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Acute Assessment of Brain Injuries in Ground-Level Falls

Pöyry, Tiina BM; Luoto, Teemu M. MD; Kataja, Anneli MD; Brander, Antti PhD, MD; Tenovuo, Olli PhD, MD; Iverson, Grant L. PhD; Öhman, Juha PhD, MD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

The Journal of Head Trauma Rehabilitation: March/April 2013 - Volume 28 - Issue 2 - p 89–97
doi: 10.1097/HTR.0b013e318250eadd
Original Articles

Objective: The purpose of this study was to characterize traumatic brain injuries (TBI) sustained in ground-level falls (GLFs). The focus was on factors associated with acute computed tomographic (CT) findings.

Methods: The sample included 575 subjects examined and treated at the Tampere University Hospital emergency department (ED). Retrospective data collection consisted of subject- and injury-related data and clinical information from the emergency department. All CT scans were analyzed and systematically coded.

Results: Ground-level falls were the mechanism of injury in 48.3% (n = 278) of the subjects. In the GLF group, independent risk factors for acute traumatic CT findings were long-term alcohol abuse, older age, being found on the ground, and left temporoparietal and occipital location of direct head impact. There were no significant differences in the incidence of any intracranial traumatic lesion type between those with GLFs and other causes of TBI. None of the classic clinical TBI severity markers studied were associated with acute traumatic CT findings in patients with GLFs.

Conclusions: Older age and long-term alcohol abuse increase the likelihood of acute intracranial CT abnormalities. The pattern of intracranial traumatic CT findings does not differ from other causes of TBI. Clinical signs and indices of TBI severity did not predict traumatic CT findings.

Department of Neurosciences and Rehabilitation (Ms Pöyry and Drs Luoto and Öhman) and Medical Imaging Centre, Department of Radiology (Drs Kataja and Brander), Tampere University Hospital, Tampere, Finland; Department of Neurology, University of Turku and Turku University Central Hospital, Turku, Finland (Dr Tenovuo); and Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada (Dr Iverson).

Corresponding Author : Teemu Luoto, MD, Tampere University Hospital, PO Box 2000, FI-33521, Tampere, Finland (

The authors thank research assistant Anne Simi for her contribution in data collection and biostatistician Mika Helminen for his assistance in statistical analysis.

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.