Head-injured adult patients with GCS of 3 on admission--who have a chance to survive?
The authors analysed a series of 111 adult patients admitted to the Department of Neurosurgery, Medical University of Lódź directly after trauma with initial GCS of 3 points. 74% of them had intracranial haematoma, mainly subdural, and were treated surgically within the first 3 hours after trauma. 8 patients had no abnormalities on CT scans. 99 (89%) patients died 2 to 30 days after injury, 8 (7%) survived in a vegetative state, and only in 4 (4%) was a satisfactory result noted, but 2 of them had a stable neurological deficit. 3 of these 4 patients had epidural haematomas and 1 had not abnormalities on repeated CT examinations. We conclude, that among patients with GCS of 3 on admission, only those without major CT abnormalities or with epidural haematoma have a chance of survival. Cases with cerebral lesions on the initial CT examination have an invariably bad prognosis. They could be taken into account as a potential organ donor from the very moment of admission, but only after cerebral circulatory arrest occurred and brain death has been proved according to internationally accepted standards.
Kotwica
Z
Z
Department of Neurosurgery, Medical University of Lódź High School of Medicine, Poland.
Jakubowski
J K
JK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011044:Poland / Q000453:epidemiology; D011379:Prognosis; D015996:Survival Rate; D014057:Tomography, X-Ray Computed