Head trauma in a newly established neurosurgical centre in Nigeria

Abstract

Background: Head trauma is a major cause of morbidity and mortality worldwide. The most active male age group (15 – 40 years) is the worst afflicted, and road traffic accident is the most common aetiologic factor. Computerized Tomograghy facilitates a comprehensive diagnosis and while treatment is mostly conservative, outcome depends on several factors. In one of Nigeria’s six geopolitical zones, a new Centre for Neurosurgery was established one year ago. To objectively build our data base, we prospectively studied the pattern and outcome of head trauma in the new Centre.
Method: A 35-point questionnaire was designed to collect data, real time, on every patient diagnosed with head trauma, from the point of admission to the time of discharge.
Results: A total of 334 patients were treated in our Unit and 197 (59%) of them were due to head trauma. Males were 147 (74.6%) and females 50 (26.4%), giving a male:female ratio of 3:1. The adult:paediatric ratio was 3:1, and most had mild head trauma 132 (67%). Road traffic accident was the most common aetiologic factor 133 (67.5%) and diagnosis was mostly with x-ray studies 192 (97.5%). Basal skull fracture 86 (43.7%) was the most common pathology and spinal trauma was associated with 13 (6.6%) cases. Treatment was mostly conservative and outcome, good in 135 (68.5%).
Conclusion: Head trauma, mostly resulting from road traffic accident, constitutes more than half of our neurosurgical cases and young male adults were the most afflicted group, predominantly with basal skull fractures. The lack of Computerized Tomography scanning facilities contributed a great deal to our outrageous mortality rate of 19.8%.