SYNOPSIS

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE

Topic

“PATTERN OF HEAD INJURIES AND ITS OUTCOME AT TERTIARY HEALTH

CENTER”

By
Dr. PAVAN
Department of General Surgery
Gulbarga Institute of Medical Sciences
Kalaburagi

Under guidance of

Dr. SANGAMESH B.T

MS (General Surgery)
Department of General Surgery
Gulbarga Institute of Medical Sciences
Kalaburagi

DEPARTMENT OF GENERAL SURGERY

GULBARGA INSTITUTE OF MEDICAL SCIENCES
KALABURAGI-585105

2025
From, Date :-
Dr. Pavan
1st Year Post Graduate,
Department of General Surgery,
Gulbarga Institute of Medical Sciences,
Kalaburagi- 585105

To,
The Co-ordinator,
Ethical Committee,
Gulbarga Institute of Medical Sciences,
Kalaburagi-585105

Subject :Request for Ethical clearance for the study to be undertaken for dissertation

Respected Sir/Madam,

With reference to the above subject,I am hereby submit the synopsis of study titled- “PATTERN
OF HEAD INJURIES AND IT'S OUTCOME AT TERTIARY HEALTH CENTER”. To be
conducted at Trauma care center ,Gulbarga institute of Medical sciences,Kalaburagi.

I kindly request the approval of the Institutional Ethical Committee to conduct this study as a
part of dissertation.

Thanking you.

Yours Sincerely,

Dr. Pavan
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE, KARNATAKA
BANGALORE

ANNEXURE-II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 Name of the candidate : Dr. PAVAN

(in block letters)

Address : FIRST YEAR POST GRADUATE,

DEPARTMENT OF GENERAL SURGERY

GULBARGA INSTITUTE OF MEDICAL

SCIENCES,KALABURGI-585105

2 Name of the Institution : GULBARGA INSTITUTE OF MEDICAL

SCIENCES, KALABURAGI-585105

3 Course of study and Subject : MS GENERAL SURGERY

4 Date of admission to the Course : 26.12.2024

5 Title of Topic : “PATTERN OF HEAD INJURIES AND

IT’S OUTCOME AT TERTIARY HEALTH
CENTER”
6. Brief Resume of Intended Work:

6.1 Need for the study:

Traumatic brain injuries are a leading cause of death and disability in India,
especially among young adults. Understanding their patterns can help reduce
mortality and long-term disability.1 With evolving transportation system,
urbanization, and lifestyles the mechanism and demographics of head injuries
are shifting necessitating updated original data.2

RTAs remain the most common cause of head injuries in India and globally,
identifying specific patterns can guide targeted preventive measures and public
health policies.3 Pattern of head injuries often shows seasonal variations (e.g.
increased RTAs during monsoons) which is under reported in Indian literature
and important to healthcare planning.4

There is paucity of Descriptive data on the types, Severity, and outcomes of

head injuries managed at tertiary centers in semiurban and urban regions like
Gulbarga. Males in the age group of 20-40years are disproportionately affected,
evaluating trends aids in demographic specific intervention.

Many patients belong to socioeconomically disadvantaged group, influencing

access to care and outcomes an area requiring focused research and intervention.
Quantifying the percentage of head injury patients needing ICU admissions or
neurosurgical intervention helps optimize resource allocation in trauma
centers. variations in the use of diagnostic tools and treatment protocols exist.
studying current practices can help establish standardized guidelines.4

This study aims at understanding different pattern of head injuries and

diagnostic modalities at our institution.

