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Volume 2023, Issue 4
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Traumatic cerebral contusion is a major global health concern due to its association with poor clinical prognosis. The aim of this study is to determine the risk factors and clinical presentation of traumatic cerebral contusion in Sudan.

A prospective cross- sectional observational hospital-based study was conducted in 90 patients with traumatic cerebral hemorrhagic contusion admitted to the National Center for Neurological Sciences (NCNS) over a period of six months.

The results show that most patients were male, age 25 to 44 years, 75.6% from rural areas, and 67.8 % from Afro-Asiatic linguistic affiliated tribes. The most common cause of traumatic brain hemorrhagic contusion was road traffic accidents (RTA) 68.9%, followed by assault 24.4%, and fall 6.7%. About 60% of the patients suffered a frontal lobe injury while 14.4% of the patients had multiple injury sites. Brain edema was observed in 22.2% of the patients. According to the Glasgow Coma Scale, 11.1% suffered severe, 30% moderate and 58.9% mild brain injury. Death rate was 8.9%

In conclusion, male gender, age 25-44 years, rural residents and victims of RTA were the most common characteristics observed in patients with traumatic hemorrhagic brain contusion in Sudan. The study also observed that brain edema and anatomical site of hemorrhage were not associated with death while male gender and GCS were. Traumatic cerebral hemorrhagic contusion is a major public health issue in Sudan carrying significant socioeconomic effects.

© 2023 Ibrahim, licensee HBKU Press.
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2023-10-19
2024-07-04
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References

  1. Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008; 7:(8):728−41. [Crossref]
     https://doi.org/10.1016/S1474-4422(08)70164-9 [Google Scholar]
  2. Lindsay W, Kim B, Lindsay N, Nancy T, Joseph G, Amy M, et al. Manual for the glasgow outcome scale-extended interview. J Neurotrauma. 2021; 38:(17):2435−46. [Crossref]
     https://doi.org/10.1089/neu.2020.7527 [Google Scholar]
  3. Maas AI, Hukkelhoven CW, Marshall LF, Steyerberg EW. Prediction of outcome in traumatic brain injury with computed tomographic characteristics: a comparison between the computed tomographic classification and combinations of computed tomographic predictors. Neurosurgery. 2005; 57:1173−82. [Crossref]
     https://doi.org/10.1227/01.neu.0000186013.63046.6b [Google Scholar]
  4. Saatman KE, Duhaime AC, Bullock R, Maas AI, Valadka A, Manley GT. Classification of traumatic brain injury for targeted therapies. J Neurotrauma. 2008 25:(7):719−38. [Crossref]
     https://doi.org/10.1089/neu.2008.0586 [Google Scholar]
  5. Narayan R, Michel M, Ansell B, Baethmann A, Biegon A, Bracken M, et al. Clinical trials in head injury. J Neurotrauma. 2002; 19:(5):503−57. [Crossref]
     https://doi.org/10.1089/089771502753754037 [Google Scholar]
  6. World Health Organization [WHO]. World report on disability. Geneva: World Health Organization;2011.
     [Google Scholar]
  7. Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation. 2007; 22:(5):341−53.
     [Google Scholar]
  8. Roozenbeek B, Maas AI, Menon DK. Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol. 2013; 9:(4):231−6. [Crossref]
     https://doi.org/10.1038/nrneurol.2013.22 [Google Scholar]
  9. Li M, Zhao Z, Yu G, Zhang J. Epidemiology of traumatic brain injury over the world: a systematic review. Austin Neurol Neurosci.. 2016; 1:(2):1007. [Crossref]
     https://doi.org/10.12865/CHSJ.44.02.13 [Google Scholar]
  10. World Health Organization. Projections of mortality and burden of disease from 2002 to 2030 (Deaths by Income Group). Geneva: World Health Organization; 2002.
     [Google Scholar]
  11. Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil. 2006; 21:(5):375−78. [Crossref]
     https://doi.org/10.1097/00001199-200609000-00001 [Google Scholar]
  12. Khair RZ, Arbab AM, Abdelrahman A. Cases and presentation of traumatic brain injury in Khartoum. J Emerg Med, Trauma Acute Care. 2010; 9:(1):27−31.
     [Google Scholar]
  13. Jadaan K, Osman M, Abudayyeh D, Gammoh H. "Traffic safety in Sudan: magnitude and future challenges" In. Proceedings of the 3rd Annual International Conference Syiah Kuala University (AIC Unsyiah)Banda Aceh;. 2013.
