2014 年 37 巻 2 号 p. 88-95
Background: The previous data of Japan Neurotrauma Data Bank collecting head injury was almost enrolled in the urban area. However, head injuries also happen in the mountain area. We analyzed the patients in our hospital located in mountain area in Tokushima prefecture, Japan to find the characteristics of the head injury in mountain area.
Methods: From April 2009 to September 2013, 285 patients with head injury were hospitalized and 10 patients with head injury who were already cardio pulmonary arrest on arrival were transported in our hospital. We researched all these patients and examined characteristics of the patients and mechanism of the injury.
Results: There were 190 men and 105 women, and the mean age was 65.7 years. The head injuries were caused by fall (35.6%), followed by tumble (29.2%) and traffic accident (26.8%). The most frequent cause in the falls was mountain slope (23.8%), followed by stairs (20.0%) and cliff (13.3%). The fall-rerated head injuries sometimes included subarachnoid hemorrhage, acute subdural hematoma and brain contusion at once. The most common trauma-related complication about the fall injury was the spinal injury and followed by the lung injury. The most common fatal case of the fall injuries was acute subdural hematoma. Physiological abnormality on arrival, Glasgow Coma Scale score ≦8, diabetes mellitus, dialysis, and anticoagulant or antiplatelet drug were significant factors of the outcome (p<0.05).
Conclusion: In the mountain area of the country, the elderlies frequently got injured with head and the most common cause of the head injury was fall. Especially, the fall from mountain slope and cliff were very dangerous and these injuries could become the high energy injury for the elderly.