Bomb Blast Head Injuries: A Two Years Experience of 154 Patients

Hospital Practices and Research, 2021

Background: Traumatic brain injury (TBI) is the damage to brain tissue and disruption of the brain function caused by an external mechanical force as evidenced by documented medical records. Objectives: The study aimed to estimate the prevalence of TBI through age-groups, severity, and mechanism of TBI. Methods: This cross-sectional study contained all TBI patients who were admitted at the main level one trauma center hospital located in southeastern Iran. Results: The number of reported patients was 445 young and old adults with TBI. In total, the mean age of the patients was 32.35 ranging from 17 to >80 years. Of the studied patients 361 (81.1%) were male and 84 (18.9%) were women. The most common principal severity of TBI among patients aged 20–29 years was moderate. This corresponds with the age groups that are known to be at higher risk for three levels of TBI. Car accident multiple trauma and head trauma show severity of TBI in both genders. Conclusion: The research findings determined the lack of ignoring the traffic control system in southeastern Iran that was the main cause of the injury; consequently, the focus of all essentials in traffic management should be considered for this problem. It must be noted that the incidence of TBI is necessary as there remains no cure for mild-to-severe TBI. As the evidence for effectiveness and specific treatment is limited, it must be subjected to demanding research. Keywords: Traumatic Brain Injuries, Trauma Center, Epidemiology, Injury Characteristics

مجلة جامعة الملك عبدالعزيز-العلوم الطبية

Traumatic brain injury is a common problem in society leading to morbidity and mortality. This study describes pattern of traumatic brain injury at King Abdulaziz University Hospital, and identify the demographic and clinical factors affected in the survivors' hospital length of stay. A retrospective study performed in January 2003 till January 2009. The incidence of traumatic brain injury requiring admission in relation to annual emergency room is 75/100,000 patients; mean age is 9.5 ± 4 years with ~81% of injuries occurring at < 30 years. Severe traumatic brain injury accounts for 15.1% of cases, whereas moderate traumatic brain injury accounts for 10.4% and mild traumatic brain injury accounts for 74.5%. Mechanisms of injuries: 46.5%, falling from a height, 26.7% motor vehicle collisions, 10.4% pedestrian-vehicle collisions and 10.4% assault victims. Factors affecting the hospital length of stay: Admission Glasgow Coma Scale (p < 0.001), loss of consciousness p < 0.001, presence of motor weakness p < 0.001, female gender p < 0.03, patients' age p < 0.001 and the nationality p < 0.001. Characteristics of traumatic brain injury: Young age, the mechanism of injury (mainly falls) and type of injury (mainly concussion). Tentatively, the patients' length of stay is predicted on the demographic and clinical data.

2012

Molecules (Basel, Switzerland), 2018

Traumatic brain injury (TBI) is one of the most frequent causes of combat casualties in Operations Iraqi Freedom (OIF), Enduring Freedom (OEF), and New Dawn (OND). Although less common than combat-related blast exposure, there have been significant numbers of blast injuries in civilian populations in the United States. Current United States Department of Defense (DoD) ICD-9 derived diagnoses of TBI in the DoD Health Care System show that, for 2016, severe and moderate TBIs accounted for just 0.7% and 12.9%, respectively, of the total of 13,634 brain injuries, while mild TBIs (mTBIs) accounted for 86% of the total. Although there is a report that there are differences in the frequency of long-term complications in mTBI between blast and non-blast TBIs, clinical presentation is classified by severity score rather than mechanism because severity scoring is associated with prognosis in clinical practice. Blast TBI (bTBI) is unique in its pathology and mechanism, but there is no treatmen...

Brain Injury, 2011

Primary objective: The eruption of Al-Aqsa Intifada created a war situation in Palestine, increasing the number of firearms injuries caused by occupying Israeli forces as well as disabling head injuries. No data were available to the Palestinian Ministry of Health and other health organizations on traumatic brain injury (TBI) in Palestine. This study, therefore, sought to determine the causes and outcomes of TBI in patients who were admitted to three hospitals in Nablus, Palestine. Research design: Retrospective review of medical records and contacts with patients and/or caregivers. Methods and procedures: The medical records of patients who were diagnosed with TBI (n ¼ 312) and admitted to any one of the three hospitals in 2006 and 2007 were reviewed. Data were also obtained from follow-up home visits and telephone calls with consenting patients and/or caregivers. Main outcomes and results: The major causes of TBI were assault (33%), falls (32.1%), road traffic crashes (29.8%) and impacts from heavy objects (3.2%). Gunshot wounds are a major cause of head injury in Palestine. Conclusions: The study shows that assault with firearms is the most frequent cause of TBI in this population and that patients with head injuries due to assault have poorer outcomes at discharge than those injured in other ways.

