Head injuries are the commonest cause of death in the surgical wards in Port Moresby and the commonest cause of death in road accidents. Three prospective and retrospective studies performed over the last decade aimed to determine the pathology and outcome in 274 head injuries admitted to Goroka in 1988-1991 (4 years) and Port Moresby in 1984-1985 and 1992-1993 (total 2.5 years). Head injuries were managed by general surgeons without CT scanning or intracranial pressure monitoring. There were 196 adults and 78 (28%) children; 195 were male and 79 female. Assaults (32%), motor vehicle accidents (49%) and falls (17%) were the commonest modes of injury. The case fatality rate was 21% (57 of 274 cases). Six of the deaths were avoidable. The fatality rates for admission Glasgow Coma Scores of 3-5, 6-8 and over 9 were 81%, 21% and 3% respectively. Two patients died of infection complicating open depressed fractures. The case fatality rate for extradural haematoma was 20% and subdural haematoma 67%. Nine patients died of associated abdominal injuries. Most of the deaths were unavoidable because of the severity of primary brain injury. The speed of diagnosis and quality of care could have been improved but the most important area is management of the airway. General surgeons properly trained in trauma care (which includes emergency airway management) are well able to cope with the majority of head-injured patients in Papua New Guinea.
Craniocerebral Trauma - epidemiology ; Craniocerebral Trauma - therapy ; Glasgow Coma Scale ; Retrospective Studies

OBJECTIVERoad traffic crashes (RTCs) are considered to be the second highest cause of mortality in Iran. The purpose of this study was to describe the morbidity and mortality of RTC during 2003-2008.

METHODSData were got from national health sources of Iran. These data included population, the number of RTCs, consequent fatalities, cause and place of death from 2003 to 2008.

RESULTSRTC incidence rate increased from 868.5 per 100 000 population in the year 2003 to 1 643.6 in 2008. A total of 2 565 deaths from RTC were recorded in Yazd from 2003 to 2008. RTC mortality rate increased from 46.1 per 100 000 population in 2003 to 46.9 in 2006, then declined to 38.8 in 2008. During this time period, overall traffic injury incidence per 100 000 population increased from 368.8 in 2003 to 647.9 in 2006, then declined to 527.9 in 2008. Head injuries were the most common cause of road traffic-related mortality from 2003 to 2008. Following road traffic accidents, most of the deaths occurred before arriving hospital.

CONCLUSIONSRoad traffic crash-related mortality and morbidity in Yazd in the recent six years are increased, but decreased in the last two years. This decline is most probably the result of a variety of interventions, including laws, police enforcement, improvements in traffic and transport, health care resources and media and public education.

Accidents, Traffic ; Craniocerebral Trauma ; Humans ; Incidence ; Iran ; epidemiology

Many of the dizziness patients annually visit ENT (ear, nose, throat) clinics because the vestibular function is the major organ to keep body balance and belongs to the Otorhinolaryngology. Nevertheless, many otolaryngologists feel that it is not easy to access the dizziness patients. The reason is that dizziness is not a final diagnosis and it is necessary to start the diagnosis of dizziness and find out the cause. Also, the causes of dizziness belong to multiple medical departments. That is why we need to pay more attention. Among them, traumatic vertigo can be manifested in various ways depending on the injury site and mechanism, and it is often difficult to predict the medical prognosis. Therefore, this review article focuses on traumatic vertigo. In this paper, we discussed its epidemiology and mechanism to help clinicians to treat patients with traumatic vertigo.
Craniocerebral Trauma ; Diagnosis ; Dizziness ; Epidemiology ; Humans ; Nose ; Otolaryngology ; Prognosis ; Vertigo

