Abstract:
Introduction: Prevalence of traumatic brain injury (TBI) is extremely high and potentially associated with severe
incapacitating consequences. Literature reports that 90% of road traffic deaths and injuries including TBI occur in
low and middle-income countries including Ghana. Computed Tomography (CT) scan is the imaging modality of
choice for the initial assessment of the extent of head injury. Some Neuro-ophthalmic injuries (NOI) may
sometimes be ambiguous and indistinct although a serious injury with potential damaging consequences. Data on
the prevalence of NOI post trauma is non-existent in Ghana to inform policy. The onus therefore lies on the
Radiologist who will review the head CT scan to be very meticulous not to miss any NOI if present. We therefore
decided to diligently review a large cross-sectional retrospective post trauma head CT scans for occurrence of NOI.
Objective: To determine the incidence of NOI secondary to head trauma and the possible loss of vision thereof in a
retrospective study using patients' head CT scan data from a tertiary hospital's CT centre in Cape Coast, Ghana.
Method: All head CT scans secondary to trauma for the period January 2016 to December 2018, were retrieved
and carefully analysed. A total number of 1043 of head CT scan images were analyzed by Consultant Radiologists.
Results: Results showed out of 1043 CT scans reviewed, 742 (71,1%) were males and 301 (28.9%) were females. A
total of 609 (58.4%) out of the 1043 patients sustained NOIs of various anatomical types. More Males 398
(65.4%) sustained NOI than females 211 (34.6%). The incidence of NOI was more among the youth as majority
167 (27.4%) of the patients were within the 18–29 years followed by 30–39 years bracket of 148 (24.3%).
Fourteen anatomical types of NOI were elicited and further analysis revealed, intra-ocular foreign body to be the
highest 107 (17.6%) cases, orbital floor fractures injury was 92 (15.1%) cases, with globe rupture injury and
intraocular hemorrhage recording 79 (13.0%) cases each. Optic nerve injury was the least revealing 7 (1.1%)
cases. There was a relationship between the gender of patient and the propensity to sustain NOI as males were
more disposed to NOI than females. Road traffic accident (RTA) was the main pervasive cause of TBI and this
accounted for 71.9% of all cases, followed by fall from height 24%, and the least cause of TBI was ascribed to
gunshot injury of 0.33%.
Conclusion: Prevalence of NOI is high. Urgent measures must therefore be implemented to reduce the RTA menace
in general and to mitigate the associated NOI and possible loss of vision thereof.
