Computed Tomography of Patients with Head Trauma following Road Traffic Accident in Benin City, Nigeria
AbstractBACKGROUND: The outcome of head trauma as a result of road accident rests with increased use of CT scan and other radiological imaging modalities for prompt diagnosis is important.
OBJECTIVE: To find out the time of presentation for CT scan, symptoms for referral for CT scan and pattern of injuries in patients with cranial CT scan following road traffic accidents.
METHODS: Retrospective analysis of cranial computed tomography (CT) films, request cards, duplicate copy of radiology reports, soft copy CT images and case notes of 61 patients who underwent cranial CT scan on account of road traffic accidents. The study CT scans were performed at the radiology department of University Teaching Hospital between 1st January 2002 and 31st December 2004.
RESULTS: 51 patients (83.6%) were male while 10 (16.4%) were female with male to female ratio of 5:1. Thirty-eight (62.3%) patients were aged 20–39 years. Forty two patients (68.9%) presented after one week of injury. No patient presented within the first six hours of injury. The symptoms needing referral for CT scan included head injury 30 (49.2%), seizures 10 16.4%), skull fractures 8 (13.1%) and persistent headache 6 (5.6%). A total of 113 lesions were seen as some patients presented with more than one lesion. The findings on CT scan included 10 patients with normal findings, 21 (34.4%) skull fractures, 21 (34.4%) intra-cerebral haemorrhage, 19 (31.2%) brain contusion, 18 (29.5%) paranasal sinus collection, 11 (18.0%) cerebral oedema, 10 (16.4%) subdural haematoma and 5 (8.2%) epidural haematoma. Over 80% of the subdural and epidural haematomas were associated with skull fractures. The yield from plain radiography was poor being positive in only 8 (13.1%) while CT scan was positive in 51 (83.61%). Also 75 (about 66%) of the 113 lesions seen on CT scan were treatable surgically.
CONCLUSION: CT scan is an effective imaging modality of patient with road traffic accident and should be promptly requested in symptomatic patients who sustain trauma to the head toward identification of lesions that are amenable to surgical treatment.
Keywords: Cranial, Computed Tomography, Head, Trauma, Road Traffic, Accidents, Benin, Nigeria
WAJM 2011; 30(6): 404–407.