Head injury is a leading cause of death and disability in Korea. It usually results from an avoidable accident. Epidemiologic data on the head injury is important for the effective reduction of this controllable disaster. The aim of this study is to estimate the incidence of head injury in Korea. Data on the incidence of the traffic accidents were collected from Traffic Accident Statistics 1998 by the National Police Agency. Proportion of head injuries due to traffic accidents was obtained from various literatures. The incidence of head injury was approximated simply by a formula H=T/0.625 [the total number of patients after traffic accidents (T) would be 62.5% of the total number of patients with head injury (H)]. In 1998, the estimated number of head injury was 109,462. The annual incidence was 236/100,000 person, 334/100,000 for males and 136/100,000 for females. The causes were road traffic accident in 62.5%, and falls in 15.6%. The operation was performed in 20.2% with a mortality of 4.0% in average. Case fatality rate was 8.2%. Annual death rate was 19/100,000 population. A public campaign is required on the basis of trustworthy epidemiologic data to reduce the incidence of head injury for the public health.
Accidents, Traffic/*statistics & numerical data ; Craniocerebral Trauma/*epidemiology ; Female ; Human ; Incidence ; Korea/epidemiology ; Male

OBJECTIVEHead injury (HI) is the leading cause of mortality and life-long disability in infants. Infants have different anatomical and pathophysiological brain structures from other age groups. The aim of this study was to survey infant HI patients admitted to Shahid Behest Hospital in Kashan, Iran from 2004 to 2010, and to identify the causes of HIs in this age group.

METHODSIn this retrospective study, all HI patients under the age of two who were hospitalized for more than 24 hours between January 2004 and January 2010 were enrolled in the study. Demographic, etiologic, and injury data were collected and a descriptive analysis was performed.

RESULTSInfants comprised 20.8% of all children (under 15 years old) with HIs and 65.1% of the injuries occurred in the home. Falls were the most common cause of injury (63.4%). In hospital mortality was 6.6 per 100 000 infants. A decreasing trend was seen in home events, but HIs caused by traffic accidents were increasing during the study period. The amount of HI infants resulting from car accidents has tripled from the years 2004 to 2010.

CONCLUSIONAlthough home events and falling are the main causes of infant HIs and need attention, our study showed an increase of HIs caused by road traffic accidents, especially by car accidents, thus legislation for the implementation of protective equipment such as child safety seats and programs is urgently needed.

Accidents, Traffic ; Adolescent ; Child ; Child, Preschool ; Craniocerebral Trauma ; epidemiology ; Humans ; Infant ; Iran ; epidemiology ; Retrospective Studies

OBJECTIVE: The aim of the present study is to estimate the incidence trend of head injury and the mortality based on traffic accident statistics and to investigate the impacts of rapid industrialization and economic growth on epidemiology of head injury in Korea over the period 1970-2012 including both pre-industrialized and post-industrialized stages. METHODS: We collected data of head injury estimated from traffic accident statistics and seven hospital based reports to see incidence trends between 1970 and 2012. We also investigated the population structure and Gross National Income (GNI) per capita of Korea over the same period. The age specific data were investigated from 1992 to 2012. RESULTS: The incidence of head injury gradually rose in the 1970s and the 1980s but stabilized until the 1990s with transient rise and then started to decline slowly in the 2000s. The mortality grew until 1991 but gradually declined ever since. However, the old age groups showed rather slight increase in both rates. The degree of decrease in the mortality has been more rapid than the incidence on head injury. CONCLUSION: In Korea during the low income stage, rapid industrialization cause considerable increase in the mortality and the incidence of head injury. During the high income stage, the incidence of head injury gradually declined and the mortality dropped more rapidly than the incidence due to preventive measures and satisfactory medical care. Nevertheless, the old age groups revealed rather slight increase in both rates owing to the large population structure and the declining birth rate.
Accidents, Traffic* ; Birth Rate ; Craniocerebral Trauma* ; Economic Development ; Epidemiology ; Head* ; Humans ; Incidence ; Korea* ; Mortality ; Industrial Development

