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      Alcohol intoxication and lack of helmet use are common in electric scooter-related traumatic brain injuries: a consecutive patient series from a tertiary university hospital

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          Abstract

          Purpose

          Clinicians have increasingly encountered traumatic brain injuries (TBI) related to electric scooter (ES) accidents. In this study, we aim to identify the modifiable risk factors for ES-related TBIs.

          Methods

          A retrospective cohort of consecutive patients treated for ES-related traumatic brain injuries in a tertiary university hospital between May 2019 and September 2021 was identified and employed for the study. The characteristics of the accidents along with the clinical and imaging findings of the injuries were collected from the patient charts.

          Results

          During the study period, 104 TBIs related to ES accidents were identified. There was a high occurrence of accidents late at night and on Saturdays. In four cases, the patient’s helmet use was mentioned (3.8%). Seventy-four patients (71%) were intoxicated. At the scene of the accident, seventy-seven (74%) of the patients had a Glasgow Coma Scale score of 13–15, three patients (3%) had a score of 9–12, and two patients (2%) had a score of 3–8. The majority (83%) of TBIs were diagnosed as concussions. Eighteen patients had evidence of intracranial injuries in the imagining. Two patients required neurosurgical procedures. The estimated population standardized incidence increased from 7.0/100,000 (95% CI 3.5–11/100,000) in 2019 to 27/100,000 (95% CI 20–34/100,000) in 2021.

          Conclusions

          Alcohol intoxication and the lack of a helmet were common in TBIs caused by ES accidents. Most of the accidents occurred late at night. Targeting these modifiable factors could decrease the incidence of ES-related TBIs.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00701-021-05098-2.

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          Most cited references25

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          Moderate and severe traumatic brain injury in adults.

          Traumatic brain injury (TBI) is a major health and socioeconomic problem that affects all societies. In recent years, patterns of injury have been changing, with more injuries, particularly contusions, occurring in older patients. Blast injuries have been identified as a novel entity with specific characteristics. Traditional approaches to the classification of clinical severity are the subject of debate owing to the widespread policy of early sedation and ventilation in more severely injured patients, and are being supplemented with structural and functional neuroimaging. Basic science research has greatly advanced our knowledge of the mechanisms involved in secondary damage, creating opportunities for medical intervention and targeted therapies; however, translating this research into patient benefit remains a challenge. Clinical management has become much more structured and evidence based since the publication of guidelines covering many aspects of care. In this Review, we summarise new developments and current knowledge and controversies, focusing on moderate and severe TBI in adults. Suggestions are provided for the way forward, with an emphasis on epidemiological monitoring, trauma organisation, and approaches to management.
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            Injuries Associated With Standing Electric Scooter Use

            Key Points Question What are the types of injuries associated with standing electric scooter use and the characteristics and behaviors of injured patients? Findings In this study of a case series, 249 patients presented to the emergency department with injuries associated with electric scooter use during a 1-year period, with 10.8% of patients younger than 18 years and only 4.4% of riders documented to be wearing a helmet. The most common injuries were fractures (31.7%), head injuries (40.2%), and soft-tissue injuries (27.7%). Meaning In this study, injuries associated with electric scooter use were common, ranged in severity, and suggest low rates of adherence to existing regulations around rider age and low rates of helmet use.
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              Epidemiology of traumatic brain injuries in Europe: a cross-sectional analysis

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                Author and article information

                Contributors
                antti.j.saarinen@utu.fi
                Journal
                Acta Neurochir (Wien)
                Acta Neurochir (Wien)
                Acta Neurochirurgica
                Springer Vienna (Vienna )
                0001-6268
                0942-0940
                14 January 2022
                14 January 2022
                : 1-11
                Affiliations
                [1 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, Department of Clinical Medicine, , University of Turku, ; Turku, Finland
                [2 ]GRID grid.410552.7, ISNI 0000 0004 0628 215X, Neurocenter, Department of Neurosurgery, , Turku University Hospital and University of Turku, ; Turku, Finland
                [3 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, Department of Anaesthesia and Intensive Care, , University of Turku and Turku University Hospital, ; Turku, Finland
                [4 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, Department of Paediatric Orthopaedic Surgery, , University of Turku and Turku University Hospital, ; Kiinamyllynkatu 4-8, 20521 Turku, Finland
                [5 ]GRID grid.7737.4, ISNI 0000 0004 0410 2071, Department of Orthopaedics and Traumatology, , University of Helsinki and Helsinki University Hospital, ; Helsinki, Finland
                Author information
                http://orcid.org/0000-0002-2742-8491
                Article
                5098
                10.1007/s00701-021-05098-2
                8759433
                35029763
                23fe2411-dacf-4fbe-b2fd-cc07b2ce9970
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 18 November 2021
                : 19 December 2021
                Funding
                Funded by: Vappu Uuspää Foundation
                Funded by: FundRef http://dx.doi.org/10.13039/501100004212, Päivikki ja Sakari Sohlbergin Säätiö;
                Funded by: University of Turku (UTU) including Turku University Central Hospital
                Categories
                Original Article - Brain trauma

                Surgery
                traumatic brain injury,tbi,electric scooter,brain trauma,traffic accident
                Surgery
                traumatic brain injury, tbi, electric scooter, brain trauma, traffic accident

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