Friday, March 29, 2024
HomeTraumaInitial Evaluation and Management of CNS Injury

Initial Evaluation and Management of CNS Injury

The Problem

Traumatic brain injury (TBI) remains a major health problem with serious socio-economic consequences. Although its incidence is decreasing in most western countries according to some estimates, severe TBI will become the third most common cause of death and disability globally by the year 2020.

In 1996, 3740 deaths from serious injuries were recorded in the United Kingdom. The death rate for all ages from a head injury in the United Kingdom is 9 deaths per 100,000 population per year, or 1% of all deaths, or 15-20% of deaths of persons aged 5-35 years.

Almost half of patients presenting to emergency departments with a head injury (1 million/y) are children younger than 16 years.

The most common causes of injury are falls (41%), assaults (20%), and road traffic accidents (13%). Road traffic accidents account for 58% of all deaths from head injury. In 1997, a fatal injury (all causes) cost the nation £902,500, a major injury cost £102,880, and a minor injury cost £7970.

(Statistics from Royal College of Surgeons of England)

United States

CNS injuries remain the leading cause of morbidity and mortality for young people throughout the world. In 1998, 148,000 Americans died from various injuries. Traumatic brain injuries (TBIs) caused 50,000 deaths. The average incidence (combined hospitalization and mortality rates) is 95 cases per 100,000 population. Twenty-two percent of people who have a TBI die from their injuries. In addition, approximately 10,000-20,000 spinal cord injuries occur each year.

The risk of incurring a TBI is especially high among adolescents, young adults, and people older than 75 years. For all ages, the risk of TBI is twice as high for males as for females. Motor vehicle crashes, violence, and falls are the leading causes of TBI. Nearly two thirds of firearm-related TBIs are classified as suicidal in intent.

The leading causes of TBI vary according to age. Falls are the leading cause of TBI among people aged 65 years and older, whereas transportation accident leads among persons aged 5-64 years. Firearms surpassed motor vehicles as the largest single cause of death associated with TBI in the United States in 1990.

The outcome of these injuries varies greatly depending on the cause. Death results from 91% of firearm-related TBIs, but only 11% of fall-related TBIs are fatal. Only a few analyses of the monetary costs of these injuries are available. The estimated total costs for the year 1985 were $37.8 billion.

A research letter by Marin et al reported that the rate of trips to US emergency departments resulting from traumatic brain injury increased 29.1% between 2006 and 2010.

(Statistics from National Center for Injury Prevention and Control)

RELATED ARTICLES
- Advertisment -

Most Popular