HYDERABAD: March 20 marks World Head Injury Awareness Day - a day dedicated to the prevention of head injuries. The theme for the years 2018 to 2020 is “Change Your Mind” and brings to light the fact that people with a brain injury are not rare and not alone.
According to Mercer’s Quality of Living (India) Rankings 2019, released recently last week, Hyderabad bagged the top spot in quality of living index but do we know that just in three months - from January to March 2019 around 34 road accidents deaths have happened out of which 14 people died of Traumatic Brain Injury (TBI). Last year of the 2550 accidents, 303 people lost their life due to Traumatic Brain
Injury. Nationally too the numbers looks bad. In all, 1.5 million people sustain serious head injury every year in India and 70% of the injured die even before they reach the hospital or get adequate help.
Traumatic Brain Injury Traumatic Brain Injury is a leading cause of disability and mortality across the globe. Statistics show that the 60 percent of the head injury victims are in the ‘Productive age’ which is between the age of 18-40 years and one can imagine the economic and financial loss to both the nation and to the their families.
Causes:
Negligent or drunken driving, over-speeding, driving on the opposite side, sudden entry onto the roads and highways are major causes of the accidents. Vehicle-pedestrian accidents account to two-third of the accident in the city. In a news report published recently, in January 2019 a total of 13 pedestrians were killed in 84 road accidents. While in 2018, 2017 and 2016 a total of 429 people lost their lives. A variety of factors including lack of awareness, ignorance by both the person who is crossing the road and the traveller and also due to bad safety measures, we are observing a large number of people falling prey to these accidents. In the last 3 months, I have personally seen two cases, both women, aged between 50 to 70 years loosing previous lives under vehicle-pedestrian accidents. Both of them have been hit on the road while they were crossing the road to the other side. The complications of a head injury decoded Sustaining a brain injury is a devastating experience for both the individual and to their family and friends. More so in India, the impact of brain injury is confusing and complicated due to the lack of awareness of the nature and effects the accident has on the brain. The experience that a loved one is in danger due to a head injury is intensely distressing and once if the patient has recovered sufficiently with confusing array of psychological changes is even more devastating. Subtle and temporary lapses in ability and behaviour, reduction in basic skills, loss of control of emotion and behaviour are some of the psychological changes we observe which effects the both the patient and associated family in brain injury. I have seen that patients often undergo a long struggle to regain physical, cognitive and social skills following the injury. In some the struggle may continue for every years often with no remarkable degree of improvement.
How do we prevent ?
Wearing a helmet, putting on the seat-belt and avoiding mobile phones while driving can bring down the numbers. Salma Nasser (Name changed) one of my patient who lost her life has to pay her life due to the carelessness of another person. A speeding motorcycle hit Salma from the back when she was riding with her Son at mid-afternoon. She was dragged for few meters and sustained fatal injuries to her skull. Though she was broughtby her son to the hospital, unfortunately we lost her. One may also note instances where children are also victims of head injuries. We see children aged between 6 to 10 years losing their lives due to negligence from us. Often, we see parents keeping their children on the petrol tank. The risk of the child slipping due to sudden doze, falling down from the moving vehicle or after being hit from the backside is high. Drunken driving and potholes after rains are also major causes of accidents.
Why Golden Hour is Important?
Golden Hour is the first hour after a traumatic head injury. In majority of the cases, victims miss out on the Golden Hour which results in death or other serious complications. More than the police, the people around the accident spot bring the victim in the ambulance to the nearest possible hospital and in some cases the Golden Hour is lost due to delay in shifting the victim from the spot to the hospital.
Time to Change Our Mind The theme, ‘Change Your Mind’ provides a platform for educating ourselves about the incidence of brain injury and to support the needs of the people with brain injury and their families. Educating ourselves and also our fellow citizens as bystanders on how to handle a patient with a head injury is important.
Bring in the change
The most common behavioural change after a brain injury is of increased irritability. People are impatient, intolerant and also easily get irritated with small things, like a small noise from children or machine. They are also short tempered and are also frustrated with themselves. Brain injuries also cause of major stress for close family members. Providing psychological support can help people with brain injuries and their family throughout the course of recovery. Let us change our mind and attitude towards the injured and assist them during their active rehabilitation more.
(The doctor is Senior Consultant Neuro and Spine Surgeon,Continental Hospitals, Hyderabad)