Traumatic brain injuries: predictive usefulness of CT.
The computed tomographic (CT) scans from 72 patients with traumatic brain injury were reviewed to determined whether a specific type, location, or size of lesion correlated with changes in neurologic function (assessed with the Glasgow Coma Scale [GCS]), patient outcome (assessed with the Glasgow Outcome Scale [GOS]), or catecholamine levels. The lesions were classified as focal or diffuse. GOS changed as a function of lesions size (P = .00004) in the 48 patients with focal hemorrhages, regardless of whether the lesions were intra- or extraaxial, and in the 19 patients with normal CT scans. Patients with lesions larger than 4,100 mm3 had a twofold greater risk of a poor outcome than patients with smaller lesions (100% vs 50%). Patients with normal CT scans were significantly more likely to have mild neurological dysfunction or none than patients with abnormal CT scans (P = .03), but lesion location, skull fracture, and pineal shift were not significant predictors of GCS or GOS scores. A positive relationship existed between lesion size and both plasma norepinephrine and epinephrine levels (P less than .02); a significant relationship existed between lesion size and GCS score (P = .02).
Kido
D K
DK
Department of Radiology, University of Rochester Medical Center, NY.
Cox
C
C
Hamill
R W
RW
Rothenberg
B M
BM
Woolf
P D
PD
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D001930:Brain Injuries / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology; D004837:Epinephrine / Q000097:blood; D015600:Glasgow Coma Scale; D006801:Humans; D009638:Norepinephrine / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D009638:Norepinephrine; D004837:Epinephrine