OUTCOME OF MILD TRAUMATIC BRAIN INJURIES: A PROSPECTIVE STUDY.
Keywords:
brain injury, mild, outcome, trauma
Abstract
Summary: Mild traumatic brain injury is the most common type of traumatic brain injury. Some victims do not consider it seriously until it is too late to salvage them. On the Glasgow Coma Scale, scores of 13-15 are considered mild traumatic brain injuries. We prospectively studied mild traumatic brain injury patients managed in our center. Objective: To determine the treatment outcome of mild traumatic brain injury patients admitted and treated in our center.
Methods: It was a prospective study of mild traumatic brain injury patients admitted to our center from August 2010 to January 2015. Traumatic brain injury patients who scored 13-15 on the Glasgow Coma Scale (GCS) after resuscitation in accident and emergency, admitted and treated qualified for the study. The Glasgow outcome score was used to assess the patients on discharge. Data were collected using structured proforma which was a component of our prospective data bank that was approved by our Research and Ethics Committee. We analyzed the data with the Environmental Performance Index info 7 software.
Results: There were 183 patients in the study. Males were 139. The mean age was 28.56 years. One hundred and twenty-two were involved in road traffic accidents. Patients with GCS of 15 were 89. One hundred and eighty-two had a favorable functional outcome. The GCS significantly affected the outcome.
Conclusion: The most common etiology was road traffic accidents with males and the age group 20-40years most commonly involved. The most common Glasgow coma score was 15. The favorable functional outcome was good.
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References
1. Kraus JF, McArthur DL, Silberman TA. Epidemiology of mild brain injury. Semin Neurol 1994; 14:1-7.
2. Povlishock JT, Katz DI. Update of neuropathology and neurological recovery after mild traumatic brain injury. J Head Trauma Rehabil 2005; 20:76-94.
3. Morganti-Kossmann MC, Yan E, Bye N. Animal models of traumatic brain injury: is there an optimal model to reproduce human brain injury in the laboratory? Injury 2010; 41(Suppl 1):S10-S13.
4. G ennarelli TA, Thibault LE, Adms JH, Graham DI, ThompsoN CJ, Marcinin RP. Diffuse axonal injury and traumatic coma in the primate. Ann Neurol 1982; 12:564-74.
5. Graham DI, McIntosh TK, Maxwell WL, Nicoli JA. Recent advances in neurotrauma. J Neuropathol Exp Neurol 2000; 59:644-51.
6. Gentry LR. Imaging of closed head injury. Radiology 1994; 191:1-17.
7. Charles A, Brennan K. Cortical spreading depression ─ new insights and persistent questions. Cephalalgia 2009; 29:1115-24.
8. Xiong Y, Mahmood A, Chopp M. Animal models of traumatic brain injury. Nat Rev Neurosci 2013; 14:128-42.
9. Rajan A. Cortical hypoexcitation defines neuronal responses in the immediate aftermath of traumatic brain injury. PLOS One 2013;8:e63454
10. Yan EB, Johnstone VP, Alwis DS, Morganti-Kossmann MC, Rajan R. Characterizing effects of inpact velocity on brain and behavior in a model of diffuse traumatic axonal injury. Neuroscience 2013; 248C:17-29
11. Teasdale G, Jennet B. Assessment .of coma and impaired consciousness. A practical scale. Lancet 1974;2(7872):81-4.
12. Jennet B, Bond M. Assessment of outcome after severe brain damage. Lancet
13. National Population Commission of Nigeria 2006 population census. www.population.gov.ng
14. Adeleye AO, Okonkwo DO. Inter-hospital transfer for neurosurgical management of mild head injury in a developing country: a needless use of scarce resources? Indian Journal of Neurotrauma 2011; 8:1-6.
15. Jacobs B, Beems T, Stulemeijer M, van Vugt AB, vander Vliet TM, Borm GF, et al. Outcome prediction in mild traumatic brain injury: age and clinical variables are stronger than CT variables. J Neurotrauma 2010; 27:655-68.
16. McMahon PJ, Hricik A, Yue JK, Puccio AM, Inoue T, Lingsma HF, et al. Symptomatology and functional outcome in mild traumatic brain injury: results from prospective TRACK-TBI study. J Neurotrauma 2014; 31:26-33.
17. Jasper US, Opara MC, Pyiki EB, Akinrolie O. The epidemiology of hospital-related head injury in Northern Nigeria. Journal of Scientific Research and Reports 2014; 3:2055-64.
