Citation

Peeters S, Blaine C, Vycheth I, Nang S, Vuthy D, Park KB. World Neurosurg. 2016; 97: 580-589.

Affiliation

Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia; Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA.

Copyright

(Copyright © 2016, Elsevier Publishing)

DOI

10.1016/j.wneu.2016.09.127

PMID

27773857

Abstract

BACKGROUND: Traumatic brain injury (TBI) is a critical public health problem worldwide with a significant socioeconomic burden. While improved safety regulations in high-income countries have resulted in a decline in traffic-related TBI, the incidence of TBI in low-income countries is on the rise. We illustrate the trends and factors involved in TBI in a large Cambodian governmental hospital in Phnom Penh. Additionally, suggestions for improvement of the country's road traffic safety are discussed.

METHODS: This is a cross-sectional study of all patients who presented with traumatic brain injury to Department of Neurosurgery at Preah Kossamak Hospital in Phnom Penh, Cambodia between November 2013 and March 2016.

RESULTS: Traumatic brain injuries in Cambodia are on the rise. 34% occur during rush hour, 5 to 9pm, and 40% during the weekend. The vast majority (74%) is due to road traffic accidents, of which 81% are motorcycle related. Helmet wear remains low at 13% and recent alcohol use was reported as 38%. The most common diagnosis is skull fracture. The subdural to epidural hematoma ratio was 1:1.05. Lastly, in both subdural and epidural hematomas the frontal lobe was most commonly involved, with 60% of epidural hematomas associated with a lucid interval.

CONCLUSIONS: Our study suggests prevention and management of TBIs can have a measurable public health impact in Cambodia. Initiative examples include helmet safety awareness campaigns, stricter penalties, improvement of pre-hospital care, and more efficient triage. High proportion of un-helmeted motorcycle accidents correlates with a rise in epidural hematomas.

Copyright © 2016 Elsevier Inc. All rights reserved.

Language: en