geijerstam JL, Oredsson S, Britton M; OCTOPUS Study. Immediate computed tomography or admission for observation after mild head injury: cost comparison in randomised controlled trial. BMJ. 2006 Sep 2;333(7566):469. doi: 10.1136/bmj.38918.659120.4F. 
  15. Jeret JS, Mandell M, Anziska B, Lipitz M, Vilceus AP, Ware JA, Zesiewicz TA. Clinical predictors of abnormality disclosed by computed tomography after mild head trauma. Neurosurgery. 1993 Jan;32(1):9-15; discussion 15-6. doi: 10.1227/00006123-199301000-00002.
  16. Yattoo G, Tabish A. The profile of head injuries and traumatic brain injury deaths in Kashmir. J Trauma Manag Outcomes. 2008 Jun 21;2(1):5. doi: 10.1186/1752-2897-2-5.
  17. Glauser J. Head injury: which patients need imaging? Which test is best? Cleve Clin J Med. 2004 Apr;71(4):353-7. doi: 10.3949/ccjm.71.4.353. 
  18. Garnett MR, Cadoux-Hudson TA, Styles P. How useful is magnetic resonance imaging in predicting severity and outcome in traumatic brain injury? Curr Opin Neurol. 2001 Dec;14(6):753-7. doi: 10.1097/00019052-200112000-00012. 
  19. Kampfl A, Schmutzhard E, Franz G, Pfausler B, Haring HP, Ulmer H, Felber S, Golaszewski S, Aichner F. Prediction of recovery from post-traumatic vegetative state with cerebral magnetic-resonance imaging. Lancet. 1998 Jun 13;351(9118):1763-7. doi: 10.1016/S0140-6736(97)10301-4. 
  20. Lee B, Newberg A. Neuroimaging in traumatic brain imaging. NeuroRx. 2005 Apr;2(2):372-83. doi: 10.1602/neurorx.2.2.372. 

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Received January 27, 2021.
Accepted February 21, 2021.
©2021 International Medical Research and Development Corporation.