By Judith Tan

MORE than eight in 10 people who go into the emergency rooms with head trauma suffer significant brain damage; and many of these patients are in the prime of their lives.

These figures from Associate Professor Ivan Ng, head of the neurosurgery department at the National Neuroscience Institute (NNI), also show that every year, about 100 to 200 people suffer traumatic brain injuries - with motor vehicle accidents accounting for almost half of them.

This is backed by the latest statistics from the Traffic Police.

Last year, 110 road users below the age of 40 were killed while almost 7,000 in the same age group were injured in road accidents.

Prof Ng, who heads the neurosurgery department at NNI, said traumatic brain injury most frequently occurs in the front of the brain.

'The frontal lobe governs a person's personality, reasoning, emotions and problem-solving abilities. When it is damaged, there will be psychological changes in the patient,' he said.

More than half of the victims treated at NNI were young adults between the ages of 18 and 40 - often the breadwinners in the family.

The professor added that only 15 per cent of people who come into the emergency rooms with head trauma have minor injuries, with symptoms such as headaches and nausea.

'The rest are usually severe...Between 25 per cent and 30 per cent usually don't survive,' he said.

Another 20 per cent will end up in a vegetative state, while the rest will live, either with no ill effects - if they are lucky - or with varying degrees of disability.

Prof Ng said almost all patients with severe head injury and as many as two-thirds of those with moderate head injury will be permanently disabled.

And although there are no statistics available on the direct cost of care for patients with head trauma here, reports in the United States show that costs, excluding inpatient care at the hospital, are estimated at more than US$25 billion (S$36.4 billion) a year.

'Such an impact would be greater when most severe head injuries occur in young adults who are in their prime,' Prof Ng said.

Four months after he suffered serious head injuries in a road accident, property agent Goh Wei Sern woke up.

But he has become a shadow of his former self. Doctors had to remove part of his brain to save his life. Mr Goh, 30, was a passenger in the back seat when the driver lost control of her car in November last year.

The outdoor enthusiast, who loved eco-diving and fishing, is now bedridden and has to be tube-fed.

Doctors had removed part of his skull and frontal lobes that were badly damaged in the crash.

'It was after seven days that his brain started bleeding. Part of his skull and his frontal lobes were removed,' his elder sister Ellen told The Straits Times.

'My brother has lost his ability to analyse and to communicate but he is showing tiny signs of improvement. He smiles every time we crack familiar jokes,' she added.

Prof Ng likened dealing with severe brain injury to fighting a fire.

'It is unlikely that the damage caused is reversible. All we can do is to prevent further harm to the brain,' he said.

The professor also said as that there is no cure, the road to recovery for brain trauma patients 'is a long and arduous one' - something the Gohs are prepared for.

'We are currently looking for a nursing home that also carries out rehabilitation for brain trauma victims. This way he would be able to improve faster,' said Ms Goh.

Shocking figures

1. 100 to 200 people suffer from traumatic brain injuries in Singapore each year.
2. 50% are caused by road accidents.
3. 50%+ of those treated at the National Neuroscience Institute are between 18 and 40 years old.
4. 85% are serious cases.
5. 25% to 30% of these usually do not survive.
6. 20% end up in vegetative state.

juditht@sph.com.sg

This article was first published in The Straits Times.