Intracranial hemorrhage in patients with head trauma on Computed Tomography scan

Abstract

Objective: To determine the frequency of intracranial hemorrhage on Computed Tomography scan in patients presenting with history of head trauma.

Materials and Methods:

165 patients with history of trauma were enrolled in the study, all referred for Computed Tomography scan (CT ). Computed Tomography scan of brain without contrast was done in axial plane with a slice thickness of 10mm from foramen magnum to vertex. Any abnormal findings were noted. Only first Computed Tomography scan of the patient examined was considered. A Performa was filled recording patient’s name, age, sex, head injury, Computed Tomography findings etc. Any bias or confounding variable was controlled by putting some risk factors in the exclusion criteria. Patients with bleeding disorders and those on anticoagulant therapy were excluded from the study as they have increased risk of developing spontaneous intracranial hemorrhage. Data analysis was done by using SPSS version 10. Mean and standard deviation were calculated for all numerical values i.e. Age. Frequency and percentage were calculated for all categorical/qualitative variables i.e. sex, head injury, mode of injury, intracranial hemorrhage.

Results:

Out of 165 patients with head injury, 25 (15.3%) showed traumatic intra cranial hemorrhage on CT scan (Table 5).Out of 25 patients, 09 (36%) had subdural hemorrhage (SDH), 05 (20%) had subarachnoid hemorrhage (SAH), 07 (28%) had epidural hemorrhage (EDH) and 04 (16%) had intra parenchymal hemorrhage (IPH). Out of 165 patients, 71 (43.1%) had road traffic accidents (RTA), 39 (23.6%) had H/o fall and 55 (33.3%) had other types of traumatic injuries i.e. firearm, blunt traumatic injury, domestic abuse .111 patients showed no fractures of skull whereas 29 patients had fracture of skull. Among various age groups, it was observed that the highest frequency of intracranial hemorrhage was in age range 16-30 years that is in 13 out of 25 patients. Male patients showed higher incidence of intracranial hemorrhage (72%) as compared to females. Patients with history of road traffic accidents showed higher incidence .

CONCLUSION : This study demonstrates that 15.3% of patients presenting with head trauma had intracranial haemorrhage (ICH) evident on CT scan. Subdural hemorrhage was the most frequent type of haemorrhage in this study. Intracranial haemorrhage present was mostly associated with road traffic accidents as compared to other traumatic injuries.