     [Google Scholar]
  14. World Health Organization [WHO]. World Report in Road Traffic injury Prevention. Geneva: World Health Organization;2004. [Crossref]
     [Google Scholar]
  15. Namas R, Ghuma A, Hermus L, Zamora R, Okonkwo DO, Billiar TR, et al. The acute inflammatory response in trauma/hemorrhage and traumatic brain injury: current state and emerging prospects. Libyan J Med. 2009; 4:(3):97−103. [Crossref]
     https://doi.org/10.4176/090325 [Google Scholar]
  16. Wong JC, Linn KA, Shinohara RT, Mateen FJ. Traumatic brain injury in Africa 2050: a modeling study. Eur J Neurol. 2016; 23:(2):382−6. [Crossref]
     https://doi.org/10.1111/ene.12877 [Google Scholar]
  17. Abdelrahman A, Khair R, Arbab AM. Neurological and psychiatric complications of traumatic brain injury (TBI). Sudanese J Psychiatry. 2010; 1:(1).
     [Google Scholar]
  18. Hardman JM, Manoukian A. Pathology of Head Trauma. Neuro-imaging Clin North Am. 2000; 12:(2):175−87. [Crossref]
     https://doi.org/10.1016/s1052-5149(02)00009-6 [Google Scholar]
  19. Kurland D, Hong C, Aarabi B, Gerzanich V, Simard J. Hemorrhagic progression of a contusion after traumatic brain injury: a review. J Neurotrauma. 2012; 29:(1):19−31. [Crossref]
     https://doi.org/10.1089/neu.2011.2122 [Google Scholar]
  20. Khoshyomn S, Tranmer BI. Diagnosis and management of pediatric closed head injury. Pediatric Surg. 2004; 13:(2):80−8. [Crossref]
     https://doi.org/10.1053/j.sempedsurg.2004.01.003 [Google Scholar]
  21. Griesbach GS, Masel BE, Helvie RE, Ashley MJ. The impact of traumatic brain injury on later life: Effects on normal aging and neurodegenerative diseases. J Neurotrauma. 2018; 35:(1):17−24. [Crossref]
     https://doi.org/10.1089/neu.2017.5103 [Google Scholar]
  22. Ziaeirad M, Alimohammadi N, Irajpour A, Aminmansour B. Association between outcome of severe traumatic brain injury and demographic, clinical, injury-related variables of patients. Iran J Nurs Midwifery Res. 2018; 23:(3):211−216. [Crossref]
     https://doi.org/10.4103/ijnmr.IJNMR_65_17 [Google Scholar]
  23. Whyte J, Gosseries O, Chervoneva I, Di Pasquale M, Giacino J, Kalmar K, et al. Predictors of short-term outcome in brain-injured patients with disorders of consciousness. Prog Brain Res. 2009; 177::63−72. [Crossref]
     https://doi.org/10.1016/S0079-6123(09)17706-3 [Google Scholar]
  24. Abedzadeh-Kalahroudi M, Razi E, Sehat M. The relationship between socioeconomic status and trauma outcomes. J Public Health. 2018; 40:(4):e431−9. [Crossref]
     https://doi.org/10.1093/pubmed/fdy033 [Google Scholar]
  25. Mohamed SA, Aldeaf SA, Elhaassan SH, Gassoum A, Abdrabo A. Homozygote A2 allele of interleukin 4 is associated with poor outcome of traumatic brain injury in Sudanese patients. J Med Dental Sci. 2016; 15:(6):92-98. [Crossref]
     https://doi.org/10.9790/0853-1506019298 [Google Scholar]
  26. Harish G, Mahadevan A, Pruthi N, Sreenivasamurthy S, Puttamallesh V, Subrahmanya T, et al. Characterization of traumatic brain injury in human brains reveals distinct cellular and molecular changes in contusion and per contusion. J Neurochem. 2015; 134:(1):156−72. [Crossref]
     https://doi.org/10.1111/jnc.13082 [Google Scholar]
