Computed tomographic findings of insurgency-related traumatic brain injury: experience from a tertiary healthcare center in Northeastern Nigeria

Abstract

Background: Traumatic brain injury (TBI) related to the ‘Boko Haram’ insurgency in northeastern Nigeria has been on the rise in the last decade. Civilian and military personnel suffer from multiple injuries, including TBI, which leads to high morbidity and mortality. Objective: To assess the computed tomography (CT) findings of insurgency-related traumatic brain injury from a tertiary hospital in northeastern Nigeria. Methods: Retrospective cross-sectional study of patients with insurgency-related TBI who were referred for head CT. Patients’ biodata, clinical and imaging findings were retrieved and analyzed. Results: Fifty-six patients with a mean age of 28.3 years (range 2-65 years) were included. The majority (85.7%) were males, and 71.4% were young adults (18-44 years). Blast injuries were the predominant mechanism (n=35, 62.5%), and moderate TBI was the most frequent severity level (n=20, 35.7%). The most commonly affected site was the cerebrum (n=43, 78.6%). CT abnormalities were observed in 47 (83.9%), with the most common finding being skull fractures (n=41, 73.2%) and scalp injury (n=31, 55.4%). The most frequent intracranial hemorrhage was intraparenchymal hemorrhage (n=12, 21.4%). The correlation between injury severity and CT findings was moderately strong (Cramer’s V = 0.408, 0.381, 0.438, χ² = 10.417, 7.575, 10.118, p=<0.05). Conclusion: Blast injury was the predominant mechanism of insurgency-related TBI in our setting, with skull fractures and associated underlying cerebral injuries representing the most frequent CT findings.