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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
DOI: 10.1055/s-0043-1776274
Original Article

Alcohol Consumption and Helmet Use in Patients with Traumatic Brain Injury due to Motorcycle Accident

Consumo de álcool e uso de capacete em pacientes com traumatismo cranioencefálico por acidente de motocicleta
Vitor de Deus da Rocha Ribeiro Gonçalves 
1   Neurosurgery Division, Santa Casa de Misericórdia de Belo Horizonte, SCMBH, Belo Horizonte, MG
,
Carlos Eduardo Cordeiro Cavalcante
2   Faculdade de Medicina, Universidade Federal do Piauí, Teresina, PI, Brazil
,
Ana Luiza Ribeiro Barroso Maia
3   Faculdade de Medicina, Centro Universitário Facid Wyden/Intituto de Educação Médica (UniFacid/Idomed), Teresina, PI, Brazil
,
Raimundo Nonato Campos Sousa
4   Department of Neurology, Faculdade de Medicina, Universidade Federal do Piauí, Teresina, PI, Brazil
,
Arquimedes Cavalcante Cardoso
4   Department of Neurology, Faculdade de Medicina, Universidade Federal do Piauí, Teresina, PI, Brazil
,
Kelson James Silva de Almeida
4   Department of Neurology, Faculdade de Medicina, Universidade Federal do Piauí, Teresina, PI, Brazil
5   Department of Neurology, Faculdade de Medicina, Centro Universitário Facid Wyden (UniFacid), Teresina, PI, Brazil
› Author Affiliations Funding The authors declare that they have not received funding from any source for the conduction of the present study.
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Abstract

Alcohol consumption is an important risk factor for traumatic brain injury (TBI), and it has a great impact on its incidence and severity. However, studies suggest potential beneficial effects of alcohol during hospitalization and in the prognosis of moderate or severe TBI, with conflicting results. The objective of the present study was to associate alcohol consumption and helmet use in TBI patients, as well as the prognostic variables and patterns of injuries secondary to TBI. We analyzed 109 medical records of patients who suffered TBI due to a motorcycle accident. We evaluated data on alcohol consumption, helmet use, TBI severity, and tomographic findings on admission. The subjects with moderate or severe TBI were evaluated regarding hospitalization, mortality and prognosis variables. Patients who wore a helmet at the time of trauma had lower rates of skull fracture and extradural hematoma (EDH), but an increased incidence of subarachnoid hemorrhage (SAH). Furthermore, patients with moderate or severe TBI who were those under alcohol intoxication had a greater need for Intensive Care Unit (ICU) admission and a tendency to have a lower in-hospital mortality rate and a higher score on the Glasgow Prognostic Score (GPS). Thus, although the consumption of alcohol has an impact on the incidence and severity of TBI at admission, it seems to be related to a lower in-hospital mortality rate and a better prognosis. In addition, helmet use is essential to prevent injuries from direct head-to-shield impact, but no similar reduction in the incidence of injuries caused by indirect forces was observed.

Resumo

O consumo de álcool é um importante fator de risco para o traumatismo cranioencefálico (TCE), e tem grande impacto em sua incidência e gravidade. Entretanto, estudos sugerem potenciais efeitos benéficos do álcool durante a internação e no prognóstico do TCE moderado ou grave, com resultados conflitantes. Neste estudo, objetivou-se associar o consumo de álcool e o uso de capacetes em pacientes com TC, além das variáveis prognósticas e dos padrões de lesões secundárias ao TCE. Analisamos 109 prontuários de pacientes com TCE por acidente de motocicleta. Avaliamos dados relativos ao consumo de álcool, uso do capacete, gravidade do TCE, e achados tomográficos admissionais. Os pacientes com TCE moderado ou grave foram avaliados em termos das variáveis de internação, mortalidade e prognóstico. Os pacientes que utilizavam capacete no momento do trauma apresentaram menores índices de fraturas cranianas e hematoma extradural (HED), e aumento da incidência de hemorragia subaracnóidea (HSA). Além disso, os pacientes com TCE moderado ou grave que haviam consumido álcool apresentaram maior necessidade de internação em Unidade de Tratamento Intensivo (UTI) e tendência a apresentar menor taxa de mortalidade intra-hospitalar e maior pontuação no Escore Prognóstico de Glasgow (EPG). Assim, apesar de o consumo de álcool ter um impacto na incidência e na gravidade do TCE à admissão, ele parece estar relacionado a uma menor taxa de mortalidade intra-hospitalar e a um melhor prognóstico. Além disso, o uso do capacete é fundamental para a prevenção de lesões por contato direto cabeça–anteparo, mas não foi observada similar redução da incidência das lesões por forças indiretas.

Keywords

traumatic brain injury - helmet - alcohol - motorcyclist - prognosis

Palavras-chave

traumatismo cranioencefálico - capacete - álcool - motociclista - prognóstico


Publication History

Received: 24 August 2022

Accepted: 21 June 2023

Article published online:
31 October 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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