COMPUTED TOMOGRAPHIC PATTERN IN PATIENTS WITH HEAD INJURIES FROM ROAD TRAFFIC ACCIDENTS SEEN IN UNIVERSITY COLLEGE HOSPITAL, IBADAN

Abstract

Globally, the most common cause of head injury is road traffic accident. Computed Tomography (CT) scan is the gold standard in the diagnosis of patients with head injuries. This study assessed the CT pattern of injuries in patients with head injuries due to Road Traffic Accident (RTA) in Ibadan, Nigeria. The CT scan of 205 patients with head injuries following road traffic accident between January 2013 to January 2014 were reviewed. Patients' data were extracted from the records of head injured patients at the medical record department of the University College Hospital, Ibadan. Data recorded included patients age, sex, educational level, types of RTA. categories of road users and CT findings of head injury. Data were analyzed using descriptive Chi square test at 95% confidence interval. The mean age of the patients was 35.14 years. Generally, RTA patients were predominantly males (83.9%). with 83.8% and 84.0% of males involved in motorbike RTA (MBRTA) and motor vehicle RTA (MYRTA) respectively. Motorbike was the most common (63.4%) cause of RTA. The motorbike riders (55.4%) and motorvehicle drivers (50.0%) had more injuries than their corresponding passengers and pedestrians. Majority of the riders and drivers had low educational levels. Most patients had abnormal findings on CT scan (74.6%). Many patients had intracranial hematomas 57.6% while 42.7% of the patients had skull fractures. Mixed lesions (intracranial hematomas and skull fractures) were seen in 65.6% of Motorbike patients and 53.2% of Motorvehicle patients. In all patients, temporal bone was the most common fractured skull bone. Chi-square test showed significant association between intracranial hematomas and skull fracture in the road traffic accident cases evaluated (P-value < 0.00). Significant association was also recorded between intracranial hematomas and skull fractures in patients involved in MBRTA (P value < 0.00). Road traffic accident continues to be a public health problem in this environment. This study highlighted a high prevalence of head injury from road traffic accident especially in men between the ages of 21-40 years. The commonest cause of head injury was motorbike road traffic accident, with the highest incidence of injuries among the riders. Contusional hematoma was the commonest intracranial hematoma while temporal bone fracture was the commonest skull bone fracture. There is high tendency of sustaining both intracranial hematomas and skull fractures in RTAs, especially when caused by motorbike RTA. Continuous efforts should be made by government for the re-enactment of road traffic rules and regulations aimed at reducing head injuries from RTA.