Intriguing clinical meta analysis of a unique dataset in traumatic brain injury from the “Asterix” comic books

Researchers from Heinrich-Heine University in Düsseldorf, Germany, have published an intriguing study on traumatic brain injury using a dataset taken from the Asterix comic series. The report appeared in Acta Neurochir (2011) 153:13511355.

We learn that the goal of the study was to “analyze the epidemiology and specific risk factors of traumatic brain injury (TBI) in the Asterix illustrated comic books. Among the illustrated literature, TBI is a predominating injury pattern.” One of the major strengths of the study is that clinical data were “correlated to information regarding the trauma mechanism, the sociocultural background of victims and offenders, and the circumstances of the traumata, to identify specific risk factors.”

Through painstaking analysis of all 34 Asterix comic books, the researchers identified 700 hundred cases of TBI in the study. “The majority of persons involved were adult and male. The major cause of trauma was assault (98.8%).” Among the most intriguing results, they found that “although over half of head-injury victims had a severe initial impairment of consciousness, no case of death or permanent neurological deficit was found.”

Epidemiological results indicated that “the largest group of head-injured characters was constituted by Romans (63.9%), while Gauls caused nearly 90% of the TBIs. A helmet had been worn by 70.5% of victims but had been lost in the vast majority of cases (87.7%). In 83% of cases, TBIs were caused under the influence of a doping agent called “the magic potion (p ≤ 0.05)”.

There is no shortage of curious information in the paper. Among other jewels, the authors found that, among victims of head injuries, 4 out of 700 were extraterrestrials. The generally favorable outcome was surprising, given the severity of the injuries (see figure below). One possible explanation given by the authors lies in the follow-up. In their own words, “in many cases, follow-up was only a few minutes. Here, a secondary deterioration after a “lucid interval” and development of intracranial hemorrhage might have been overlooked. However, most figures returned at later time points without any deficit.”

Clearly, more work needs to be done to follow-up this very interesting research. The authors declared no conflict of interest. The funding source was not acknowledged in the paper, however. 😉

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