国家创伤中心轻度脑外伤颅内可手术病变的发病率

IF 0.7 Q4 CLINICAL NEUROLOGY Egyptian journal of neurosurgery Pub Date : 2024-02-02 DOI:10.1186/s41984-024-00268-7
Selekeowei Peter Kespi Kpuduwei, Ayodeji Salman Yusuf
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摘要

轻度创伤性脑损伤(TBI)在大多数急诊室的头部创伤中占多数。尽管轻度 TBI 患者可根据头部损伤建议进行复查并出院,但仍有相当数量的患者因可手术的颅内病变而需要入院观察或干预治疗。本研究旨在确定轻度创伤性脑损伤患者中可手术病变的发生率。这是一项前瞻性研究,对象是在阿布贾国家创伤中心接受头颅计算机断层扫描(CT)检查的轻度创伤性脑损伤成年患者。所有参与者均已知情同意,且该研究已获得医院的伦理许可。研究共招募了 103 名接受头颅 CT 检查的轻度创伤性脑损伤患者,他们的年龄在 16-76 岁之间,平均年龄为 32.25 岁(12.35 岁)。根据治疗意向,其中 20 人(20.4%)在 CT 扫描中被诊断为可手术的颅内病变,其中男性 19 人,女性 2 人。其中大部分(14 例,66.7%)为 20-40 岁的青壮年。在可手术的患者中,有 16 例硬膜外血肿(76.2%)、3 例硬膜下血肿(14.3%)和 2 例凹陷性颅骨骨折(9.5%)。大量轻度创伤性脑损伤患者出现了可手术的颅内病变。因此,有必要对轻度创伤性脑损伤患者进行适当筛查,以避免漏诊可手术病灶。
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Prevalence of operable intracranial lesions from mild traumatic brain injury in a National Trauma Centre
Mild traumatic brain injury (TBI) occupies majority of head traumas in most emergency units. Although patients with mild TBI can be reviewed and discharged on head injury advice, a sizeable number require admission for observation or intervention due to operable intracranial lesions. The aim of the study was to establish the prevalence of operable lesions in patients with mild TBI. This was a prospective study of consecutive adult patients with mild TBI who had cranial computerized tomography (CT) done at the National Trauma Centre, Abuja. All participants gave informed consent and the study had ethical clearance in the Hospital. One hundred and three mild TBI patients with cranial CTs were recruited aged 16–76 years with mean age of 32.25 $$\pm$$ 12.35 years. With intention to treat, twenty (20.4%) of them were diagnosed with operable intracranial lesions on CT scans, 19 males and 2 females. Majority of them (14; 66.7%) were young adults within 20–40 years of age. The lesions were 16 extradural haematomas (76.2%), 3 subdural haematomas (14.3%) and 2 depressed skull fractures (9.5%) of the operable cohort. Significant number of patients with mild TBI had operable intracranial lesions. Therefore, there is need to screen patients with mild TBI appropriately in order to avoid missed operable lesions.
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