Analysis of moderate and severe traumatic brain injury associated with skull base fracture: a local tertiary center experience

IF 0.7 Q4 CLINICAL NEUROLOGY Egyptian journal of neurosurgery Pub Date : 2024-09-16 DOI:10.1186/s41984-024-00325-1
Mahmoud Saad, Ali A. Mowafy, Ahmed M. Naser, Abdelaziz Abdalhamid Ismail, Ahmed Zaher, Samer Serag, Ibrahim Serag, Mostafa Shahein
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Abstract

Traumatic brain injury (TBI) is a major medical and social concern in developing countries. TBI-related morbidity and mortality statistics in Egypt are lacking and do not reflect the actual magnitude of the problem. To overview the incidence of moderate and severe head trauma in a heavily populated developing country and document the outcome of moderate and severe TBI associated with skull base fracture (SBF). Data of patients admitted to our center with moderate and severe TBI associated with skull base fracture (SBF) were reviewed in the period between January 2019 and March 2023. The most common type of trauma was road traffic accidents in 54.2% of the patients; 91.2% had Single SBF (middle cranial fossa fracture was predominant 58.5%). 25.5% had an initial GCS of ≤ 8. Periorbital ecchymosis was the most common presenting sign in 36.3%. The most frequent complication (37.3%) was pneumocephalus. The presence of skull base fracture inversely affected the Glasgow outcome scale extended GOSE (P = 0.001, r = 0.674). Higher initial GCS scores were positively correlated with good GOSE (GOSE) (P = 0.001, r =− 0.222). RTA represents a significant cause for moderate and severe TBI in young male population. SBF is associated with poor outcome in moderate and severe TBI. Higher initial GCS score was positively correlated with good GOSE. It is important to have an overview of different types of TBI in Egypt.
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与颅底骨折相关的中度和重度创伤性脑损伤分析:地方三级中心的经验
创伤性脑损伤(TBI)是发展中国家的一个主要医疗和社会问题。埃及缺乏与创伤性脑损伤相关的发病率和死亡率统计数据,无法反映问题的实际严重程度。本研究旨在概述一个人口众多的发展中国家中度和重度头部创伤的发病率,并记录与颅底骨折(SBF)相关的中度和重度创伤性脑损伤的结果。我们回顾了本中心在2019年1月至2023年3月期间收治的伴有颅底骨折(SBF)的中度和重度创伤性脑损伤患者的数据。54.2%的患者最常见的创伤类型为道路交通事故;91.2%的患者为单发SBF(中颅窝骨折占58.5%)。25.5%的患者初始GCS≤8。眶周瘀斑是最常见的症状,占 36.3%。最常见的并发症(37.3%)是气胸。颅底骨折的存在对格拉斯哥结果量表扩展 GOSE 有反向影响(P = 0.001,r = 0.674)。较高的初始 GCS 评分与良好 GOSE 呈正相关(P = 0.001,r =- 0.222)。在年轻男性人群中,RTA 是导致中度和重度创伤性脑损伤的一个重要原因。SBF与中度和重度创伤性脑损伤的不良预后有关。较高的初始 GCS 评分与良好的 GOSE 呈正相关。对埃及不同类型的创伤性脑损伤进行概述非常重要。
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