Objective: Rapid urbanization and motorization without corresponding increases in helmet usage have made traumatic brain injury due to road traffic accidents a major public health crisis in Cambodia. This analysis was conducted to quantify the impact of helmets on severity of injury, neurosurgical indication, and functional outcomes at discharge for motorcycle operators who required hospitalization for a traumatic brain injury following a road traffic accident in Cambodia.
Methods: The medical records of 491 motorcycle operators who presented to a major tertiary care center in Cambodia with traumatic brain injury were retrospectively analyzed using multivariate logistic regression.
Results: The most common injuries at presentation were contusions (47.0%), epidural hematomas (30.1%), subdural hematomas (27.9%), subarachnoid hemorrhages (12.4%), skull fractures (21.4%), and facial fractures (18.5%). Moderate-to-severe loss of consciousness was present in 36.3% of patients. Not wearing a helmet was associated with an odds ratio of 2.20 (95% confidence interval [CI], 1.15–4.22) for presenting with moderate to severe loss of consciousness compared to helmeted patients. Craniotomy or craniectomy was indicated for evacuation of hematoma in 20.0% of cases, and nonhelmeted patients had 3.21-fold higher odds of requiring neurosurgical intervention (95% CI, 1.25–8.27). Furthermore, lack of helmet usage was associated with 2.72-fold higher odds of discharge with functional deficits (95% CI, 1.14–6.49). In total, 30.1% of patients were discharged with severe functional deficits.
Conclusions: Helmets demonstrate a protective effect and may be an effective public health intervention to significantly reduce the burden of traumatic brain injury in Cambodia and other developing countries with increasing rates of motorization across the world. 相似文献
AbstractObjective: Fatal brain injuries result from physiological changes in brain tissues, subsequent to primary damage caused by head impact. Although efforts have been made in past studies to estimate the probability of brain injury, none of them involved prediction of such physiological changes. The goal of this study was to evaluate the fatality prediction capability of a novel approach that predicts an increase in intracranial pressure (ICP) due to primary head injury to estimate the fatality rate using clinical data that correlate ICP with fatality rate.Methods: A total of 12 sets of head acceleration time histories were used to represent no, severe, and fatal brain injury. They were obtained from the literature presenting head kinematics data in noninjurious volunteer sled tests or from accident reconstruction for severe and fatal injury cases. These were first applied to a Global Human Body Models Consortium (GHBMC) head–brain model to predict nodal displacement time histories of the brain, which were then fed into FEBio to predict ICP. A Weibull distribution was applied to the data for the relationship between fatality rate and ICP obtained from a clinical paper to estimate fatality rate from ICP (procedure A). Fatality rate was also estimated by applying the temporal and spatial maximum value of maximum principal strain (MPSmax) obtained from the GHBMC simulation to an injury probability function for MPSmax (procedure B). Estimated fatality rates were compared between the 2 procedures.Results: Both procedures estimated higher average fatality rate for higher injury severity. The average fatality rate for procedure A without ischemia representation and procedure B was 72.4 and 51.0% for the fatal injury group and 8.2 and 21.7% for the severe injury group, respectively, showing that procedure A provides more distinct classification between fatal and nonfatal brain injury. It was also found that representation of ischemia in procedure A provides results sensitive to injury severity and impact conditions, requiring further validation of the initial estimate for the relationship between brain compression and ischemic cell death.Conclusions: Prediction of the probability of fatality by means of a combination of simulations of the primary brain deformation and subsequent ICP increase was found to be more distinct compared to the prediction of primary injury alone combined with the injury probability function from a past study in the select 12 head impact cases. 相似文献
In order to study the distribution of benzo[a]pyrene (B[a]P) in rat brain, Sprague-Dawley male rats, 21-day-old, weighted 40–50 g were given a single intravenous (iv) injection of 3.7 × 105 Bq kg?1 of 14C-B[a]P. Rats were sacrificed at 1, 6, 12, 24, or 48 h after the administration of radiolabeled B[a]P. Light microscopic autoradiography and gamma counting were used. Gamma counting and light microscopic autoradiography showed that 14C-B[a]P localized in hippocampus at 1 h, in cerebral cortex at 6 h, and corpus striatum at 24 h after treatment. After B[a]P administration, silver grains rose with time reaching a peak at 24 h and sharp decrease at 48 h. The silver grains distribution was higher in neurons than in gliocytes. Thus, B[a]P penetrated the blood-brain barrier and distributed in various regions of rat brain. 相似文献
Abstract Male Baladi rabbits were acutely and sub‐chronically intoxicated with cyanofenphos and profenophos. The levels of cholesterol, triglycerides, B‐lipoproteins and total proteins were determined in the serum, brain, spinal cord and sciatic nerve of rabbits. Moreover, the activities of alkaline phosphatase, acid phosphatase and glutamic‐pyruvic transaminase were determined in the liver of the animals. The whole Studie revealed that the biochemical constituents were highly affected by the tested insecticides. Also, the liver function suffered from adverse effects of the tested insecticides. 相似文献