According to the
World Health Organization (WHO), Traumatic Brain Injury (TBI) is one of
the 21st century epidemics similar to malaria and HIV/AIDS; and it is
not only restricted to the developed world1.
In Palestine, since the outbreak of Al-Aqsa Intifada in 2000, there has
been an increase in the number of assaults by bullet injuries used by
Israeli soldiers.
Morbidity and mortality reports showed that high numbers of injuries
were in the head; consequently, the Traumatic Brain Injuries (TBIs) are
considered a major public health problem in Palestine. Objectives of the
study The main aim of the study was to determine the major causes of
TBI in patients admitted to Rafidia, Al-Ittihad, and the Specialized
Arab hospitals between 2006- 2007.
Subjects and Methods The study was carried out retrospectively by
reviewing the medical records of TBI patients admitted to the three
targeted hospitals in Nablus in 2006 and 2007.
Gathering data for 312 TBI patients from their medical records by
filling of case survey sheet for each patient. Glasgow Coma Scale (GCS)
was used to assess the level of severity of TBI. Results The study
showed that the major causes of TBI were assaults (33%), followed by
falls (32.1%), road traffic accidents (29.8%), and hits by heavy objects
(3.2%). Falls and hits by heavy objects were more common among children
aged less than 5 years old, while assaults and road traffic accidents
were more common among age group 19-29 years.
Males were found to be more exposed to the causes of TBI than females.
The study also showed that about 29.2% of the study population had
sustained functional disability, and 6.7% had been fatally injured as
outcome following TBI at hospital discharge.
Among the admitted patients with head injuries, 66.7% had died due to
assaults, 19% due to road traffic accidents, 9.5% due to falls, and 4.8%
due to hits by heavy objects.
Conclusion Assaults are the major leading cause of TBI. Majority of
them, assaults were caused by bullets and head blows of Israeli forces.
Assaults were associated with more severe injuries compared to the
others. Morbidity and mortality are very high among assaults victims.