EC Neurology

Background: The 2023 Gaza War inflicted a high burden of neurotrauma on civilians, overwhelming local healthcare systems. This study aimed to document the epidemiological and clinical characteristics of neurotrauma cases and identify demographic and injury-related predictors of traumatic brain injury (TBI) severity.

Methods: A prospective observational study was conducted from October 2023 to July 2024 in Al-Aqsa Hospital, Gaza. All patients presenting with war-related neurotrauma (n = 679) were consecutively enrolled. Data were collected using a structured tool and included demographics, injury type, TBI classification, and clinical outcomes. Chi-square tests and logistic regression analyses were performed to explore associations and predictors of TBI severity.

Results: Among the 679 patients, 452 (66.6%) were male and 227 (33.4%) were female. The majority sustained blunt injuries (79.5%), with cranial trauma being the most common (88.5%). TBI severity distribution was as follows: moderate (43.0%), severe (26.2%), mild (18.6%), and unclassified (12.2%). Statistically significant associations were found between TBI severity and gender (p = 0.005), age group (p < 0.001), injury mechanism (p < 0.001), and anatomical site (p = 0.002). Logistic regression identified spinal injury (OR = 4.22, 95% CI: 2.29-7.78, p < 0.001), male gender (OR = 2.42, p = 0.002), age >60 (OR = 2.97, p = 0.004), and penetrating injury (OR = 1.91, p = 0.010) as significant predictors of severe TBI.

Conclusion: Neurotrauma during the Gaza War disproportionately affected young males and was predominantly caused by blunt cranial injuries. Severe TBI was more likely among males, the elderly, and those with penetrating or spinal injuries. These findings underscore the need for targeted preventive measures, improved trauma triage, and resource allocation during armed conflicts.

 Keywords: Gaza War; Neurotrauma; Traumatic Brain Injury; Penetrating Injury; Spinal Trauma

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