  27. Kisser J, Waldstein SR, Evans MK, Zonderman AB. Lifetime prevalence of traumatic brain injury in a demographically diverse community sample. Brain Inj. 2017; 31:(5):620−3. [Crossref]
     https://doi.org/10.1080/02699052.2017.1283057 [Google Scholar]
  28. Hilmer LV, Park KB, Vycheth IV, Wirsching M. Cerebral contusion: an investigation of etiology, risk factors, related diagnosis, and the surgical management at a major government hospital in Cambodia. Asian J Neurosurg. 2018; 13:(1):23−30. [Crossref]
     https://doi.org/10.4103/ajns.AJNS_342_16 [Google Scholar]
  29. Eaton J, Hanif AB, Grudzikak J, Chrles A. Epidemiology, management, and functional outcomes of traumatic brain injury in Sub-Saharan Africa. World Neurosurg. 2017; 108::650−5. [Crossref]
     https://doi.org/10.1016/j.wneu.2017.09.084 [Google Scholar]
  30. Moshiro C, Heuch I, Astrom AN, Setel P, Hemed Y, Kvale G. Injury morbidity in an Urban and rural area in Tanzania: an epidemiological survaey. BMC Public Health. 2005; 5:(28):11. [Crossref]
     https://doi.org/10.1186/1471-2458-5-11 [Google Scholar]
  31. Abdalla S. Pattern of vulnerability to non-fatal injuries in Sudan: initial evidence from national cross-sectional survey. Inj Prev. 2014; 20::310−31. [Crossref]
     https://doi.org/10.1136/injuryprev-2013-040884 [Google Scholar]
  32. Labinjo M, Juillard C, Kobusingye OC, Hyder AA. The burden of road traffic injuries in Nigeria: results of population-based survey. Inj Prev. 2009; 15:(3):157−62. [Crossref]
     https://doi.org/10.1136/ip.2008.020255 [Google Scholar]
  33. Andersson N, Cockcroft A, Ansari U, Omer K, Ansari NM, Khan A, et al. Barriers to disclosing and reporting violence among women in Pakistan: findings from a national household survey and focus group discussion. J Interpers Violence. 2010; 25:(11):1965−85. [Crossref]
     https://doi.org/10.1177/0886260509354512 [Google Scholar]
  34. Bodanapally U, Shanmuganathan KG, Issa G, Drezizin D. Daual-Energy T.R. CT in Hemorrhagic progression of cerebral contusion: overestimation of hematoma volume on standard 120-KVImmages and rectification with virtual high- energy monochromatic images after contrast-enhanced whole-body imaging. AJNR Am J Neuroradiol. 2018; 39:(4):658−62. [Crossref]
     https://doi.org/10.3174/ajnr.A5558 [Google Scholar]
  35. Martin RM, Wright MJ, Lutkenhoff ES, Ellingson BM, Van Horn JD, Tubi M, et al. Traumatic hemorrhagic brain injury: impact of location and resorption on cognitive outcome. J Neurosurg. 2017; 126:(3):796−804. [Crossref]
     https://doi.org/10.3171/2016.3.JNS151781 [Google Scholar]
  36. Thierauf A, Preuss J, Lingnitz E, Madea B. Retrospective analysis of fata falls. Forensic Sci Int. 2010; 198:(1−3):92−6. [Crossref]
     https://doi.org/10.1016/j.forsciint.2010.01.010 [Google Scholar]
  37. Rogers AJ, Maher CO, Schunk JE, Quayle K, Jacobs E, Lichenstein R, et al. Incidental findings in children with blunt head trauma evaluated with cranial CT scans. Pediatrics. 2013; 132:(2):e356−63. [Crossref]
     https://doi.org/10.1542/peds.2013-0299 [Google Scholar]
  38. Kabore AF, Ouedraogo A, Ki KB, Traore SSI, Traaore IA, Bouugouma CTH, et al. Head computed tomography scan in isolated traumatic brain injury in low-income country. World Neurosurg. 2017; 107::382−388.