6.2 Review of Literature

Naz Karim conducted retrospective cohort study at university teaching hospital

of Kigali to investigate demographics, mechanism and degree of acute medical
intervention amongst prehospital patients with head injuries, of 2,426 patients
 1,669 were found to have traumatic brain injuries. Data from 945 prehospital
patients were accrued with 534 of these patients diagnosed with head injury.
The median age was 30 (80%) of them male, motor vehicle collision accounted
for 78% of all head injuries, emergency intervention includes intubation (6.7%),
IV fluids (2.7%) Oxygen administration (4.9%). A total 184 patients were
admitted with 13% of them requiring craniotomies. 6

Eric k Kim and Deepak sure conducted cohort study on Pattern of head and neck
injuries at four public hospitals in Mumbai,Delhi,Kolkata. Out of 171(80.7%)
were males and adults 18 to 55yrs (60.2%), falls (36.8%), RTA (36.3%), were
the predominant mechanism of injuries. 37.7% Required intensive care unit
admission, 11.7% died, more than 20% of the patients were diagnosed with
unspecified injury of neck. Those with diagnosis had a higher mortality rate and
ICU admissions rate than those without the diagnosis.7

Nishanth goyal conducted study at AIIMS Rishikesh Uttarakhand on locked up

inside -Head injury patterns during corona virus disease 2019 pandemic. The
number of admissions was 2.7%/week while it was 6.8%/week during the
unlock period. RTA was the mode of injury in 29.6% patients during lockdown
while during the unlock period it was 56.9% mild and moderate head injuries
decreased by 41% and severe head injuries increased by 156.25% during
COVID 19 pandemic. The mortality among neurotrauma patients increased
from 12.4% to 22.5% during era.8

Sun Hyu conducted study on characteristics of fall related head injury v/s non
head injury in the older adults. The study aimed to examine the characteristics of
older adults who suffered a head injury after a ground level fall in comparison to
non-head injury patients as well as the factors associated with Severity in those
with head injury. The study gives conclusion of male sex with advanced age,
indoor fall, and the presence of obstacles on the floor were risk factors for
severe injury in the head injury group in older adult’s individuals who suffered a
ground level fall.9

6.3 OBJECTIVES OF THE STUDY

1. To know most common age group and gender.

 2. To evaluate common cause of head injury.

3. Use of GCS score for assessment of head injuries.

4. To describe the different modalities of treatment and follow up in head injury

cases.

7 MATERIALS AND METHODS

7.1 SOURCE OF DATA

All patients attending Trauma care center(OPD and IPD) at casuality with head
injury.

7.2 METHOD OF COLLECTION OF DATA

A..Study Design : A Hospital based Descriptive cross-sectional study.

B.Study Period: June 2025 to November 2026.

C.Place of study: Trauma care center ,Gulbarga institute of medical sciences.

D.Sample size:

E. INCLUSION CRITERIA :

 Patients Presenting with head injuries at Trauma care center.

 Patients with above aged above 18 years and below 60 years.

F. EXCLUSION CRITERIA :

1. Pregnant and lactating women

2. Patients below 18 years of age

3.Patients aged 60 years and above.

4. Patients unwilling to participate in the study.

G. METHODOLOGY:

 After obtaining approval and clearance from the institutional ethics

 committee, the patients fulfilling the inclusion crieteria will be enrolled for
the study after obtaining informed consent.
 Consent to be taken from the patient and attenders for inclusion into the
study..
 Scoring to be done with respect to signs and symptoms and using GCS
scoring system.
 Diagnosis is confirmed by imaging studies.

F. STATISTICAL ANALYSIS :

Appropriate Statistical test applied.

Does the study require any investigations to be conducted on patients ( if so,

please describe briefly ) :