Journal of Neurosciences in Rural Practice, 2016

Traumatic brain injury (TBI), a significant public health problem, is a leading cause of disability and mortality in all regions of the globe despite advancement in prevention and treatments. Its global incidence is rising, and it is predicted to surpass many diseases as a major cause of death and disability by the year 2020. [1] TBI is the main cause of one-third to one-half of all trauma deaths and the leading cause of disability in people under forty, severely disabling 15-20/100,000 populations per year. [2] The World Health Organization estimates that almost 90% of deaths due to injuries occur in low-and middle-income countries (LAMICs), where 85% of population live, and this situation will continue to represent an important global health problem in the upcoming years. [3,4] TBI is a leading cause of mortality, morbidity, disability, and socioeconomic losses in India as well. It is estimated that nearly 1.5-2 million persons are injured, and 1 million die every year in India. [5] India and other developing countries are facing the major challenges of prevention, prehospital care, and rehabilitation in their

EAS Journal of Radiology and Imaging Technology, 2021

Background: Traumatic brain injury and its implications lead to huge public health issues. Annually, TBI affects approximately 50 million individuals all around the world. Head injury is the leading neurological reason for despondency and fatality, particularly influencing the youngsters. 85% to 90% are mild or moderate TBI. Objective: To find prevalence of traumatic brain injuries on computed tomography and that of severity classification from mild to severe grade. Material and Methods: 100 patients with history of head trauma were evaluated in this study, which came to emergency department of Public sector. GCS was taken and all were referred to CT. Noncontrast CT of brain was performed with slice thickness of 3mm from skull base to vertex. And analysis was done using (SPSS) Statistical Package for the Social Sciences version 21. Results: Of 100 TBI patients, men composed 66% and women 34%. Falls (38%), violence (2%) and other causes (5%) all collectively cause fewer traumas than RTA (55%) specifically in patients of age group 16-26 years. Different traumatic brain injuries were noted including EDH (22%), IPH (23%), SAH (9%), SDH (27%), Contusion (4%) and infarction (15%). Noteworthy, most of the brain injuries were observed as mild TBI in 65% of cases accounting for more than moderate (21%) and severe TBI (14%). Conclusion: The study concludes that 65% of patients who acquired head trauma had mild TBI while remaining 21% and 14% consumed moderate and severe TBI respectively. Subdural and intraparenchymal hemorrhages are most frequent type of diagnosis in TBI.

The Lancet Neurology, 2008

Traumatic brain injury (TBI) is a major health and socioeconomic problem that aff ects all societies. In recent years, patterns of injury have been changing, with more injuries, particularly contusions, occurring in older patients. Blast injuries have been identifi ed as a novel entity with specifi c characteristics. Traditional approaches to the classifi cation of clinical severity are the subject of debate owing to the widespread policy of early sedation and ventilation in more severely injured patients, and are being supplemented with structural and functional neuroimaging. Basic science research has greatly advanced our knowledge of the mechanisms involved in secondary damage, creating opportunities for medical intervention and targeted therapies; however, translating this research into patient benefi t remains a challenge. Clinical management has become much more structured and evidence based since the publication of guidelines covering many aspects of care. In this Review, we summarise new developments and current knowledge and controversies, focusing on moderate and severe TBI in adults. Suggestions are provided for the way forward, with an emphasis on epidemiological monitoring, trauma organisation, and approaches to management.

Journal of Neurotrauma, 2011

Many soldiers returning from the current conflicts in Iraq and Afghanistan have had at least one exposure to an explosive event and a significant number have symptoms consistent with traumatic brain injury. Although blast injury risk functions have been determined and validated for pulmonary injury, there is little information on the blast levels necessary to cause blast brain injury. Anesthetized male New Zealand White rabbits were exposed to varying levels of shock tube blast exposure focused on the head, while their thoraces were protected. The specimens were euthanized and evaluated when the blast resulted in respiratory arrest that was non-responsive to resuscitation or at 4 h post-exposure. Injury was evaluated by gross examination and histological evaluation. The fatality data from brain injury were then analyzed using Fisher's exact test to determine a brain fatality risk function. Greater blast intensity was associated with post-blast apnea and the need for mechanical ventilation. Gross examination revealed multifocal subdural hemorrhages, most often near the brainstem, at more intense levels of exposure. Histological evaluation revealed subdural and subarachnoid hemorrhages in the nonresponsive respiratory-arrested specimens. A fatality risk function from blast exposure to the head was determined for the rabbit specimens with an LD 50 at a peak overpressure of 750 kPa. Scaling techniques were used to predict injury risk at other blast overpressure/duration combinations. The fatality risk function showed that the blast level needed to cause fatality from an overpressure wave exposure to the head was greater than the peak overpressure needed to cause fatality from pulmonary injury. This risk function can be used to guide future research for blast brain injury by providing a realistic fatality risk to guide the design of protection or to evaluate injury.

Journal of Neurotrauma