Traumatic Cranial Nerve Injuries – An Institutional Experience

Abstract

Introduction: Road Traffic accidents (RTA) in India are the sixth among the leading cause of death. The cranial nerves serve several essential functions. Loss of these functions can adversely affect the quality of life. This study was conducted to assess the incidence of Cranial Nerve Injury (CNI), radiological and clinical patterns and to ascertain the significant and often debilitating effect of CNI in otherwise non-life threatening Traumatic Brain Injuries. Methodology: This prospective study was conducted in the Department of Neurosurgery, SRIHER between April 2019 and September 2021. A total of 62 patients among the 402 patients with TBI had CNI. Patients with GCS <9 were excluded from the study. Results: Three fourth of the patients belonged to the 21–50 age group (n = 301) and 78 % of the study population were men (n = 313). Patients with cranial nerve injuries, ear bleed and nasal bleed occurred in a higher proportion compared to patients without CNI −58 %(n = 36) vs 15 %(n = 60). Forty Two of the 62 patients with CNI had an associated skull base fracture, the incidence of which was considerably high compared to those without CNI (68 % vs 23 %). The average GOS for patients with TBI and CNI was worse than for those with TBI without CNI in our study group (2.64 vs 1.43). Conclusion: Patients with TBI with CNI often tend to be younger and have a poor outcome. Early identification with aggressive neuro-rehabilitation may improve the outcome.

Keywords

• Traumatic brain injury
• Cranial nerve injury
• Neuro-rehabilitation
• Skull base fractures