A Perspective From the Middle East on the Topic of Concussion

Background- Concussion is the most prevalent form of traumatic brain injury. Western countries debate it as a public health issue. Middle Eastern (ME) countries lag behind with a concussion incidence surveillance of 25% that of European countries. Objective- The purpose of our study was to review concussion resulting from traumatic brain or sports injuries in civilian nationals of the ME. Methods- We carried out PubMed literature search of all related articles in the past thirty years using search terms reflecting concussion and sports injuries in ME countries of Bahrain, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Saudi Arabia, Syria, Turkey, United Arab Emirates, and Yemen. Results- 72 articles met our search criteria with relatively little data found on concussion within the parameters of this review. However, the reports that were found were diverse. Israel, Turkey and Iran led in publications. Motor vehicle accidents were the leading cause of concussion from TBI (50-57%) followed by domestic injuries (30-40%) and sports injuries at 4-7%. Extremity injuries were most commonly reported unlike head injuries often invisible and underreported. Male gender, young children, pedestrian and car traffic accidents, lack of protective gear, cell phone use, impulsive behaviors as well as training overload, lack of sleep, contact sports and violence were all risk factors for concussion. Conclusions- In this review, we highlighted the nascent topic of concussion in the ME and the need for additional research dictating awareness programs and implementing new safety policies to lower morbidity and mortality across all ages.