Pattern of Fatal Head Injuries in Ibadan — A 10 Year Review

Abstract

Head injury is an important cause of mortality worldwide. The objective of the present study was to analyse the pattern of fatal head injury among patients seen in University College Hospital, Ibadan. The study was based on retrospective investigation of cases of fatal head injury referred by the coroner to the Department of Pathology, University College Hospital, between 1991 and 2000. Pertinent clinical and postmortem findings were extracted from available coroner's autopsy records. There were 529 cases (402 males and 127 females). Their ages ranged from <1 year to 90 years (mean=33 years), the average age of females (27.8) being less than that of males (34.6) (p=0.00003). 83.8% were road traffic accidents, 8.9% falls from a height, 3.8% assault, and 3% gunshot injuries. 79.1% had a GCS of 8 or less at presentation. The mean survival period of children aged less than 15 years was 2 days while that of adolescents and adults aged 15 years and above was 5.6 days (p=0.02). Subdural (62.4%), subarachnoid (24.6%), epidural (10.2%), and intracerebral (10%) haemorrhages were the major causes of death. Skull fractures occurred in 38.2%, while cerebral contusions occurred in 22.1%. Intracranial infection was relatively uncommon in these patients. The present study has shown that young adults, predominantly males in their most productive years of life, are especially prone to fatal head injury.

A Comprehensive Study of Fatal Head Injuries among Motorcyclists: A One Year Prospective Study.

“…Among the cases studied, majority were males (77.27%) than females (22.72%). Similarly male predominance were observed by various researchers in their studies [2,3,4,5,6]. The peak incidence was observed in the age group of third and fourth decades (61.36%).…”

Pattern of head injury in central India population

“…Similar findings were observed by other researchers [13][14][15][16][17][18] except Akang et and Lai et al who observed that the peak age of such victims was in fourth decade. 19,20 This could be because young adults are the prime bread earners of the family and remain outdoors during most of the day. Furthermore, young people are by nature indulge in more violent activities.…”

Epidemiological pattern and outcome of head injuries during festive and non-festive periods in a tertiary hospital, Nnewi, Nigeria

“…[10][11][12][13] This finding, however, is at a discord with the situation in the US where falls were reported to be the leading etiologic factor. 9 Interpersonal violence accounts for 51% of nonfatal TBI among Africans, as against 10% for whites, while motor vehicle accidents cause 27% of African nonfatal TBI and 63% among whites.…”

“…8 As has been previously reported by other local studies in Nigeria, the very active >20 -30 year group are the most commonly affected, majority being affected by mobilopathy especially motorcycle accidents. [10][11][12][13] This is as opposed to the 15 -19 years old peak incidence age in the US perhaps as a result of the fact that US youths drive cars at an earlier age than Nigerian youths who would usually take up motorcycle driving at this age. 15 Falls are shown to be a greater etiologic factor at the extremes of age and this is in agreement with most other studies.…”