18. Joseph B, Pandit V, Aziz H, Kulvatunyou N, Zangbar B, Green DJ, et al. Mild traumatic brain injury defined by Glasgow Coma Scale: is it really mild? Brain injury 2015; 29:11-16.
19. Carlson AP, Ramirez P, Kennedy G, McLean AR, Murray-Krezan C, Stippler M. Low rate of delayed deterioration requiring surgical treatment in patients transferred to a tertiary care center for mild traumatic brain injury. Neurosurg Focus 2010; 29:E5.
20. Akanji AO, Akinola RA, Balogun BO, Akano AO, Atalabi MO, Akinkunmi MAN, et al. Computerized tomography scan and head injury: the experience in a tertiary hospital in Nigeria: a cross section study. Medical Practice and Review 2015; 6:1-15.
21. Mebrahtu G, Liu HQ, Tsighe A. The profile of CT scan findings in acute head trauma in Orotta hospital, Asmara, Eritrea. Journal of Eritrean Medical Association 2009; 4:5-8.
22. Emejulu JKC, Ekweogwu CO, Nottioge T. The burden of motorcycle-related neurotrauma in South-East Nigeria. Journal of Clinical Medicine and Research 2009; 1:13-17.
23. Washington CW, Grubb RL. Are routine repeat imaging and intensive care unit admission necessary in mild traumatic brain injury? J Neurosurg 2012; 116:549-57.
24. Ibańez J, Arikan F, Pedraza S, Sânchez E, Poca MA, Rodriguez D, et al. Reliability of clinical guidelines in the detection of patients at risk following mild head injury: results of a prospective study. J Neurosurg 2004; 100:825-34.
25. Seddighi AS, Motiei-Langroudi R, Sadeghian H, Maudi M, Zati A, Ashenghi E, et al. Factors predicting early deterioration in mild brain trauma: a prospective study. Brain Injury 2013; 27:1666-70.
26. Syed AT, Lone NA, Wani MA, Bhat AS. Clinical management of patients with minor head injuries. International Journal of Health Sciences, Quassim University 2007; 1:131-140.
27. Hunter JV, Wilde EA, Tong KA, Holshouser BA. Emerging imaging tools for use with traumatic brain injury research. J Neurotrauma 2012; 29:654-71.
28. Orison WW, Gentry LR, Stimac GK, Tarrel RM, Espinosa MC, Cobb LC. Blinded comparison of cranial CT and MR in closed head injury evaluation. Am J Neuroradiol 1994; 15:351-6.
29. Mittl RL, Grossman RI, Hiehle JF, Hurst RW, Kauder DR, Gennarelli TA, et al. Prevalence of MR evidence of diffuse axonal injury in patients with mild head injury and normal head CT findings. Am J Neuroradiol 1994;15:1583-89
30. Inglese M, Makani S, Johnson G, Cohen BA, Silver JA, Gonen O, et al. Diffuse axonal injury in mild traumatic brain injury: a diffusion tensor imaging study. J Neurosurg 2005; 103:298-303.
31. Gallagher CN, Hutchinson PJ, Picard JD. Neuroimaging in trauma. Curr Opin Neurol 2007;20:403-9
32. af Geijerstam J-L, Briton M. Mild head injury: reliability of early cccomputed tomographic findings in trage for admission. Emerg Med J 2005; 22:103-7.
33. Bor-Seng-Shu E, Aguiar PH, Matushita H, et al. Actual asymptomatic epidural hematomas in childhood. Childs Nervous System 1997;13:605-7
34. Snoey ER, Levitt MA. Delayed diagnosis of subdural hematoma following normal computed tomography scan. Ann Emerg Med 1994;23:1127-31
35. Schunk JE, Rodgerson JD, Wooddward GA. The utility of head computed tomographic scanning in pediatric patients with the normal neurologic examination in the emergency department. Pediatr Emerg Care 1996; 12:60-5.
36. Davies KG, Jamjoom AB, Burgess NA. Childhood extradural hematomas, not always obvious. Br J Clin Pract 1990; 44:420-1.
37. de Andrade AF, de Almeide AN, Bor-Seng-Shu E, Lourenco L, Mandel M, Marino R jr. The value of cranial computed tomography in high-risk mildly head-injured patients. Surg Neurol 2006; 65(Suppl1):S10-S13.
38. Yavz SM, Asirdizer M, Cetin G, Baki YG, Alintok M. The correlation between skull fractures and intracranial lesions due to traffic accidents. Am J Forensic Pathol 2003; 24:339-45?
