THE ROLE OF COMPUTED TOMOGRAPHY IN THE EVALUATION OF TRAUMATIC BRAIN INJURY: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.71000/0xnzk363Keywords:
computed tomography, Glasgow coma scale, Brain Injuries, , Traumatic, Epidemiology, Hematoma, Subdural, Pakistan, Road Traffic AccidentsAbstract
Background: Traumatic brain injury (TBI) represents a disruption of normal brain function caused by sudden physical impact, leading to significant global morbidity and mortality. It contributes substantially to long-term disability, cognitive decline, and socioeconomic burden, particularly in low- and middle-income countries. Computed tomography (CT) remains the primary imaging modality for early detection, classification, and management planning of intracranial injuries.
Objective: To evaluate the diagnostic role of CT scan in assessing the pattern and severity of traumatic brain injury in patients presenting to tertiary care hospitals in Peshawar.
Methods: A descriptive cross-sectional study was conducted from February to July 2023 in two tertiary care hospitals in Peshawar. A total of 350 patients of both genders and all age groups presenting with head trauma were included through convenience sampling. The severity of TBI was determined using the Glasgow Coma Scale (GCS), and CT scans were performed to identify and categorize hematomas. Patients with a history of cerebrovascular disease, anticoagulant use, hypertension, or bleeding disorders were excluded. Data were analyzed using SPSS version 26, with frequencies, percentages, and chi-square tests applied where appropriate (p<0.05 considered significant).
Results: Out of 350 patients, males constituted 73% (n=257) and females 27% (n=93). The most affected age group was 11–20 years (26.6%), followed by 21–30 years (22.9%). Road traffic accidents were the leading cause of TBI (54%), followed by falls (38%) and other causes (8%). Mild TBI was most common (59.7%), followed by moderate (24.0%) and severe (16.3%). Subdural hematoma was the most frequent CT finding (36%), followed by epidural (33%), intracerebral (20%), and subarachnoid hematomas (11%).
Conclusion: Traumatic brain injury was predominantly observed in young males, mainly due to road traffic accidents, with mild TBI and subdural hematoma being the most prevalent. Strengthening road safety regulations, improving public awareness, and ensuring timely CT evaluation are essential for reducing TBI-related morbidity and mortality.
References
Stanton AN, Toms J, Ritter A. Attacked and Shaken by a Dog: A Cause of Traumatic Brain and Carotid Injury in an Infant. Pediatr Neurosurg. 2021;56(2):140-5.
Akie TE, Gupta M, Rodriguez RM, Hendey GW, Wilson JL, Quinones AK, et al. Characteristics of Intracranial Injuries in Pediatric Patients Following Blunt Head Trauma. Pediatr Emerg Care. 2024;40(9):e202-e8.
Levin JH, Pecoraro A, Ochs V, Meagher A, Steenburg SD, Hammer PM. Characterization of fatal blunt injuries using postmortem computed tomography. J Trauma Acute Care Surg. 2023;95(2):186-90.
Steinruecke M, Nair S, Venturini S, Siannis F, Hutchinson PJ, Kolias A, et al. Clinical Characteristics and Outcomes of Traumatic Brain Injury in a High-Volume Tertiary Care Center in India: A Prospective Observational Cohort Study. Neurosurgery. 2025;97(2):436-47.
Lupascu IT, Hostiuc S, Minoiu CA, Hostiuc M, Popa BV. Comparison of Traumatic Brain Injury in Adult Patients with and without Facial Fractures. Tomography. 2024;10(10):1534-46.
Azuma M, Nakada H, Kitatani K, Shinkawa N, Khant ZA, Ochiai H, et al. Conditional unnecessity of head CT for whole-body CT of traffic accident victims: a pilot study. Emerg Radiol. 2021;28(2):273-8.
Chandankhede AR, Thombre SD, Shukla D. Correlating Intracranial Pressure Following Decompressive Craniectomy With Neurological Outcomes in Severe Traumatic Brain Injury Patients: A Prospective Observational Study. Cureus. 2023;15(6):e40119.
