ABSTRACT
Objective:
Primary brain injuries, which are the result of severe head trauma and cannot be prevented, are always catastrophic and fatal. Yet, if diagnostic and therapeutic steps are taken promptly after a craniocerebral injury, further brain insults may be prevented and the victim’s death can be avoided within 24 hours.
Materials and Methods:
Source of data, sample size, inclusion criteria, exclusion criteria, statistical methods.
Results:
One hundred individuals with confirmed cumputer tomography (CT) scan results of severe head trauma participated in this analysis. Seventy men and thirty women accounted for the total number of patients. The research included 70% men and 30% women. The M/F ratio is 2.3:1. Males between the ages of 21 and 30 (a total of 21 patients) had the highest rate of head injury in our analysis. Males had a lower incidence overall, with nine cases in the 0–10 age range, 11 cases in the 11–20 age range, five cases in the 41–50 age range, three cases in the 51–60 age range, and four cases in patients older than 61. Similarly, eight of the female patients were in the 21–30 age range. There were also four patients between the ages of 0 and 10, four between the ages of 11 and 20, two between the ages of 41 and 50, five between the ages of 51 and 60, and three among those older than 61.
Summary and Conclusion:
Men were more likely than women to sustain a head injury. The majority of the study population consisted of patients between the ages of 21 and 30 and 31 and 40. Injuries were found to most often occur in car crashes.
KEYWORDS: Brain damage, cranial injury, head trauma, traumatic lesion
INTRODUCTION
Understanding the pathophysiology and processes of trauma gives doctors a window into how the body reacts to harm, which in turn offers a basis for rational treatment. An injury to the head might include damage to the scalp, calvarium, or brain. As a result, it is crucial for a diagnostic radiologist to have a firm grasp of the pathophysiology of brain injuries and associated imaging manifestations.[1]
AIM AND OBJECTIVES
The purpose of this study was to assess the value of CT scans for individuals who have had a head injury and to use CT to characterize the range of hemorrhages that might result from head trauma. The goal of this study was to compare the glasgow coma scale (GCS) levels of early CT imaging to the patient prognosis.
Review of literature
Based on a principle first described in 1917 and proved by an Austrian Mathematician J. Radon that a three-dimensional object could be reproduced from an infinite set of all its projections, G.N. Hounsfield developed a technique with the help of a computer and called it computerized axial tomography (CAT) scanning.
Hounsfield along with Ambrose in 1973 presented the first paper on “computerized Axial Tomography (CAT) – ‘A new method utilizing X-rays’ at the 32nd Annual Congress of the British Institute of Radiology. It was a great leap for medical science.[2]” In April 1976, Merino-De Villasante J. and Taveras presented a detailed report of a retrospective examination of one hundred instances of head trauma by CT.[3] They determined that, after a head injury, CT should be the first neuroradiological technique performed. They concluded that the severity of the clinical presentation is proportional to the degree of CT abnormalities.[4,5,6]
Minor: Local areas of edema.
Moderate: Edema up to 1one-third of the cerebral hemisphere and mild shift of midline structures. Localized contusion.
Major: Severe edema in more than half of the cerebral hemisphere. Hemorrhage anywhere. Pronounced midline shift. They also identified the entity known as delayed traumatic cerebral hematoma.
MATERIALS AND METHODS
Source of data
Patients who sustained head trauma and were sent to the Department of Radio-Diagnosis at Krishna Hospital, Krishna Institute of Medical Sciences, Karad, between November 2017 and April 2019, were included in the current research.
Sample size
The study comprised a total of one hundred patients with head injury referred to Krishna Hospital, Karad.
Inclusion criteria
Patients of all age groups with head trauma, head trauma that has occurred within 24 hours, and patients with head trauma treated as in-patients were included in the study.
Exclusion criteria
Cranial trauma during childbirth and patients with nontraumatic intracranial bleed were excluded from the study.
Statistical methods
Rates, ratios, and percentages of different diagnoses and outcomes made by computed tomography will be computed. The Chi-square test will be used for the comparison of CT findings of different variables, and the P -value will be calculated.
RESULTS
One hundred individuals who had CT scans that showed they had received head trauma were included. Seventy of the 100 cases were men, whereas 30 were women. There were 70% male patients and 30% female participants in the research. The gender distribution is around 2.3 males for every female. The current investigation found that men aged 21-30 had the highest rate of head injury (21 cases). Men aged 0–10 have a prevalence of 9, 11-20 have a prevalence of 17, 31-40 have a prevalence of 5, 41-50 have a prevalence of 3, and 61+ have a prevalence of 4. The highest number of female cases (8) occurred between the ages of 21 and 30. There were also four patients in the 0–10 age range, four in the 11-20 age range, four in the 31-40 age range, two in the 41-50 age range, five in the 51-60 age range, and three in the 61+ age range.
In our study, we found that out of 100 patients, 68 showed RTA, and the remaining 32 showed other types of injuries on CT scan respectively [Table1].
Table 1.
Incidence of different modes of injury
| Type of injury | No. of cases/percentage |
|---|---|
| Road traffic accident | 68 |
| Others | 32 |
| Total | 100.00 |
Source: Compiled by the researcher
In our study, we found that out of 100 patients, the maximum number of patients showed a linear type of fracture up to 42 patients (64.6%), followed by a depressed type of fracture up to 15 patients (23.1%), a mixed fracture up to 12 patients (18.46%), and the remaining others showed a skull-base type of fracture on a CT scan up to 8 (12.3%), respectively [Table 2].
Table 2.
Incidence of the types of fractures as observed on CT scan
| Type of fracture | No. of cases | Percentage |
|---|---|---|
| Linear | 42 | 64.6 |
| Depressed | 15 | 23.1 |
| Skull base | 8 | 12.3 |
| Mixed | 12 | 18.46 |
| Total | 65 | 100.00 |
Source: Compiled by the researcher
DISCUSSION
A total of 100 patients with head injury with positive findings on CT scan were included in the study.
The majority of the participants in this analysis were adults in the 21-30 age range. Patients younger than 35 years old were more likely to have a head injury, according to a study by Olabinri EO et al.[7] Researchers such asc Khan F et al.[8] (2003) found that the average age of head injury patients was 29 years and that the greatest incidence of traumatic brain injury (TBIs) occurred in those aged 15 to 35.
Road traffic accidents were found to be the most common mode of injury in this study accounting for 68%. Matsui T et al.[9] also reported rood traffic accident (RTA) as the major cause albeit in a lesser population (39%). Palmer AM et al.[10] in their study reported vehicular accidents as the major mode of head injury with an incidence of 72%.
SUMMARY AND CONCLUSION
Almost all CT-detected skull fractures were linear in nature. Skull fractures that went undetected on standard radiographs might be seen using computed tomography. There were more patients with a GCS of 8 who had had a serious brain injury. Of the several intracranial injuries studied, the most common was a contusion. The second most frequent intracranial lesion was cerebral edema. More often than other types of hemorrhages, subdural hematomas occur. In most instances, a fracture was present underneath the extradural hematoma. One of the most prevalent causes of death was a subdural hematoma accompanied by cerebral edema.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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