OBJECTIVE: Head injury is the main cause of death and severe disability in bicycle-related injuries. The purpose of this study was to compare the demographic characteristics and injury mechanisms of bicycle-related head injuries according to the severity and outcome and determine the main risk factors and common types of accompanying injuries. METHODS: A total of 205 patients who were admitted to the neurosurgery department of our hospital for bicycle-related head injuries between 2007 and 2016 were analyzed. We categorized the patients into two groups according to severity and outcome of head injury, and then identified the differences in age, sex, and cause of injury between the two groups. RESULTS: Collisions with a motor vehicle increased the risk of severe head injury (p=0.011), resulted in poor outcomes (Glasgow Outcome Scale [GOS] ≤3; p=0.022), and caused more accompanying chest/abdominal (p<0.001) and pelvic/lower extremity injuries (p=0.001) than other mechanisms. Older age and high grade of head injury severity resulted in poor outcomes (p=0.028 and p<0.001, respectively), and caused more accompanying chest/abdominal injuries (p<0.032 and p<0.001, respectively) compared with younger age and low grade of head injury severity. CONCLUSION: In bicycle-related head injuries, collision with motor vehicle is one of the most important risk factor for high grade of head injury severity and outcome. In addition, bicycle-related head injuries are often accompanied by injuries of other parts of the body.
Cause of Death ; Craniocerebral Trauma* ; Epidemiology* ; Extremities ; Head* ; Humans ; Motor Vehicles ; Neurosurgery ; Risk Factors*

OBJECTIVE: Earlier reports have revealed that the incidence of posttraumatic hydrocephalus (PTH) is higher among patients who underwent decompressive craniectomy (DC). The aim of this study was to determine the influencing factors for the development of PTH after DC. METHODS: A total of 693 head trauma patients admitted in our hospital between March 2004 and May 2007 were reviewed. Among thee, we analyzed 55 patients with severe traumatic brain injury who underwent DC. We excluded patients who had confounding variables. The 33 patients were finally enrolled in the study and data were collected retrospectively for these patients. The patients were divided into two groups: nonhydrocephalus group (Group I) and hydrocephalus group (Group II). Related factors assessed were individual Glasgow Coma Score (GCS), age, sex, radiological findings, type of operation, re-operation and outcome. RESULTS: Of the 693 patients with head trauma, 28 (4.0%) developed PTH. Fifty-five patients underwent DC and 13 (23.6%) developed PTH. Eleven of the 33 study patients (30.3%) who had no confounding factors were diagnosed with PTH. Significant differences in the type of craniectomy and re-operation were found between Group I and II. CONCLUSION: It is suggested that the size of DC and repeated operation may promote posttraumatic hydrocephalus in severe head trauma patients who underwent DC.
Brain Injuries ; Coma ; Confounding Factors (Epidemiology) ; Craniocerebral Trauma ; Craniotomy ; Decompressive Craniectomy ; Humans ; Hydrocephalus ; Incidence ; Retrospective Studies

Traumatic Brain Injury (TBI) is as common in elderly people as it is in young adults. Compared to TBI among young adults, TBI among the elderly differs in mechanism of injury, clinical presentation, comorbidities, and prognosis. This article begins with an overview of the literature on epidemiology, unique characteristics and pathophysiology of geriatric head injuries. Neurological sequelae and indices of general outcome following TBI will be disussed. We will discuss the proposed relationship between TBI and Alzheimer's disease, which lead to a greater understanding of the pathogenesis of both TBI and Alzheimer's disease. The literature about the assessment and management of TBI will be reviewed.
Aged* ; Alzheimer Disease ; Brain Injuries* ; Comorbidity ; Craniocerebral Trauma ; Epidemiology ; Humans ; Prognosis ; Young Adult

OBJECTIVETo study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan'an district (urban) and Jiangjin district (rural) of Chongqing, and to discuss the corresponding strategies for its prevention and cure.

METHODSRecords of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan'an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries. Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared.

RESULTSBetween the year 2000 and 2006, the average annual incidence of traffic injuries and mortality rate in the aged people in Nan'an district were 124.62/100 000 and 13.85/ 100 000 respectively, higher than that in Jiangjin district (27.49/ 100 000, 7.13/100 000, P less than 0.01). However, the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%, higher than that in Nan'an district (10.00%, P less than 0.01). Head injury was the primary cause of death. Totally 76.58% of casualties were pede-strians. Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system.

CONCLUSIONSThe traffic environment is unfavorable to the aged people. It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law, so as to provide a safe road traffic environment for the aged people.

Accidents, Traffic ; Craniocerebral Trauma ; epidemiology ; Humans ; Incidence ; Risk Factors ; Wounds and Injuries