Cranial and spinal injuries in motorcycle accidents: A hospital-based study

BACKGROUND: Injuries caused by motorcycle accidents have been reported in several studies with an examination from a general trauma point of view. However, to our knowledge, there is no detailed study specific to central nervous system injuries. This research was focused on central nervous system injuries associated with motorcycle accidents.
METHODS: The medical records of 540 patients who were admitted to the emergency department between 2008 and 2016 as the result of a motorcycle accident were retrospectively evaluated. Data were collected from electronic medical records, follow-up forms, and radiological images. Information on patient age, gender, type and site of injury, helmet use, alcohol level, Glasgow Coma Scale score on admission, length of stay in the intensive care unit and hospital, neurological status on discharge, and follow-up was collected and analyzed.
RESULTS: A total of 486 of 540 patients (90%) were male, 54 (10%) were female, and the mean age was 31±18 years (range: 2–85 years, median: 25 years). Cranial injuries were detected in 320 cases (59%). The distribution of cranial injuries was: epidural hemorrhage (12.6%), subdural hemorrhage (15.2%), depressed fracture (10.4%), linear fracture (23%), skull base fracture (5.5%), diffuse axonal injury (9.3%), subarachnoid hemorrhage (25.2%), intracerebral hemorrhage (13.5%), and contusion (26.3%). Spinal fractures were detected in 52 cases (9.6%). Twenty-two (4.07%) of the spinal fractures were observed in the cervical region, 10 (1.85%) in the thoracic region, and 20 (3.7%) in the lumbar region. The mean length of stay in the hospital was 8.2±4 days and 7 days in the intensive care unit. Sixty-eight patients (12.6%) died. Traumatic cranial entities other than linear fracture were associated with an elevated level of mortality. A Glasgow Coma Scale score of 6 or less was associated with significant mortality (68%).
CONCLUSION: A detailed report of motorcycle accident-associated central nervous system injuries is provided. The use of protective equipment, such as helmets, significantly reduced the rate of cerebral injury and death.

Motosiklet kazalarýnda kafa ve omurga yaralanmalarý: Hastane tabanlý bir çalýþma

AMAÇ: Motosiklet kazalarýna baðlý yaralanmalar, genel travma açýsýndan çeþitli çalýþmalarda incelenmiþtir. Bununla birlikte, merkezi sinir sistemi yaralanmalarýna iliþkin ayrýntýlý bir çalýþma yoktur. Bu çalýþma motosiklet kazalarý ile iliþkili merkezi sinir sistemi yaralanmalarýna odaklanmýþtýr.
GEREÇ VE YÖNTEM: 2008 ile 2016 yýllarý arasýnda motosiklet kazasý nedeniyle acil servise baþvuran 540 hastanýn týbbi kayýtlarý geriye dönük olarak deðerlendirildi. Veriler elektronik týbbi kayýtlardan, takip formlarýndan ve radyolojik görüntülerden elde edildi. Hastalarýn yaþý, cinsiyeti, yaralanma tipi ve yeri, kask kullanýmý, alkol düzeyleri, Glasgow Koma Skorlarý, yoðun bakým ünitesinde kalýþ süreleri, taburcu olurken ve takiplerde nörolojik durumlarý gibi bilgiler toplanmýþtýr.
BULGULAR: Çalýþmaya alýnan 540 olgunun 486’sý (%90) erkek, 54’ü (%10) kadýn, yaþ ortalamasý 31±18 (daðýlým 2–85, medyan 25) idi. Kraniyal yaralanmalar 320 olguda (%59) saptandý. Kraniyal yaralanmalarýn daðýlýmý þöyledir: Epidural kanama (%12.6), subdural hemoraji (%15.2), deprese kýrýk (%10.4), lineer kýrýk (%23), kafa tabaný kýrýðý (%5.5), diffüz aksonal yaralanma (%9.3), subaraknoid kanama (%25.2), intraserebral hemoraji (%13.5), kontüzyon (%26.3). Spinal kýrýklar 52 olguda (%9.6) tespit edildi. Servikal bölgede 22 (%4.07) omurga kýrýðý, torasik bölgede 10 (%1.85) ve lomber bölgede 20 (%3.7) gözlendi. Hastanede kalýþ süresi yoðun bakýmda ortalama 8.2±4 gün, ortalama yedi gündü. Altmýþ sekiz hasta (%12.6) hayatýný kaybetti. Lineer kýrýk hariç diðer tüm kraniyal yaralanmalar yüksek mortalite ile ilþkiliydi. Ayrýca, 6 veya daha düþük Glasgow Koma Skorlarý, önemli mortalite (%68) ile iliþkilendirildi.
TARTIÞMA: Motosiklet kazalarýnýn neden olduðu merkezi sinir sistemi yaralanmalarýnýn ayrýntýlý bir raporu verilmiþtir. Kask gibi koruyucu ekipmanlarýn kullanýlmasý, beyin hasarý ve ölüm oranýný önemli ölçüde azaltýr.