39. Ford LE, McLaurin RL. Mechanism of extradural hematoma. J Neurosurg 1963; 20:760-9.
40. Ashraf S, Jonari A, Abdul RG, Jafri MA. The role of repeat head computed tomography in the management of mild traumatic brain injury patients with positive initial head CT. Med J Malaysia 2012;67:305-8.
41. Kisat M, Zafar SN, Latif A, Villegas LV, Efron DT, Stevens KA, et al. Predictors of positive head CT scan and neurosurgical procedures after minor head trauma. J Surg Res 2012; 173:31-7.
42. Masel BE, Dewitt DS. Traumatic brain injury: a disease process, not an event. J Neurotrauma 2010; 27:1529-40.
2. Povlishock JT, Katz DI. Update of neuropathology and neurological recovery after mild traumatic brain injury. J Head Trauma Rehabil 2005; 20:76-94.
3. Morganti-Kossmann MC, Yan E, Bye N. Animal models of traumatic brain injury: is there an optimal model to reproduce human brain injury in the laboratory? Injury 2010; 41(Suppl 1):S10-S13.
4. G ennarelli TA, Thibault LE, Adms JH, Graham DI, ThompsoN CJ, Marcinin RP. Diffuse axonal injury and traumatic coma in the primate. Ann Neurol 1982; 12:564-74.
5. Graham DI, McIntosh TK, Maxwell WL, Nicoli JA. Recent advances in neurotrauma. J Neuropathol Exp Neurol 2000; 59:644-51.
6. Gentry LR. Imaging of closed head injury. Radiology 1994; 191:1-17.
7. Charles A, Brennan K. Cortical spreading depression ─ new insights and persistent questions. Cephalalgia 2009; 29:1115-24.
8. Xiong Y, Mahmood A, Chopp M. Animal models of traumatic brain injury. Nat Rev Neurosci 2013; 14:128-42.
9. Rajan A. Cortical hypoexcitation defines neuronal responses in the immediate aftermath of traumatic brain injury. PLOS One 2013;8:e63454
10. Yan EB, Johnstone VP, Alwis DS, Morganti-Kossmann MC, Rajan R. Characterizing effects of inpact velocity on brain and behavior in a model of diffuse traumatic axonal injury. Neuroscience 2013; 248C:17-29
11. Teasdale G, Jennet B. Assessment .of coma and impaired consciousness. A practical scale. Lancet 1974;2(7872):81-4.
12. Jennet B, Bond M. Assessment of outcome after severe brain damage. Lancet
13. National Population Commission of Nigeria 2006 population census. www.population.gov.ng
14. Adeleye AO, Okonkwo DO. Inter-hospital transfer for neurosurgical management of mild head injury in a developing country: a needless use of scarce resources? Indian Journal of Neurotrauma 2011; 8:1-6.
15. Jacobs B, Beems T, Stulemeijer M, van Vugt AB, vander Vliet TM, Borm GF, et al. Outcome prediction in mild traumatic brain injury: age and clinical variables are stronger than CT variables. J Neurotrauma 2010; 27:655-68.
16. McMahon PJ, Hricik A, Yue JK, Puccio AM, Inoue T, Lingsma HF, et al. Symptomatology and functional outcome in mild traumatic brain injury: results from prospective TRACK-TBI study. J Neurotrauma 2014; 31:26-33.
17. Jasper US, Opara MC, Pyiki EB, Akinrolie O. The epidemiology of hospital-related head injury in Northern Nigeria. Journal of Scientific Research and Reports 2014; 3:2055-64.
18. Joseph B, Pandit V, Aziz H, Kulvatunyou N, Zangbar B, Green DJ, et al. Mild traumatic brain injury defined by Glasgow Coma Scale: is it really mild? Brain injury 2015; 29:11-16.
19. Carlson AP, Ramirez P, Kennedy G, McLean AR, Murray-Krezan C, Stippler M. Low rate of delayed deterioration requiring surgical treatment in patients transferred to a tertiary care center for mild traumatic brain injury. Neurosurg Focus 2010; 29:E5.
20. Akanji AO, Akinola RA, Balogun BO, Akano AO, Atalabi MO, Akinkunmi MAN, et al. Computerized tomography scan and head injury: the experience in a tertiary hospital in Nigeria: a cross section study. Medical Practice and Review 2015; 6:1-15.
21. Mebrahtu G, Liu HQ, Tsighe A. The profile of CT scan findings in acute head trauma in Orotta hospital, Asmara, Eritrea. Journal of Eritrean Medical Association 2009; 4:5-8.
