Head injury awareness

HEAD INJURIES are relatively common in South Africa and have a devastating impact on many people’s lives.

It has been estimated that 89 000 new cases of traumatic brain injuries are reported every year in our country. Speaking on World Head Injury Awareness Day on March 20, Dr Andre Mochan, a neurologist at Netcare Rehabilitation Hospital in Johannesburg, said that given the large number of people in South Africa who are affected by traumatic brain injuries (TBIs), our society should be more aware of the substantial disability it could cause and the distressing impact it has on families. “We need to work together to prevent head injuries as far as possible and, in the event of a person sustaining brain trauma, effectively treat it to ensure the best possible outcome,” he added.

“Traumatic brain injury is one of the leading causes of disability in South Africa. It often results in prolonged or non-reversible brain damage, which can have grave implications for patients and their families. Such head injuries could result in personality changes, physical disability, a state of coma, or even death. Many victims are rendered incapable of looking after themselves and have to be cared for by their families,” points out Dr Mochan.

According to government statistics, the most common cause of head injuries are motor vehicle, bicycle or vehicle-pedestrian accidents, which make up a half of all cases. Falls account for a further 25 per cent and violence for some 20 per cent. Dr Mochan observes that these figures roughly correspond with the breakdown of the causes of serious brain injury in patients who are admitted for rehabilitation at Netcare Rehabilitation Hospital. “The hospital sees around twice as many men as women for TBIs, which is largely because men tend to engage in more reckless behaviour and participate in more dangerous activities,” he adds.

“Large numbers of people are fighting personal battles to overcome disabilities they have suffered as a result of traumatic head injury. Our role is to assist and support patients and their families and work with acute care hospitals to integrate patients back into their communities as fully as possible. With the correct treatment and rehabilitation, this can be successfully achieved in a large number of TBI patients.” He says that the effects of traumatic head injuries vary greatly and depend upon how much damage was caused to the brain. This can vary from negligible damage to damage that is so severe that it impacts all areas of an individual’s life. Neurological injury can produce physical, emotional, psychological, cognitive and behavioural changes. It can even result in personality changes.

Brain injuries are categorised according to whether the injury is an open (penetrating) or closed trauma and according to the severity of the brain trauma, which could range from a concussion to a more severe contusion. There are also varying types of bleeding or haemorrhage within and around the brain that could cause focal brain damage. Bleeding in the brain may require urgent surgery to prevent intracranial pressure building, which can kill.

“How much an individual could expect to recover from a severe brain injury depends upon how seriously the brain was injured and which areas were affected. There is a period after the injury during which the brain spontaneously tries to repair itself. The focus of the first phase of rehabilitation is on working with this natural recovery process, and then on an individual’s skills and functions,” says Dr Mochan.

What should you do if you suspect someone has suffered a serious head injury? Mande Toubkin, Netcare’s general manager of emergency, trauma, transplant and corporate social investment, advises the public to phone an emergency medical services provider such as Netcare911 (082 911) immediately, as it is essential that rapid and appropriate medical care be given to persons with a suspected brain injury. While waiting for paramedics to arrive, try to keep the person’s head and neck still, as trauma to the head may mean possible spinal injuries.

“Netcare’s emergency departments around the country deal with large numbers of head injury cases each year. As a concerned corporate citizen of South Africa, Netcare believes that the problem of head injuries needs to be addressed urgently. This is one of the reasons why we have put in place the Trauma Injury Prevention (TIP) programme, which primarily aims through educational initiatives to prevent South Africans, and particularly children, youths and the elderly, from experiencing trauma injuries.”

The TIP team advises schoolchildren on the importance of using protective gear such as helmets when engaging in potentially risky activities such as riding bicycles, quad bikes and tricycles or when roller- blading and skateboarding. “We want our children to be well versed in safety from an early age,” Toubkin adds.

Parents are able to attend TIP classes that explore such subjects as burns, house safety, drowning, child abuse and first aid. Aside from helmet safety, younger children learn about the importance of wearing seat belts when travelling in a car, road safety, water safety, animal safety and sports injuries. The programme for teens focuses on the dangers of distracted driving, driving without a seat belt or under the influence of alcohol/drugs, depression and motorbike safety. The initiative for the elderly includes education on falls, the dangers of driving without a seat belt, as well as drinking and driving.

Dr Mochan says that TBIs vary and everyone is affected differently. Each patient, therefore, requires a rehabilitation approach that is unique to his or her particular case. This allows rehabilitation experts to develop strategies that are customised for the individual challenges faced by the patient. “The rehabilitation process starts as soon as the patient is medically stable, and could take months or even years, depending on the severity of the brain injury. The goal of our rehabilitation efforts is to assist each of our patients in returning to a life of maximum possible independence,” says Dr Mochan.

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