     [Google Scholar]
  39. Al-Kuwaiti A, Hefny A, Bello A, Hani O, Eid H, Zidan M. Epidemiology of head injury in the United Arab Emirates. Turk J Trauma Emerg Surg. 2012; 18:(3):213−8. [Crossref]
     https://doi.org/10.5505/tjtes.2012.03710 [Google Scholar]
  40. Krebs E, Gerardo CJ, Park LP, Nickenig-Vissoci JR, Byiringiro JC, Byiringiro F, et al. Mortality-associated characteristics of patients with traumatic brain injury at the university hospital of Kigali, Rwanda. World Neursurg. 2017; 102::571−82. [Crossref]
     https://doi.org/10.1016/j.wneu2017.03.001 [Google Scholar]
  41. Shutter L, Tong KA, Holshouser BA, Proton MRS. In acute traumatic brain injury: role for glutamate/glutamine and choline for outcome prediction. J Neurotrauma. 2004; 21:(12):1693−705. [Crossref]
     https://doi.org/10.1089/neu.2004.21.1693 [Google Scholar]
  42. Czlonkowska A, Ciesielska A, Gromadzka G, Kurkowska-Jastrzebska I. Estrogen and cytokines production-the possible cause of gender differences in neurological diseases. Curr Pharm Design. 2005; 11:(8):1017-1030. [Crossref]
     https://doi.org/10.2174/1381612053381693 [Google Scholar]
  43. Munivenkatappa A, Agrawal A, Shukla DP, Kumaraswamy D, Devi BI. Traumatic brain injury: Does gender influence outcomes?. Int J Crit Illn Inj Sci. 2016; 6:(2):70−3. [Crossref]
     https://doi.org/10.4103/2229-5151.183024 [Google Scholar]
  44. Gary KW, Arango-Lasprilla JC, Stevens LF. Do racial/ethnic differences exist in post-injury outcome after TBI? A comprehensive review of the literature. Brain Inj. 23:(10):775−89. [Crossref]
     https://doi.org/10.1080/02699050903200563 [Google Scholar]
  45. Sorani MD, Lee M, Kim H, Meeker M, Manley GT. Race/ethnicity and traumatic brain injury at a single, diverse center. J Trauma Acute Care. 2009; 67:(1):75−80.
     [Google Scholar]
  46. Kulesza B, Nogalski A, Kulesza T, Prystupa A. Prognostic factors in traumatic brain injury and their association with outcome. J. Pre-Clin Clin Res. 2015; 9:(2):163−6. [Crossref]
     https://doi.org/10.5604/18982395.1186499 [Google Scholar]
  47. Tucker B, Aston J, Dines M, Caraman E, Yacyshyn M, McCarthy M, et al. Early Brain edema is a predictor of in-hospital mortality in traumatic brain injury. Advanced Emerg Med. 2017; 53:(1):18−29.
     [Google Scholar]
  48. Muehlschlegel S, Carandang R, Ouillette C, Hall W, Anderson F, Goldberg R. Frequency and impact of intensive care unit complication on moderate-sever traumatic brain injury: early results of outcome prognostication in traumatic brain injury (OPTIMISM) study. Neurocrit Care. 2013; 18:(3):318−31. [Crossref]
     https://doi.org/10.1007/s12028-013-9817-2 [Google Scholar]
  49. Fevzullah A, Merih I, Hikmet A, Murant A, Osman A. Effects of anti-edema drugs on diffuse cerebral edema in rats: experimental study. Turk J Trauma Emerg Surg. 2013; 19:(2):89−97.
     [Google Scholar]
  50. Iaccarino C, Schiavi P, Picetti E, Goldoni M, Cerasti D, Caspani M, et al. Patients with brain contusions: predictors of outcome and relationship between radiological and clinical evolution. J Neurosurg. 2014; 120:(4):908−18. [Crossref]
     https://doi.org/10.3171/2013.12.JNS131090 [Google Scholar]
  51. Wong GK, Tang BY, Yeung JH, Collins G, Rainer T, Ng SC, et al. Traumatic intracerebral hemorrhaged: Is the CT pattern related to outcome?. Br J Neurosurg. 2009; 23:(6):601−5.
     [Google Scholar]
  52. Caroli M, Locatelli M, Campanella R, Balbi S, Martinlli F, Arienta C. Multiple intracranial lesions in head injury: clinical considerations, prognostic factors, management, and result in 95 patients. Surg Neurol. 2001; 56:(2):82−8. [Crossref]
     https://doi.org/10.1016/s0090-3019(01)00540-7 [Google Scholar]
  53. Hasar TB, Yaralanmalar S, Prognoz C, Yaralanmalar B. Traumatic brain injury due to gunshot wounds: a single institution's experience with 442 consecutive patients. Turk Neurosurg. 2009; 19:(3):216−23.
     [Google Scholar]
/content/journals/10.5339/jemtac.2023.27
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Risk factors and clinical presentation of traumatic cerebral hemorrhagic contusion in Sudanese patients at the National Center for Neurological Sciences, Khartoum, Sudan
Journal of Emergency Medicine, Trauma and Acute Care 2023, 27 (2023); https://doi.org/10.5339/jemtac.2023.27
/content/journals/10.5339/jemtac.2023.27
/content/journals/10.5339/jemtac.2023.27
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Keyword(s): National Center for Neurological Sciences (NCNS), road traffic accidents (RTA), Sudanese and traumatic cerebral contusion

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