Traumatic Head and Brain Injuries in Cases Attending Assiut University Hospitals: Medicolegal Evaluation and Outcomes

Abstract

Introduction: Head injuries represent a major threat to public health and are significant risk factors for disability and death across all age groups worldwide. Objectives: The purpose of this study was to assess the medico legal aspect of traumatic head injuries and to identify factors affecting the outcome and mortality rates following these injuries. Methods: This was cross-sectional study of 2917 cases with head injuries attended to the Emergency and Neurosurgery Departments at Assiut University Hospitals, Assiut, Egypt, over a period of one year from September 2021 to August 2022. Demographic data and injury characteristics were gathered. The severity of head injury was assessed by the Glasgow Coma Scale (GCS). Results: A total of 2917 individuals with head injuries met the inclusion criteria. Nearly one third (34.2%) were in age <10 years and (27.9%) were between (25 to <50) years old. 79.7% of cases were males. Fall from height was the most common mode of injuries (23.3%) followed by motor car accidents (21.2%). Accidental manner of exposure was the most common (94.2%). 32.7%of head injuries were found at multiple sites of skull vault. Concomitant abdominal injuries were found in (87.4%) of cases. Vomiting was the most frequent clinical presentation (53.6%) among study cases. Mixed types of intracranial hemorrhage (18.7%) were the most frequent Computed Tomography (CT) scan findings. 75% of the study patients had complete recovery while 9% of them died. Intracranial hemorrhage was the most leading cause of death (37.5%). Conclusion: Adult males were most frequently exposed to head trauma, and falls from height were responsible for the majority. Death rate was significantly high in old age, in those with GCS score ≤13 and in those with associated cardiothoracic and urogenital injuries.