SERIOUS BRAIN INJURY FROM TRAFFIC-RELATED CAUSES - PRIORITIES FOR PRIMARY PREVENTION

This study evaluated the incidence and outcome of serious brain injury from traffic-related causes in 695 patients admitted to the Departmen t of Neurosurgery at Karolinska Hospital during 1981-1992. A total of 37.3% of patients were car occupants, 28.1% pedestrians, 12.9% bicycli sts, 12.2% car-bicycle/car-moped and 9.5% motorcycle riders. The domin ating injury was brain contusion (61.6%) verified with computerized to mography. The level of consciousness was evaluated by the Glasgow Coma Scale (GCS) and outcome by the Glasgow Outcome Scale (GOS) at dischar ge and 6-36 months thereafter. The final outcome was 67.5% good recove ry (GOS 4-5), 11.5% severely disabled (GOS 2-3) and 21.0% GOS 1 or bra in dead. Patients with GOS <4 (32.5%) were severely disabled and motiv ate priorities for injury prevention. Car occupants represent 40.7% of the total, followed by pedestrians at 33.6% and bicyclists at 18.2%. Much remains to be done in the primary prevention of disabling brain i njury to car occupants and pedestrians. In order to achieve a more-eff ective primary prevention, future research should be directed toward b iomechanical aspects of brain contusion as a dominating brain injury. (C) 1997 Elsevier Science Ltd.