 NCCT Brain
 HIV
7.3  HBsAg

7.4 Has ethical clearance been obtained from ethical committee of your
institution in case needed?

Awaited Ethical Clearance

8. REFERENCES
1) Dewan MC, Rattani A, Gupta S, Baticulon RE, Hung YC, Punchak
M, Agrawal A, Adeleye AO, Shrime MG, Rubiano AM, Rosenfeld
JV. Estimating the global incidence of traumatic brain injury.
Journal of neurosurgery. 2018 Apr 27;130(4):1080-97.
2) Majdan M, Plancikova D, Brazinova A, Rusnak M, Nieboer D,
Feigin V, Maas A. Epidemiology of traumatic brain injuries in
Europe: a cross-sectional analysis. The Lancet Public Health. 2016
Dec 1;1(2):e76-83.
3) World Health Organization. International statistical classification of
diseases and related health problems: 10th revision (ICD-10).
Volume 1: Tabular List. Geneva: WHO; 2016. p. 1047–52.
4) LeBlanc J, Seresova A, Laberge‐Poirier A, Tabet S, Alturki AY, Feyz M, De
 Guise E. Cognitive‐communication performance following mild traumatic
brain injury: Influence of sex, age, education, site of lesion and
bilingualism. International Journal of Language & Communication

Disorders. 2021 Jan;56(1):130-44..

5) Khan KA, Choudhary M, Sinha VD, Gora N, Bairwa M. Predictors of

outcome after traumatic brain injuries: experience of a tertiary health care
institution in Northwest India. World neurosurgery. 2019 Jun 1;126:e699-
705.
6) Karim N, Mumporeze L And at all. Epidemiology of patients with
head injury at a tertiary hospital in Rwanda. Western journal of
emergency medicine. 2021 Nov 5;22(6):1374.
7) Kim SH, Kim S, Cho GC, Lee JH, Park EJ, Lee DH. Characteristics
of fall‐related head injury versus non‐head injury in the older adults.
BMC geriatrics. 2021 Dec;21:1-1.
8) Goyal N, Swain SK, Gupta K, Chaturvedi J, Arora RK, Sharma SK.
“Locked up inside home”–Head injury patterns during coronavirus
disease of 2019 pandemic. Surgical neurology international. 2020
Nov 18;11:395.
9) Kim EK, Suri D, Mahajan A, Bhandarkar P, Khajanchi M, Gadgil A,
Ranganathan K, Gerdin Warnberg M, Roy N, Raykar NP. Patterns of
head and neck injuries in urban India: A multicenter study. OTO
open. 2022 Oct;6(4):2473974X221128217.
10) Teasdale G, Jennett B. Assessment of coma and impaired
consciousness: a practical scale. The lancet. 1974 Jul
13;304(7872):81-4
9. Signature of Candidate

10. Remarks of guide

11 11.1 Name and Designation DR. SANGAMESH B.T

of the Guide (in block MS (GENERAL SURGERY)
letters) ASSISTANT PROFESSOR
DEPT OF GENERAL SURGERY
GULBARGA INSTITUTE OF MEDICAL
SCIENCES KALABURAGI -585101

11.2 Signature

Co-Guide ( if any) DR.SHAKIH MAHMOOD ALI

11.3 Head of the Department DR. SHIVAKUMAR C.R

MS (GENERAL SURGERY), FAMS,FAIS
HEAD OF THE DEPARTMENT
DEPT OF GENERAL SURGERY
GULBARGA INSTITUTE OF MEDICAL
SCIENCES KALABURAGI -585101
11.4 Signature

12 12.1 Remarks of Chairman

and Principal

12.2 Signature
 Annexure 2

ರೋಗಿಗೆ ಮಾಹಿತಿ ನೀಡಿದ ಸಮ್ಮತಿ ನಮೂನೆ

ದಿನಾಂಕ:
ಸ್ಥಳ:

