Computed tomographic evaluation of head injury patients in Umuahia, Abia State Nigeria

Abstract

Background: Trauma to the scalp, skull and brain is defined as head injury. Head injury is a silent killer, especially in patients that have intracranial  hemorrhage with mass effect on the brain parenchyma. It is a major health challenge worldwide especially in places where there is lack of medical  insurance, ignorance and non availability of the right imaging modality. Before the advent of Computed Tomography (CT), plain radiographs had been  the imaging modality available for the evaluation of head injury. Plain radiographs give limited information about head injury because apart from skull  fractures, plain radiographs cannot confirm diagnosis of intracranial collections, brain contusions and others. CT scan was chosen because its four  dimensional images can be reconstructed with volume rendering, bone details can be evaluated, and with the Hounsfield unit, measurements of  collections, haematomas can be evaluated. There are not much reports on head injury findings in Umuahia and hence this study is set to contribute to the data on head injury in and around Umuahia.

Materials and methods: This is a retrospective study of patients with head injury that came for head CT scan examination in Umuahia from January 2022  to December 2022. Patients were scanned with 160 slides Canon Aquilion CT Scanner; patients were made to lie in supine position. 3mm axial slices  were taken from the base of the skull to the vertex with reformatted images. No contrast was used because it is contraindicated in traumatic brain  injury. Patients gender, age, aetiology of injury and findings of radiologists were collected as data and entered into Microsoft Excel data base and  statistically analyzed using statistical package for social sciences for windows (SPSS inc., USA) version 21.0, and results tabulated.

Results: Out of the total population studied (108), 82.4% were males while 17.6% were females. Majority of the cases fell within the age group of 51yrs-  60yrs(20.4%), followed by 21yrs-30yrs(19.4%) and the least being below1yr (1.9%). Road traffic accident was the commonest cause of head injury (64%),  followed by fall from height (19.4%), trauma to the head with weapons (13.9%) while glass bottle trauma and unknown causes were the least having  (0.9%) and (1%) respectively. CT findings revealed that 52.1% of the cases resulted in hemorrhages, 18.6% resulted in hematoma formations, 6.5% were  soft tissue injuries, 5.4% were pneumo-cephalus and 1.6% resulted in cerebral edema.

Conclusions: Computed Tomography (CT) scan is a very useful tool  in the evaluation of patients with head injury. The study showed that more males were involved with head injuries than females and that the most  common cause of head injury in Umuahia, Abia State, is road traffic accident with intra-cerebral haemorrhage being the commonest CT finding.