Cranial and spinal injuries in motorcycle accidents: A hospital-based study.

BACKGROUND: Injuries caused by motorcycle accidents have been reported in several studies with an examination from a general trauma point of view. However, to our knowledge, there is no detailed study specific to central nervous system injuries. This research was focused on central nervous system injuries associated with motorcycle accidents.

METHODS: The medical records of 540 patients who were admitted to the emergency department between 2008 and 2016 as the result of a motorcycle accident were retrospectively evaluated. Data were collected from electronic medical records, follow-up forms, and radiological images. Information on patient age, gender, type and site of injury, helmet use, alcohol level, Glasgow Coma Scale score on admission, length of stay in the intensive care unit and hospital, neurological status on discharge, and follow-up was collected and analyzed.

RESULTS: A total of 486 of 540 patients (90%) were male, 54 (10%) were female, and the mean age was 31+-18 years (range: 2-85 years, median: 25 years). Cranial injuries were detected in 320 cases (59%). The distribution of cranial injuries was: epidural hemorrhage (12.6%), subdural hemorrhage (15.2%), depressed fracture (10.4%), linear fracture (23%), skull base fracture (5.5%), diffuse axonal injury (9.3%), subarachnoid hemorrhage (25.2%), intracerebral hemorrhage (13.5%), and contusion (26.3%). Spinal fractures were detected in 52 cases (9.6%). Twenty-two (4.07%) of the spinal fractures were observed in the cervical region, 10 (1.85%) in the thoracic region, and 20 (3.7%) in the lumbar region. The mean length of stay in the hospital was 8.2+-4 days and 7 days in the intensive care unit. Sixty-eight patients (12.6%) died. Traumatic cranial entities other than linear fracture were associated with an elevated level of mortality. A Glasgow Coma Scale score of 6 or less was associated with significant mortality (68%).

CONCLUSION: A detailed report of motorcycle accident-associated central nervous system injuries is provided. The use of protective equipment, such as helmets, significantly reduced the rate of cerebral injury and death.