ನಾನು, ಶ್ರೀ/MRS ಮಗಳು/ಹೆಂಡತಿ

ಶ್ಶ್ರೀಮತಿ ……………………………………………………ಶಸ್ತ್ರಚಿಕಿತ್ಸೆಗೆ
ಒಳಗಾಗುತ್ತಿರುವ ರೋಗಿಗಳಿಗೆ ಮಾರ್ಗದರ್ಶಿ ಅನ್ನು ಅಭ್ಯರ್ಥಿ ಡಾ. ಪಾಟೀಲ್ ಎ ಬಿ,
ಅರಿವಳಿಕೆ ವಿಭಾಗದ ಸ್ನಾತಕೋತ್ತರ ಪದವಿ, ಡಾ. ಜಗದೀಶ್ ಎಂ ಬಿ ಅವರ
ಮಾರ್ಗದರ್ಶನದಲ್ಲಿ, ಪ್ರೊಫೆಸರ್ ಮತ್ತು ಮುಖ್ಯಗುರುಗಳು, ಅರವಳಿಕೆ ವಿಭಾಗ,
ಗುಲ್ಬರ್ಗ ವೈದ್ಯಕೀಯ ವಿಜ್ಞಾನಗಳ ಸಂಸ್ಥೆ, ಕಲಬುರಗಿ, ಈ ಅಧ್ಯಯನದ ಸಮಯದಲ್ಲಿ
ಮಾಡಲಾಗುವ ಕಾರ್ಯವಿಧಾನಗಳು ಮತ್ತು ತನಿಖೆಗಳ ಬಗ್ಗೆ ನನಗೆ ವಿವರಿಸಲಾಗಿದೆ. ಈ
ಅಧ್ಯಯನದ ತನಿಖಾಧಿಕಾರಿಗಳೊಂದಿಗೆ ಪ್ರಕರಣದ ದಾಖಲೆಗಳಲ್ಲಿನ ವೈದ್ಯಕೀಯ ಮಾಹಿತಿ
ಮತ್ತು ವಿವರಗಳನ್ನು ಹಂಚಿಕೊಳ್ಳಲು ನನಗೆ ಯಾವುದೇ ವಿರೋಧವಿಲ್ಲ. ಅಧ್ಯಯನದಲ್ಲಿ
ರಚಿಸಲಾದ ಡೇಟಾವನ್ನು ಪ್ರಕಟಣೆ/ಪ್ರಬಂಧ ಉದ್ದೇಶಗಳಿಗಾಗಿ ಬಳಸಬಹುದು ಮತ್ತು ನನ್ನ
ವೈಯಕ್ತಿಕ ಗುರುತನ್ನು ಬಹಿರಂಗಪಡಿಸಲಾಗುವುದಿಲ್ಲ ಎಂದು ನನಗೆ ತಿಳಿದಿದೆ.
ಈ ಅಧ್ಯಯನದಲ್ಲಿ ಭಾಗವಹಿಸಲು ನನಗೆ ಯಾವುದೇ ಹಣಕಾಸಿನ ಪ್ರೋತ್ಸಾಹವನ್ನು
ನೀಡಲಾಗಿಲ್ಲ ಅಥವಾ ನಾನು ಅಧ್ಯಯನದಿಂದ ಯಾವುದೇ ಹಣಕಾಸಿನ ಪ್ರಯೋಜನಗಳನ್ನು
ಪಡೆಯುವುದಿಲ್ಲ ಎಂದು ನಾನು ದೃಢೀಕರಿಸುತ್ತೇನೆ.
ಈ ಅಧ್ಯಯನದಲ್ಲಿ ನನ್ನ ಮಗ/ಮಗಳು/ಹೆಂಡತಿಯ ಭಾಗವಹಿಸುವಿಕೆಯು ಸಂಪೂರ್ಣವಾಗಿ
ಸ್ವಯಂಪ್ರೇರಿತವಾಗಿದೆ ಮತ್ತು ನಿರ್ದಿಷ್ಟ ಅವಧಿಗೆ ಅಧ್ಯಯನದಲ್ಲಿ ಭಾಗವಹಿಸುವ
ಬಗ್ಗೆ ಉದ್ದೇಶಪೂರ್ವಕವಾಗಿ ಒಪ್ಪಿಗೆಯನ್ನು ನೀಡುತ್ತೇನೆ ಎಂದು ನಾನು
ಅರ್ಥಮಾಡಿಕೊಂಡಿದ್ದೇನೆ.

