Objectives: Head injury is a devastating condition in developing countries like South Africa, contributing significantly to mortality and morbidity. The various factors affecting outcome like age, gender, mechanism of injury, clinical, radiological findings and treatment is reported. Their relation to outcome (Glasgow Outcome Score) of treatment in Chris Hani Baragwanath Academic hospital is analyzed. Methods: This is a retrospective, descriptive and demographic profile study. The sample group consists of moderate to severe head injury patients admitted in the neurosurgical unit of Chris Hani Baragwanath Academic hospital from January 2011 to June 2012. The data includes age, gender, nature of head injury (scalp, skull, intracranial), mode of injury (fall from height, road traffic accident, fire arm injury, assault, blast injury), condition at presentation [Glasgow Coma Scale (GCS)], pupillary reaction, Computed Tomography (CT) scan findings, treatment received and outcome [Glasgow Outcome Score (GOS)] of treatment. Results: A total of 292 patients was enrolled in the study, 258 males (88.3%) and 34 females (11.6%). In the age distribution 50 patients were below 19 years, 161 patients were between 20 to 39 years, 60 patients 40 to 59 years and 21 patients above 60 years. The various mechanisms of injury noted were assault in 127 patients, pedestrian vehicular accident in 50 patients, motor vehicular accident in 33 patients, motor bike accidents in 4 patients, train accidents in 2 patients, gunshot injury in 6 patients, fall from height in 35 patients and struck by heavy object in 5 patients.123 patients had a GCS between 3-5, 72 patients GCS between 6-8 and 97 patients GCS 8-12. 192 patients had equal and reacting pupils after the head injury, 52 patients unilateral fixed pupils and 10 patients bilateral fixed pupils. The Computed tomography (CT) of the brain showed 287 patients with focal intracranial findings, 107 with diffuse brain injury and 168 patients with features of raised intracranial pressure. 129 patients (44.1%) were surgically treated and 163 patients (55.8%) treated conservatively with medical treatment. The variables age, mechanism of injury, GCS, pupillary reaction, raised intracranial pressure and type of management was compared to GOS and found to be statistically significant. Conclusions: The outcome of patients with moderate to severe head injury has no effect on gender but has a significant relationship between age and mortality. The mechanism of head injury has a direct effect on the prognosis with gunshot head having the worst outcome. The important prognostic factors affecting the outcome include: age of patients, severity of head injury (GCS), pupillary reactivity to light and the pathology of the brain CT scan. The unfavorable prognostic factors are: old age, non-reacting pupils to light, severe head injury (low GCS) and raised ICP after head injury. Medical or surgical management have similar mortality rate. / Submitted in fulfillment for the requirements of the degree of Master of Medicine in Neurosurgery Faculty of Health Science University of Witwatersrand

This thesis is submitted in partial fulfillment of the requirements for the degree of Master of Science in Emergency Medicine( Msc Med EM), Division of Emergency Medicine, University of Witwatersrand , Faculty of Health Sciences , School of Clinical Medicine, Department of Family Medicine, 2012 / 1. BACKGROUND AND SETTING The study was conducted at Vryheid district hospital in the Kwazulu- Natal province. The increasing number of traumatic brain injuries seen at the hospital has prompted me to describe traumatic brain injuries in the community. Data was collected from the records of casualty department and the hospital wards. 2. AIM This thesis describes traumatic brain injuries at Vryheid district hospital during 2009. 3. METHODS It is a retrospective cohort study with a total sample size of 596 participants; retrieved from patients’ registers at the hospital’s casualty department and hospital wards. 4. RESULTS - The peak age of occurrence of traumatic brain injuries (TBI) at Vryheid is between 20 and 30 years with 75% of injuries happening in younger than 35 years and a mean age of 29 years. - 78% of traumatic brain injuries occurred in female patients but it is important to note that females are in greater number than males at Abaqulusi municipality. - Blacks are the most affected by the traumatic brain injuries at Vryheid: 97% versus 2.4% in white and 0.3 in Asians. - Blunt traumatic brain injuries are the most common type of TBI at Vryheid: 97%. - Assault injuries constitute the major cause of traumatic brain injuries ( 57 %) followed by motor vehicle accidents (40%) - Mild traumatic brain injuries represent 75% of traumatic brain injuries presenting at Vryheid during 2009. - The majority of TBI patients at Vryheid were discharged either from casualty department or from the wards and only as small number of patients died or was transferred out. Moreover, 60% of patients were treated as ambulatory patients. - 94% of TBI at Vryheid hospital had a good prognosis and only a small percentage was associated with bad prognosis. - The mean hospital length stay at Vryheid was 2.2 days with a minimum of less than a day (62%) and a maximum of 129 days. 5. CONCLUSION In 2009, traumatic brain injuries were found to be common at Vryheid hospital in the black population and were mainly due to assault injuries and motor vehicle accidents. Moreover, motor vehicle accidents were associated with high mortality. Although, the majority of traumatic brain injuries at Vryheid hospital were mild, 10% were severe. Thus, TBI at Vryheid constitutes a public health concern that needs to be addressed by the SA government in consultation and collaboration with various stakeholders.

Thesis (doctoral)--København, 1980.

Diss. (sammanfattning) Stockholm : Karol. inst., 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 4 uppsatser.

Thesis (M.Sc.)--Memorial University of Newfoundland, 2002. / Bibliography: leaves113-128.

Thesis (M.Sc. (Physiology))--Mahidol University, 1982.

Thesis (doctoral)--Rijksuniversiteit te Groningen.

Considerable interest has been expressed regarding the issue of recovery of language following head injury in childhood. The two questions most frequently addressed are: 1) Do children recover linguistic abilities faster and better than adults after suffering a head Injury? 2) Is the linguistic disorder, if evident, mainly syntactic or lexical in nature? We have examined 8 children from 6;10-17; 0 who suffered traumatic head injury and who are in varying stages of recovery. Each child has been matched with a normal child of the same age. Despite reports of complete recovery from childhood aphasia, our results indicate persistent word finding problems, with otherwise normal language abilities. There was no correlation between severity of deficit and age at injury or length of coma. / Medicine, Faculty of / Audiology and Speech Sciences, School of / Graduate

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.