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A Retrospective Study on Cause of Death in Head Injury Patients with GCS 13 and above in Salem District

L. Sankar, Associate Professor, Department Of Neurosurgery, Government Mohan Kumaramangalam Medical College, Salem, Tamil Nadu 636109, India. , Parthiban Durai Samy1 , L. Sankar2

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International Journal of Neurology and Neurosurgery 10(4):p 115-119, Oct-Dec 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10418.4

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Abstract

  Introduction: Mlld traumatic brain injury is defined by the American Congress of Rehabilitation Medicine as involving an alteration in consciousness (amnesia or confusion), less than 30 minutes of loss of consciousness, or less than 24 hours of post traumatic amnesia, with focal neurological deficits that may or may not be transient. Materials and Methods: This retrospective study was conducted in 2016-2018 in Department of Neurosurgery, Government Mohan Kumaramangalam Medical College Salem. 45 cases got selected based on the GCS criteria. These patients case sheets were collected from the following data’s were collected from the case sheets. Age, sex, date of admission, date of surgery (if performed), date of death, diagnosis, mode of injury, history of loss of consciousness, vomiting, ENT bleed, seizures, GCS at the time of admission, associated injuries, first CT scan brain findings, other investigations done, opinions obtained from other departments for associated injuries or medical conditions, preliminary investigations, date of deterioration, cause of deterioration as evidenced by supporting investigations or examination findings. Results: Majority of the patient (23 patients) who were admitted with mild head injury and have died had bifrontal or frontal contusions alone or in association with contusions in other areas of the brain. 20 patients had subdural hemorrhage, which includes acute and chronic, 5 patients had extradural hemorrhage, 19 patients had a subarachnoid hemorrhage, 19 patients had skull fractures visible on CT scans and 7 patients had pneumocephalus. Many patients had more than one finding on a CT scan. Conculsion: Focal injuries are those visible injuries limited to a well circumscribed part of the brain whereas diffuse injury is one in which there is no visible macroscopic structural damage to the brain, but associated with widespread dysfunction of the brain. Even in its mildest form, diffuse injury may be assisted only with alterations in neuronal excitability, neurotransmission related injuries and/or receptor related injuries. In its more severe cases it may be associated with structural damage at microscopic levels without any visible mass lesion. 

Keywords: Head Injury; Glass Coma Scale; CT Findings; Fractures
 

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10418.4

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