Arif Abubakar Ahmed


Background : Traumatic brain injury (TBI) remains a significant cause of neurological morbidity and mortality. The annual incidence of head injury in Pakistan has been estimated as 50/100,000 population based on data from public sector hospitals. Studies based on routine follow-up CT imaging have shown that approximately 20% to 50% of patients with TBI will develop progressive hemorrhagic injury (PHI).

Objective: To identify and study the importance of serial brain CT brain imaging in Traumatic Brain Injury (TBI) and analyze their evolution to redefine treatment strategies for trauma research in our region.

Materials and Methods: It is a retrospective study analyzing head trauma patients presenting to our emergency department over a period of six months between July and December 2016 in Liaquat National Medical College and Hospital, Karachi. Out of 468 patients, 202 patients were followed up and their data was recorded.

Results: Out of all the causes, Road Traffic accidents (RTA) was most common cause 125 patients (61.8%). The most frequent age group affected was between the age of 31-50 years. Intraparenchymal contusions (IPC) was the most frequent CT finding found in 78.7% of the patients and the least common finding was pneumocranium only 10.8%.

On follow up studies, out of the 202 patients, 54 of them had significant increase since their last control CT and the remaining 148 had either stable or resolution in their findings. Patients with moderate GCS [≥9-12], Intraparenchymal contusion (IPC) and subdural hematoma (SDH) were the common factors that were found to contribute to progressive hemorrhagic injury (PHI).

Conclusion: The results of our study suggest that follow up imaging after TBI allows for more suitable patient care, like the facilitation in identifying this specific group of patients and warranting change in their treatment plan, either conservative or surgical. This will result in a potentially favorable outcome.

Keywords: Accident, Contusion, CT scan brain, Head trauma, Traumatic brain injury (TBI)

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