Thesis (M.Sc. (Med.) (Emergency Medicine))--University of the Witwatersrand, Faculty of Health Sciences, 2012. / An audit of patients with moderate to severe head injuries in Leratong regional hospital ABSTRACT The aim of this study was to review the clinical presentation, underlying brain injury and clinical outcomes of moderate and severe traumatic brain injuries (TBI) patients managed in a regional hospital setting. The records of 95 patients with moderate and severe traumatic brain injury who were treated at Leratong hospital from 01 January to 31 December 2009 were studied. Demographic data, referral criteria to neurosurgeon, criteria for computerized tomography (CT) scan and their findings were reviewed. Outcomes were death, alive with and without complication/ disability. The relationships between outcomes, age, blood pressure, pulse, Glasgow coma scales (GCS) score, abnormal pupil and CT scan findings were analyzed. The following variables were statistically significant in showing a strong association with mortality; subdural haematoma (46%), lower GCS (5.8 ± 2.7), bradycardia (76.4 ± 29.7) and abnormal pupil characteristics (54%). All patients with perforating gunshot wounds to head died. However, 88% patients with brain contusions lived. Patients with a lower GCS (7.3 ± 3.3), hypotension (69.1 ± 25.7) and contusion (48%) had a strong association with development of complications and disability. In contrast, those with facial fractures (92%) were less likely to develop complications or die. Computerized tomography (CT) scan referrals had a poor outcome as result of delays in transfer. Moderate TBI patients treated in this setting did not experience a higher mortality when compared to figures in the literature. It was found that majority of patients (95%) required conservative management instead of craniotomies. Taking into account 46% of missing records regional hospitals might be appropriate facilities for triaging and a supervised conservative management of TBI. However, a need arise to review triage criteria to neurosurgeon while being specific to our South African hospital setting. Lastly, a conduction of a multicenter prospective study in regional hospitals will enable a more comprehensive understanding of head trauma at this level of care.

Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Health Sciences, 1987.

Thesis (M.Med.Sc.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 44-48)

Thesis (PhD (Psychology) ) -- University of Limpopo (Medunsa Campus) , 2010. / The aim of the study was to investigate the effect of Cumulative Mild Head Injury (CMHI) or concussion and Post-Concussive symptomatology of football players. For this purpose, a non-equivalent quasi experimental design of fifteen (15) professional football players and non-contact control group of fifteen (15) university volleyball players were assessed on 4 reaction time tasks and Post-Concussion Symptom questionnaire. The main findings of the study showed no significant difference on cognitive changes among football players and the control group. However, the two sample t-test, ANOVA and ANCOVA analysis in respect of both football players and the volleyball control group, provided significant results of a probability of CMHI or concussion on the CALCAP’s Sequential 1 Reaction Time Test. The study makes important theoretical and practical contributions to the understanding of Post-Concussion syndrome. The study suggests that some of the Post-Concussion symptoms persist after an initial concussion

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

No description available.

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

No description available.

No description available.

ABSTRACT Trauma in South Africa has been described as a “malignant epidemic” (Muckart DJ, 1991)5. Trauma is most acute in Sub-Saharan Africa, where deaths from trauma is higher than in any other region of the world where the risk of death from injury is greatest, especially for men aged 15-29 years (Murray CJL, in Bowley etal, 2002)5.The recognition of concurrent life threatening injuries is critical, given that patients with facial fractures seldom die in the absence of airway problems, massive bleeding, aspiration of blood into the lungs and massive head injury30. There are several reports in the literature regarding multisystem trauma and facial fractures. Head injuries are commonly associated with facial fractures, and facial fractures can be markers for brain injury16 .This study is aimed to identify the prevalence of head injuries associated with maxillofacial trauma in the Johannesburg General Hospital, Gauteng, South Africa. The data was collected from 1st January 2003 to 30th June 2003. A total of 196 patients with maxillofacial injuries were treated and 176 were included in the study. The data was analyzed using SASTM for WindowsTM. From the results it was found that of the 176 patients the majority were males comprising 88.07% of the study. Based on the GCS scores alone it was shown that 38.06% patients suffered head injuries. After reviewing patient records, it was found that of the whole sample only 31.25% of patients suffered true head injuries based on CT scan and neurosurgery findings. It was also shown that the most frequent mechanism of injury with headinjuries was gunshot wounds at 52.72% and the most common maxillofacial injury associated with head injury was panfacial fractures at 23.63%. In this study we also reviewed the outcome of the patients based on mortality rates. A total of 24 patients (13.63%) died from associated injuries. Of these patients 2 (1.13%) died from associated injuries due to polytrauma and 22 (12.5%) died due to severe head injury. We found that severe maxillofacial injuries involving the midfacial region such as panfacial fractures, zygomatic complex fractures and Le Fort fractures are frequently seen in patients with significant head injury. This should alert trauma unit personnel during assessment of patients to the fact that if a patient presents with significant midfacial trauma, one might expect that an underlying head injury is present. It is important to make note, that of the associated injuries present with maxillofacial trauma, involvement of the central nervous system including concussion, is the most frequent.