title: Traumatic brain injuries: experience from a tertiary care centre in Pakistan.
abstract: OBJECTIVE
  Traumatic Brain Injury (TBI) is one of the leading causes for morbidity, mortality and economic loss. The impact is much worse in developing countries like Pakistan. The objective of our study was to highlight the etiological pattern and distribution of TBI in Pakistan.
  
  
  METHODS
  From July 2009 to June 2011, 1378 patients presenting to our Accident and Emergency Department with head injury were included in the study. Patients underwent detailed clinical and radiological evaluation as per trauma protocol.
  
  
  RESULTS
  The most commonly affected age group was 21 to 30 years (34.1%) with male to female ratio of 3.3:1. Injuries were predominantly caused by road traffic accident (62.6%), followed by fall (31.7%) and assault (5.5%). Amongst those with RTA less than 1% of the patients were wearing proper safety equipment. The most common CT scan finding was brain contusion (14.1%); others included traumatic sub-arachnoid hemorrhage (7.1%), subdural hematoma (7.6%), extra-dural hematoma (5.8%) and depressed skull fracture (4.6%).
  
  
  CONCLUSIONS
  Motorbike accidents are a major cause of severe traumatic brain injury. Although this can be minimized by wearing proper helmets, its use is limited. Moreover, there is an imperative need to implement proper referral system amongst hospitals citywide in order to minimize the consequences of secondary brain injury.
authors.affiliation: Liaquat National Hospital, Department of Neurosurgery, Karachi, Pakistan.
authors.forename: Muhammad Sohail
authors.initials: MS
authors.lastname: Umerani
authors.forename: Asad
authors.initials: A
authors.lastname: Abbas
authors.forename: Salman
authors.initials: S
authors.lastname: Sharif
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003415:Crime; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010154:Pakistan; D011446:Prospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed; D055815:Young Adult