Srivastava Syamantak, Kannan Ganapathyvel, Srisaravanan J, Rajaraajan K
Department of Neurosurgery, Madurai Medical College & Government Rajaji Hospital, Madurai, Tamil Nadu, India.
Department of Neurosurgery, Thoothukudi Medical College & Hospital, Thoothukudi, Tamil Nadu, India.
Asian J Neurosurg. 2024 Jun 25;19(3):374-379. doi: 10.1055/s-0043-1776992. eCollection 2024 Sep.
Contrecoup brain injury refers to the classical opposite of the primary impact. Tamil Nadu has the highest rate of road traffic accident in India. Madurai has peak mortality due to accidents in India. Previous studies done on contrecoup head injury had shown patterns of injuries and mechanism of injury. Outcome and management of only occipitofrontal contrecoup head injury has been taken in this study. Mortality in this specific group is very high. Seventy-six patients of this specific head injury were admitted at Government Rajaji Hospital, Madurai. Patients were assessed for Glasgow coma scale (GCS), age, sex, progression of volume, mortality, traumatic brain injury-induced coagulopathy, and pillion rider outcome. Fourteen patients were surgically treated by decompressive craniectomy. Conservative management was done by antiepileptic and antiedema measures. Mostly affected were males ( = 54) followed by females ( = 22). GCS on admission mean value 9. In our study, mortality was 32% with sudden death of three patients due to hypothalamic compression. Hospital stay of the patient was significantly increased with progression of lesion with mean 9 days and -value less than 0.01. Pillion riders ( = 18) were also affected in our study. Traumatic brain injury-induced coagulopathy ( = 12) was also detected, which was treated by injection tranexamic acid and injection vitamin K, thereby not leading to any death due to coagulopathy with significant -value less than 0.01. We recommend helmet for both main and pillion rider with strict speeding regulations.
对冲性脑损伤是指与原发性撞击相反的典型情况。泰米尔纳德邦是印度道路交通事故发生率最高的地区。马杜赖的事故死亡率在印度居首。先前关于对冲性头部损伤的研究已经揭示了损伤模式和损伤机制。本研究仅纳入了枕额部对冲性头部损伤的结果和治疗情况。这一特定群体的死亡率非常高。76例这种特定头部损伤的患者被收治于马杜赖的政府拉贾吉医院。对患者进行了格拉斯哥昏迷量表（GCS）、年龄、性别、血肿量进展、死亡率、创伤性脑损伤所致凝血病以及后座乘客情况的评估。14例患者接受了减压颅骨切除术。通过抗癫痫和抗水肿措施进行保守治疗。受影响最多的是男性（n = 54），其次是女性（n = 22）。入院时GCS平均值为9。在我们的研究中，死亡率为32%，3例患者因下丘脑受压突然死亡。随着病变进展，患者的住院时间显著延长，平均为9天，P值小于0.01。我们的研究中后座乘客（n = 18）也受到了影响。还检测到创伤性脑损伤所致凝血病（n = 12），通过注射氨甲环酸和维生素K进行治疗，因此未因凝血病导致任何死亡，P值显著小于0.01。我们建议主骑和后座乘客都佩戴头盔，并严格执行限速规定。
