Computer Tomography in Management and Prognosis of Patients with Severe Brain Injury

摘要

This study examines the influence of computer tomography on the diagnosis and treatment of patients with severe brain damage, and investigates whether it is possible to make predictions on the outcome of these patients, based on CT findings. To this end, a series of computer tomograms was made of 173 consecutive patients with severe brain damage. One hundred and twenty-one of the 173 patients were comatose on admission. The other 52 patients were non-comatose, but showed impaired consciousness and/or neurological deficit. The computer tomograms were made, as far as possible, at predetermined intervals after the accident. There was a high percentage of abnormal findings on the computer tomograms made on admission. In 61 patients, the abnormalities detected on the CT scans could be checked by operation or autopsy. In all cases the CT diagnosis was confirmed. This study shows that accurate predictions of death can be made for a number of patients with severe brain damage. Accurate predictions of survival were also made, albeit for a much smaller number of patients. The formulation of probability statements about the quality of survival proved to be impossible, because of the relatively small number of survivors and because of the technical limitations of the scanner used. (Auth.). Includes Dutch summary; 103 refs.; 25 figs.; 25 tabs. (Atomindex citation 17:059209)