Traumatic brain injury in young adults: a series of cases and analysis of their prognosis

Abstract

Introduction: traumatic brain injury (TBI) and associated traumatic injuries continue to stand out as one of the main causes of morbidity and mortality. Pre-hospital management, as well as the time of arrival and admission to the emergency area, the period to enter the operating room, postoperative management and in the intensive care unit are vital. Objectives: the general objective is to present a series of 3 clinical cases of young patients with head trauma who suffered motorcycle accidents on the coast of Ecuador and who were treated in Guayaquil, to emphasize the prevention of complications, in addition to describing the diagnosis. and neurocritical treatment performed. Materials and methods: clinical cases are presented; authorization is obtained from the teaching and research department for access and review of medical records and images. Clinical cases: all the cases corresponded to young, male patients who presented a motorcycle traffic accident without a helmet, the first case presented diffuse axonal injury, and required several months in the intensive care unit, the second case was a patient with a fracture. sunken right parietal artery, which was diagnosed and treated opportunely receiving surgical treatment with good results, the third case presented epidural hematoma, which underwent a hemispheric decompressive craniectomy on the right side and drainage of the epidural hematoma, obtaining satisfactory results. Discussion: in this population, a lack of safety measures was observed, such as the use of a helmet, which resulted in patients presenting: diffuse axonal injury, fractures with collapse, and bruises. Nuclear magnetic resonance and computerized axial tomography of the brain were important in the evaluation of the lesions, since they allowed making a timely decision and choosing the type of treatment, as well as knowing the prognosis in each case. Conclusions: Head trauma is an emergency that requires immediate resolution, it is a growing problem and the main cause of mortality and morbidity in young adults, with a high burden on health care, causing disability in previously healthy patients, the hospital transfer system and time influence its prognosis, interrelated with diagnosis and timely treatment. The cases presented were promptly resolved with a good response. The patient who presented diffuse axonal injury had severe neurological sequelae. It is important to highlight that the three cases presented were due to a motorbike traffic accident, without the use of a helmet, a situation that must be prevented.