22. Emejulu JKC, Ekweogwu CO, Nottioge T. The burden of motorcycle-related neurotrauma in South-East Nigeria. Journal of Clinical Medicine and Research 2009; 1:13-17.
23. Washington CW, Grubb RL. Are routine repeat imaging and intensive care unit admission necessary in mild traumatic brain injury? J Neurosurg 2012; 116:549-57.
24. Ibańez J, Arikan F, Pedraza S, Sânchez E, Poca MA, Rodriguez D, et al. Reliability of clinical guidelines in the detection of patients at risk following mild head injury: results of a prospective study. J Neurosurg 2004; 100:825-34.
25. Seddighi AS, Motiei-Langroudi R, Sadeghian H, Maudi M, Zati A, Ashenghi E, et al. Factors predicting early deterioration in mild brain trauma: a prospective study. Brain Injury 2013; 27:1666-70.
26. Syed AT, Lone NA, Wani MA, Bhat AS. Clinical management of patients with minor head injuries. International Journal of Health Sciences, Quassim University 2007; 1:131-140.
27. Hunter JV, Wilde EA, Tong KA, Holshouser BA. Emerging imaging tools for use with traumatic brain injury research. J Neurotrauma 2012; 29:654-71.
28. Orison WW, Gentry LR, Stimac GK, Tarrel RM, Espinosa MC, Cobb LC. Blinded comparison of cranial CT and MR in closed head injury evaluation. Am J Neuroradiol 1994; 15:351-6.
29. Mittl RL, Grossman RI, Hiehle JF, Hurst RW, Kauder DR, Gennarelli TA, et al. Prevalence of MR evidence of diffuse axonal injury in patients with mild head injury and normal head CT findings. Am J Neuroradiol 1994;15:1583-89
30. Inglese M, Makani S, Johnson G, Cohen BA, Silver JA, Gonen O, et al. Diffuse axonal injury in mild traumatic brain injury: a diffusion tensor imaging study. J Neurosurg 2005; 103:298-303.
31. Gallagher CN, Hutchinson PJ, Picard JD. Neuroimaging in trauma. Curr Opin Neurol 2007;20:403-9
32. af Geijerstam J-L, Briton M. Mild head injury: reliability of early cccomputed tomographic findings in trage for admission. Emerg Med J 2005; 22:103-7.
33. Bor-Seng-Shu E, Aguiar PH, Matushita H, et al. Actual asymptomatic epidural hematomas in childhood. Childs Nervous System 1997;13:605-7
34. Snoey ER, Levitt MA. Delayed diagnosis of subdural hematoma following normal computed tomography scan. Ann Emerg Med 1994;23:1127-31
35. Schunk JE, Rodgerson JD, Wooddward GA. The utility of head computed tomographic scanning in pediatric patients with the normal neurologic examination in the emergency department. Pediatr Emerg Care 1996; 12:60-5.
36. Davies KG, Jamjoom AB, Burgess NA. Childhood extradural hematomas, not always obvious. Br J Clin Pract 1990; 44:420-1.
37. de Andrade AF, de Almeide AN, Bor-Seng-Shu E, Lourenco L, Mandel M, Marino R jr. The value of cranial computed tomography in high-risk mildly head-injured patients. Surg Neurol 2006; 65(Suppl1):S10-S13.
38. Yavz SM, Asirdizer M, Cetin G, Baki YG, Alintok M. The correlation between skull fractures and intracranial lesions due to traffic accidents. Am J Forensic Pathol 2003; 24:339-45?
39. Ford LE, McLaurin RL. Mechanism of extradural hematoma. J Neurosurg 1963; 20:760-9.
40. Ashraf S, Jonari A, Abdul RG, Jafri MA. The role of repeat head computed tomography in the management of mild traumatic brain injury patients with positive initial head CT. Med J Malaysia 2012;67:305-8.
41. Kisat M, Zafar SN, Latif A, Villegas LV, Efron DT, Stevens KA, et al. Predictors of positive head CT scan and neurosurgical procedures after minor head trauma. J Surg Res 2012; 173:31-7.
42. Masel BE, Dewitt DS. Traumatic brain injury: a disease process, not an event. J Neurotrauma 2010; 27:1529-40.
How to Cite
1.
Nnadi MON, Fente BG. OUTCOME OF MILD TRAUMATIC BRAIN INJURIES: A PROSPECTIVE STUDY. Med. res. chronicles [Internet]. 2015Sep.29 [cited 2024Dec.22];2(5):597-09. Available from: https://medrech.com/index.php/medrech/article/view/127
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Original Research Article