Oezel L, Jaekel C, Bieler D, Stuewe D, Neubert A, Lefering R, et al. [Differences in injury patterns in motorcycle accidents involving children and adolescents]. Unfallchirurgie (Heidelb). 2022;125(11):880-91.
Suligavi SS, Saiyad SN, Doddamani SS, Mathri A. Early Diagnosis of Hidden Hearing Loss Following Temporal Bone Fractures. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):4336-40.
Bareikis K, Gustaitiene G, Kozenevskyte E, Deltuva VP, Tamasauskas A. Electric scooter - related CT - positive brain injuries: a five - year single - centre experience overview. Neurosurg Rev. 2024;47(1):597.
Al Mukhtar A, Bergenfeldt H, Edelhamre M, Vedin T, Larsson PA, Öberg S. The epidemiology of and management of pediatric patients with head trauma: a hospital-based study from Southern Sweden. Scand J Trauma Resusc Emerg Med. 2022;30(1):67.
Nugroho AW, Masrika NUE. The epidemiology of motorcycle-related acute traumatic brain injury: The NOMADEN study. Surg Neurol Int. 2025;16:27.
Khan SI, Karim R, Khan SI, Chowdhury MAK, Shill MC, Pasha FM, et al. Factors affecting severity and prognosis of traumatic brain injury among Bangladeshi patients: An institution based cross-sectional study. Traffic Inj Prev. 2024;25(8):1072-80.
Shakir M, Altaf A, Irshad HA, Hussain N, Pirzada S, Tariq M, et al. Factors Delaying the Continuum of Care for the Management of Traumatic Brain Injury in Low- and Middle-Income Countries: A Systematic Review. World Neurosurg. 2023;180:169-93.e3.
Weppner JL, Tu J, Khan A, Raucheisen JS. Pheochromocytoma-Induced Hypertension After Traumatic Brain Injury. Cureus. 2023;15(8):e44161.
Regmi M, Bhatta OP, Sharma MR. Pre-hospital care, pre-hospital delay, and in-hospital delay in patients with traumatic brain injury in getting neurosurgical care in a tertiary care center: A Cross-Sectional study. JNMA J Nepal Med Assoc. 2024;62(275):416-20.
Chen CH, Hsieh YW, Huang JF, Hsu CP, Chung CY, Chen CC. Predictors of In-Hospital Mortality for Road Traffic Accident-Related Severe Traumatic Brain Injury. J Pers Med. 2021;11(12).
Rabiu TB, Ogundipe H. Profile of Pediatric Traumatic Brain Injury in South-West Nigeria. World Neurosurg. 2022;166:e711-e20.
Omotoso BR, Harrichandparsad R, Lazarus L. The Spectrum of Vascular Injuries Secondary to Traumatic Brain Injury: A Single-Center Study Based on Digital Subtraction Angiography. World Neurosurg. 2025;199:124108.
Cho MJ, Yi KS, Choi CH, Yum KS, Cha SH, Kim Y, et al. Sphenoid sinus pseudoaneurysm with carotid cavernous fistula presenting with delayed subarachnoid hemorrhage: A case report. Medicine (Baltimore). 2021;100(24):e26383.
Kouitcheu R, Diallo M, Mbende A, Pape A, Sugewe E, Varlet G. Traumatic brain injury in children: 18 years of management. Pan Afr Med J. 2020;37:235.
Javeed F, Rehman L, Masroor M, Khan M. The prediction of outcomes in patients admitted with traumatic brain injury using the Rotterdam Score. Cureus. 2022 Sep 30;14(9).
Ahmed AA. A REVIEW OF SERIAL BRAIN CT IN PATIENTS WITH TRAUMATIC BRAIN INJURY: A TERTIARY CARE EXPERIENCE. PJR. 2020 Feb 1;29(4).
Khatun MM, Akter MS, Parvin SS, Reza MT. Traumatic Brain Injury And Its Findings On Computed Tomography; A Tertiary Care Hospital Experience. Journal of Radiology and Clinical Imaging. 2023;6(2):123-6.
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