Background: India accounts for six percent of world’s Road traffic accidents (RTA).^[1] Nearly half of all traumatic brain injuries(TBI) patients are transported to a hospital without neurosurgical expertise which increases morbidity and mortality ^[2,3]. Methods: A total of 412   head injuries cases were included. A complete history, clinical examination, routine and special investigation, method of transportation, alcohol or substance abuse and outcome were noted.

Results: Most common cause of head injuries was RTA (76%) followed by   fall (15.78%) and assault (7.52%). After performing univariate logistic regression, first hospital, time for CT, mode of injury, gender, education level, injury place, referral, alcohol/drug, handicap and high energy injury were the significant factors responsible for late admission.  

Conclusions: The common reason due to  the delay in arriving the hospital being lack of neurosurgeons, computerized tomography(CT) scan head followed by lack of beds or ICU facilities and high cost in private hospitals.