ಭಾಗವಹಿಸುವವರ ಹೆಸರು: ತನಿಖಾಧಿಕಾರಿಯ ಸಹಿ:

ರೋಗಿಯ ಸಹಿ / ಹೆಬ್ಬೆರಳಿನ ಅನಿಸಿಕೆ:

ರೋಗಿಯ ಅಟೆಂಡೆಂಟ್/ಸಾಕ್ಷಿಯ ಹೆಸರು:

ಸಹಿ/ಹೆಬ್ಬೆರಳಿನ
 INFORMED CONSENT FORM

Date:

Place:

I, Mr./Mrs. ,son/ daughter/wife of Mr.

/Mrs.
, aged years, have been
explained in my own understandable language about the study entitled:
“PATTERN OF HEAD INJURIES AND IT’S OUTCOME AT TERTIARY HEALTH
CENTER” carried out by Dr. Pavan, Post Graduate, Department of General
Surgery, under the guidance of Dr. Sangamesh BT, Assistant Professor,
Department of General Surgery, Gulbarga Institute of Medical Sciences,
Kalaburagi.
I have been informed about the procedures, investigations, and treatment
plans that will be followed during the course of this study. I have no
objection to sharing my medical records and case-related information with
the investigator for research purposes. I understand that the data
collected during this study may be used for publication and dissertation
purposes, and I am assured that my personal identity will remain
confidential. I confirm that I have not been offered any monetary benefit
for participating in this study and understand that I will not receive any
financial compensation for my participation.
I also understand that my participation in this study is completely
voluntary, and I am free to withdraw from the study at any time without
affecting my ongoing medical care.
By signing this form, I provide my free and informed consent to take part
in the above- mentioned study.

Participant’s Name: Signature/Thumb Impression

of Patient: Signature of Investigator:

Patient Attendant/Witness’s Name: Signature/Thumb Impression of
Attendant/Witness
 PROFORMA FOR DATA COLLECTION
1.PATIENT IDENTIFICATION

A.Name:

B.Age:

C.Sex:

D.IP/OP NO.:

E.Date of admission:

F.Date of discharge/Death:

G.Address:

H.Contact No.:

2.MODE OF CIRCUMTANCES OF INJURY

A.Date and Time of injury:

B.Place of injury:

a.Road

b.Home

c.Work place

d.Other place

C.Mode of injury:

Road Traffic Accident

Fall From Height

13
 Assault

Fall on Level Ground

Sports Injury

Others

USE OF HELMET

Yes

No

ALCOHOL INFLUENCCE AT THE TIME OF INJURY

Yes

No

Not known

3.CLINICAL PRESENTATION

a.Time from injury to hospital arrival: hrs

b.Loss of Conciousness:

Yes:

No:

c.Vomiting:

Yes:

No:

14
d.Seizures:

Yes:

No:

f.ENT Bleeding:

Yes:

No:

4.GLASSGOW COMA SCALE AT ADMISSION

Eye opening(E):

Verbal Response(V):

Motor Response(M):

Total score: /15

5.RADIOLOGICAL FINDINGS

Scalp Haematoma

Skull Fractures

Extradural Haematoma (EDH)

Subdural Haematoma (SDH)

Subarachnoid Haemorrhage (SAH)

Intracerebral Haemorrhage (ICH)

Diffuse axonal injury (DAI)

Cerebral Edema

15
 Normal scan

6.MANAGEMENT

CONSERVATIVE

SURGICAL

Craniotomy

Burr Hole Injury

Decompressive Craniectomy

ICU Stay Required

Yes

No

Duration of ICU Stay: days

7.OUTCOME

Recovered without deficit

Recovered with neurological deficit

Referred

Discharge against medical advice

Death

8.INVESTIGATIONS

HIV

HBSAG

CT BRAIN

16
9.DIAGNOSIS:

10.PLAN OF TREATMENT

11.CT BRAIN REPORTS

17