Neurosurgical Injuries Associated With the Use of Personal Watercrafts.

INTRODUCTION:  A personal watercraft is widely used for recreation on coastlines, rivers, and lakes. This study aimed to identify the spectrum of neurosurgical injuries related to personal watercraft accidents in Puerto Rico.

METHODS: A retrospective study was performed utilizing the University of Puerto Rico neurosurgery database to identify patients who had been consulted to the neurosurgery service from 2005 to 2023 due to a personal watercraft-related neurosurgical injury. For each identified patient, basic demographics, injuries received, Glasgow coma scale score at arrival, American Spinal Injury Association impairment scale grade, surgery performed, and outcome upon discharge using the modified Rankin scale (mRS) score were collected. Descriptive statistics were used to report frequency and mean values.

RESULTS: Our service evaluated 11 patients with a personal watercraft-related neurosurgical injury diagnosis during the study period. The mean age of the patients was 35 (± 9). Around 82% of the patients were males. Ejection from the personal watercraft was the mechanism of the trauma in 73% of the patients. Three patients were impacted by a personal watercraft. There were seven spinal injuries and four brain injuries. Among the spinal injured patients, two had neurological deficits. None of the patients with brain trauma required urgent surgery; however, three arrived intubated. Two of them showed signs of diffuse axonal injuries on the head CT scan, while the other had multiple brain contusions. Upon discharge, 70% of the patients had a mRS grade of 0-3.

CONCLUSIONS: Personal watercraft accidents causing significant neurological injuries to the brain and spine are infrequent. Injuries were more prevalent among male patients in their thirties. Most patients showed good outcomes when discharged from the hospital. Moderate to severe disability occurred more frequently among spinal injured patients due to residual deficits requiring assistance for ambulation and activities of daily living.