I. To assess the effect of direction of force on the craniofacial skeleton and its influence on the severity of brain injury sustained by maxillofacial trauma patients. ii. To assess the effect of the time between the incident and the patient reporting to the Hospital on severity of brain injury. iii. To determine the incidence of head injury under the influence of alcohol. iv. To determine the percentage of pedestrian related injuries in RTA.

Five hundred and forty-two patients from a tertiary care hospital who sustained head injury were divided into two groups: Those struck with predominantly anterior force and predominantly lateral force. The first recorded Glasgow coma score (GCS), requirement for intubation, and requirement for decompressive craniectomy/craniotomy were recorded, used as markers of the severity of brain injury. Incidence of pedestrian injury, alcohol consumption and time of reporting to hospital after the injury were also recorded.

An average GCS of seven was found in the lateral group and 12 in the anterior group, this difference was statistically significant. These results show that the skeletal anatomy of the skull influences the severity of head injury.

The delicate lattice-like structure in the upper and midface act as a crumple zone, absorbing force. Conversely in the lateral aspect of the head, there is a lack of collapsible interface, resulting in a direct energy transfer to the brain.