Mild traumatic brain injury at a single neurosurgical center in South africa

Background: For several decades mild traumatic brain injury (mTBI) has been increasingly recognized as a distinct clinical entity with its own specific diagnostic criteria and risk of persistent sequelae. Methods: We conducted a retrospective chart review of 228 patients referred to the neurosurgical department at our institution, over a 3-year period, with mTBI. Data collected and analyzed in this study included subject age, gender, mechanism of injury, presenting symptoms, presenting Glasgow Coma Score, presenting CT brain findings, symptoms in subjects who followed-up 1-month post discharge, and symptoms in subjects who followed-up between 1 and 3 months post discharge. Results: Regarding age 108/228 (47%) subjects were 19 to 35-years old, 61/228 (27%) subjects were above 35-years, 46/228 (20%) subjects were 1 to 12-years old, and 13/228 (6%) subjects were 12 to 18-years old. In terms of gender 186/228 (82%) subjects were male and 42/228 (18%) subjects were female. Considering the most common mechanisms of injury 141/228 (62%) subjects reported having been assaulted, 66/228 (29%) subjects reported a fall, and 18/228 (8%) subjects had been involved in a motor vehicle accident. In terms of presentation, 67/228 (29%) subjects reported a history of loss of consciousness, and 62/228 (27%) subjects reported a headache, which were the most common presentations. Considering outcome, at the 1-month post injury out-patient neurosurgical appointment only 100/228 (44%) subjects attended and 128/228 (56%) absconded. Conclusion: Our study supports a loss of consciousness and headache as the most common presentations in mTBI. Our further study finding was that in our environment the majority of patients do not attend their scheduled 1-month out-patient follow-up appointment.