Masood Jawaid, Ghulam Mustafa Wardug, Junaid Ashraf.
Pattern of head injuries at Civil Hospital, Karachi.
Pak J Surg Jan ;22(2):91-5.

Objective: To assess the pattern of Head Injuries at Civil Hospital, Karachi, a tertiary care public hospital of Karachi. Design & Duration: Retrospective descriptive study from January to December 2004. Setting: Dept. of NeuroSurgery, Civil Hospital, Karachi. Patients: All patients that were admitted with Head Injuries in the department. Methodology: The hospital records of all the patients admitted to the Neuro-Surgical Department at Civil Hospital Karachi in 2004 were reviewed. The demographic data of the patients, cause of injury, Glasgow Coma Scale (GCS) at presentation, diagnosis, associated injuries, management and outcome were analyzed. Results: A total of 439 patients were admitted in 2004, including 362 (82.5%) males and 77 (17.5%) females. Most of the patients 306 (69.7%) were in the first three decades of life. Road traffic accident was the commonest cause of head trauma, accounting for 219 (49.9%) admissions, followed by fall from height in 179 (40.8%), assault in 19 (4.3%) and gunshot injuries in 9 (2.1%) cases. The majority of the patients (50.1%) sustained mild head injury with a GCS of 13-15 on admission. Extradural haematoma was diagnosed in 92 (20.9%) patients, acute subdural haema- toma in 29 (6.3%), acute subarachnoid haemorrhage in 17 (3.9%), intracerebral haematoma in 13 (3.0%) and cerebral contusion in 89 (20.2%) cases. A total of 169 (38.5%) patients presented with a diffuse injury, with cerebral concussion in 107 (24.4%) and more severe diffuse brain injury in 62 (14.1%) patients. Fracture of the skull was seen in 105 (23.9%) patients. Fifty-four (12.3%) patients had associated injuries. Surgery was performed in 64 (14.6%) patients. The mean hospital stay was 4.21 (SD 4.52) days. Forty six (10.5%) patients died during the study period. Conclusion: Adults, predominantly males in their most productive years of life, are especially prone to acute head injury. Recognizing the pattern of head injury helps to identify high-risk groups and environments, which thus helps us to design better preventive measures.

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