During a twenty month period 1331 patients sustaining central nervous system (CNS) trauma were admitted to the University of Virginia Medical Center. The data base consists of 80% head injuries, 12% spine injuries and 8% combined head/spine injuries which represents all such injuries occuring in a well-defined geographic area. This report focuses on 645 patients who were injured in vehicular accidents (87% automobile and 13% two-axle truck). The injured person was most often the driver of the vehicle (59%). Sixty-one percent of patients tested had a positive blood alcohol level on admission and 51% of this group were legally intoxicated (blood ETOH>.10%). Automobiles were placed in four categories based on wheel base size from subcompact to full size. Fifty-four percent of those injured were in either intermediate or full size cars.

The severity of neurologic injury was measured with the Glasgow Coma Scale (GCS). While the literature shows that the relative risk of being injured at all in a smaller v. larger vehicle is greater, (20,21) our findings in patients with CNS injuries DO NOT support previous studies that persons in smaller vehicles are more severely injured. Only 4% of patients were wearing seat belts at the time of injury and none of the patients who died were wearing seat belts.

Our analysis indicates in this series 1) nearly two-thirds of (tested) patients involved in vehicular accidents were using alcohol;​ 2) outcome from injury can be improved with seat belt usage;​ and 3) the size of the vehicle is not a determinant in severity of injury or outcome.