Cerebral contusion: An investigation of etiology, risk factors, related diagnoses, and the surgical management at a major government hospital in Cambodia

Louise Hilmer; Kee Park; Iv Vycheth; Michael Wirsching

doi:10.4103/ajns.AJNS_342_16

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2018; 13(01): 23-30
DOI: 10.4103/ajns.AJNS_342_16

Original Article

Cerebral contusion: An investigation of etiology, risk factors, related diagnoses, and the surgical management at a major government hospital in Cambodia

Louise Hilmer

Department for Global Health, Albert-Ludwigs-University Freiburg, Freiburg

,

Kee Park

¹Department of Global Health, Social Medicine, Harvard Medical School, Boston, Massachusetts

,

Iv Vycheth

²Department of Neurosurgery, Cambodia Neurosurgical Support Project, Preah Kossamak Hospital, University of Health Sciences, Phnom Penh 12157

,

Michael Wirsching

Department for Global Health, Albert-Ludwigs-University Freiburg, Freiburg

› Author Affiliations

Abstract

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Introduction: Cerebral contusions are a common type of injury among the Cambodian population, mostly due to road traffic accidents. This article aims to assess various aspects around brain contusion focusing on the condition at admission, residing province, mechanism and time of injury, age and sex distribution with differing helmet wearing, and alcohol consumption patterns. Hospitalization-related data such as treatment and outcome were analyzed. Methods: This was a retrospective analysis of 406 cases who have been admitted during the period between May 2013 and May 2016. Results: Two hundred and ninety-five (75.51%) of the patients came from rural areas, 312 (76.84%) were male (mean age 31.17 ± 12.90 years for males and 38.5 ± 16.29 years for females). The average hospital stay amounted to 10.51 ± 6.67 days. One hundred and eight two cases (52.29%) happened between 4.00 and 11.00 p.m. Three hundred and nineteen (79%) of the injured patients were motorcycle drivers and 18% pedestrians. Male patients had an alcohol involvement in 135 (49.45%) (females in 5 [6.25%]) cases and 26 (10%) wore a helmet (females in 5 [6.25%]). Surgery was performed in 82 cases, specifically craniotomy and craniectomy +/− elevation of a depressed skull fracture. Two hundred and ninety-six (73.09%) patients showed related second diagnosis, mostly subdural hematoma in 96 (32.43%) and epidural hematoma in 63 (21.28%) cases. Fifty patients (13.16%) had a Glasgow Coma Scale of 3–8. 92 (24.21%) of 9–12 and 238 (62.63%) of 13–15 on admission. Most of the patients were discharged with an improved status 324 (91.52%) according to the Glasgow Outcome Scale 4 or 5. Conclusion: The severity and resulting neurologic impairment of cerebral contusions show the importance of more in-depth research and prevention programs.

Key-words:

Brain contusion - Cambodia - cerebral contusion - global health - motorcycle

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