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Traumatic brain injuries: experience from a tertiary care centre in Pakistan
Muhammad Sohail Umerani1, Asad Abbas, Salman Sharif
1Liaquat National Hospital, Department of Neurosurgery, Karachi, Pakistan.
Insights
Road traffic accidents, particularly involving motorbikes, are the primary cause of traumatic brain injury (TBI) in Pakistan. Limited helmet use and the need for improved hospital referral systems highlight critical public health concerns.
Area of Science:
- Neuroscience
- Public Health
- Trauma Surgery
Background:
- Traumatic Brain Injury (TBI) presents a significant global health challenge, leading to substantial morbidity, mortality, and economic burden.
- The impact of TBI is disproportionately severe in developing nations, with Pakistan facing particular challenges.
Purpose of the Study:
- To investigate and delineate the etiological patterns and demographic distribution of Traumatic Brain Injury (TBI) within Pakistan.
- To provide crucial data for targeted public health interventions and trauma care improvements.
Main Methods:
- A retrospective study analyzing 1378 patients presenting with head injuries to an Accident and Emergency Department between July 2009 and June 2011.
- Comprehensive clinical and radiological evaluations were performed on all included patients according to established trauma protocols.
Main Results:
- The most affected demographic was young adults aged 21–30 years (34.1%), with a male-to-female ratio of 3.3:1.
- Road traffic accidents (RTAs) were the leading cause (62.6%), followed by falls (31.7%) and assaults (5.5%).
- Common CT findings included brain contusions (14.1%), subdural hematoma (7.6%), sub-arachnoid hemorrhage (7.1%), and extra-dural hematoma (5.8%).
Conclusions:
- Motorbike accidents are a major contributor to severe TBI, underscoring the need for increased helmet usage.
- The study highlights the urgent necessity for an optimized citywide hospital referral system to mitigate secondary brain injury consequences.
Aim:
Traumatic Brain Injury (TBI) is one of the leading causes for morbidity, mortality and economic loss. The impact is much worse in developing countries like Pakistan. The objective of our study was to highlight the etiological pattern and distribution of TBI in Pakistan.
Material And Methods:
From July 2009 to June 2011, 1378 patients presenting to our Accident and Emergency Department with head injury were included in the study. Patients underwent detailed clinical and radiological evaluation as per trauma protocol.
Results:
The most commonly affected age group was 21 to 30 years (34.1%) with male to female ratio of 3.3:1. Injuries were predominantly caused by road traffic accident (62.6%), followed by fall (31.7%) and assault (5.5%). Amongst those with RTA less than 1% of the patients were wearing proper safety equipment. The most common CT scan finding was brain contusion (14.1%); others included traumatic sub-arachnoid hemorrhage (7.1%), subdural hematoma (7.6%), extra-dural hematoma (5.8%) and depressed skull fracture (4.6%).
Conclusion:
Motorbike accidents are a major cause of severe traumatic brain injury. Although this can be minimized by wearing proper helmets, its use is limited. Moreover, there is an imperative need to implement proper referral system amongst hospitals citywide in order to minimize the consequences of secondary brain injury.
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