Assessment of Prognosis in Cranio Cerebral Trauma Based on Findings on First CT Scan.

摘要

Background: Traumatic Brain Injuries (TBIs) are a leading cause of morbidity, mortality, disability and socioeconomic losses in India and other developing countries. The first Computed Tomography (CT) scan of TBI patient is vital in diagnosing underlying neuroparenchymal injury and also plays a predictive role. Aim and Objectives: We intended to correlate features on the admission CT scan of brain that might help in predicting prognosis and survival in patients with head injury. Material and Methods: All patients with head injury referred for CT scan of brain were included in the study and evaluated for craniocerebral injury. Patient outcome was measured with Glasgow outcome score at the time of discharge. Results were statistically analyzed to assess feasibility of predicting the prognosis. Results: Of the 327 patients who presented exclusively with head trauma, 206 (67.1%) had abnormal CT scans. Patients who had a midline shift had statistically significantly higher mortality. Patients with diffuse axonal injury and burst lobe had a higher mortality rate. The mortality among the patients that had contusions was lower compared to those who did not have contusions. Subdural hematoma, extradural hematoma, intraventricular or subarachnoid hemorrhage did not statistically significantly alter the mortality rate .There was marked increase in the morality rate as the magnitude of midline shift increased. Conclusion: Basal cistern effacement, midline shift 15mm, burst lobe, diffuse axonal injury and herniation are associated with increased mortality. Predicting percentage mortality is especially important as it will help patients' family to have a better insight about the patient's condition and the likely outcome.