scholarly journals Evaluation of Head Computed Tomography Assessment of Brain Swelling after Acute Traumatic Brain Injury: A Pilot study

2019 ◽  
Vol 38 (04) ◽  
pp. 257-262
Author(s):  
Robson Luis Amorim ◽  
Barbara Albuquerque Morais ◽  
Francisco Otávio Camargo Pereira ◽  
Matheus Fernandes Oliveira ◽  
Almir Ferreira Andrade ◽  
...  

Abstract Objective To evaluate the interobserver reliability of a new scale created for quantitatively assessing brain swelling in traumatic brain injury (TBI) patients using the computed tomography (CT) findings in three levels. Methods Computed tomography scans of severe head injury patients were randomly selected from a tertiary hospital image database and evaluated by independent groups of neurosurgeons, neurosurgery residents, radiologists, and intensivists from the same hospital. Each specialist assessed the tomographic findings, applying zero to six points in a new scale. The Kappa coefficient was calculated to assess interobserver agreement. Results The highest reliability coefficient was obtained by the neurosurgeons group (0.791; 95% confidence interval [CI]: 0.975–0.607; p < 0.001), followed by the neurosurgery residents group (0.402; 95%CI: 0.569–0.236; p < 0.001) and by the radiologists group (0.301; 95%CI: 0.488–0.113; p < 0.002). The lowest coefficient was found among the intensivists (0.248; 95%CI: 0.415–0.081; p = 0.004). Conclusion The proposed scale showed good reliability among neurosurgeons, and moderate overall reliability. This tomographic classification might be useful to better assist severe TBI victims, allowing to identify the worsening or amelioration of brain swelling, which should be further investigated. The scale seems to be feasible, even in low income countries, where the cost of intracranial pressure (ICP) monitoring is higher than that of CTs.

2008 ◽  
Vol 38 (2) ◽  
pp. 452-458 ◽  
Author(s):  
M. J De Silva ◽  
I. Roberts ◽  
P. Perel ◽  
P. Edwards ◽  
M. G Kenward ◽  
...  

2016 ◽  
Vol 5 (2) ◽  
pp. 5-12
Author(s):  
A. Adam ◽  
A. Alhassan ◽  
I. Yabasin

Traumatic brain injury (TBI) is considered as one of the most silent epidemics and its incidence is rising worldwide due to injuries associated with the increased use of motor vehicles and bad road network, particularly in middle-income and low-income countries including Ghana. The aim of this study was to assess the incidence of TBI, cause of injury as well as outcomes of patient’s care in the Tamale Teaching Hospital in Ghana. This retrospective study was carried out at the Tamale Teaching Hospital, the only Tertiary referral hospital in the whole of the savanna ecological zone of Ghana over 43 months from January 2009 to July 2012. All patients admitted into the hospital and diagnosed as having TBI were included in the study. The medical records of a total of 671 patients who were diagnosed with TBI were reviewed. Information regarding the age, sex, occupation and initial external cause of injury was retrieved. Data regarding length of hospital stay and treatment outcome were also retrieved. External cause of injury was classified according to International Classification of Diseases (ICD) guidelines as Road Traffic Accidents (RTA) (irrespective of type), fall from height, assault, gunshot, game or sport related accident and other causes. Road traffic accident accounts for relatively high incidence of hospitalized TBI. Majority of the patients were male within the 21-30 year age group. The high number of Intensive Care Unit (ICU) fatalities may indicate that more resources and facilities (intensive care nurses and equipment to monitor intracranial pressure) are needed to help in the management of cases particularly head injuries. Journal of Medical and Biomedical Sciences (2016) 5(2), 5-12


2017 ◽  
Vol 107 ◽  
pp. 382-388 ◽  
Author(s):  
Armel Flavien Kabore ◽  
Aziz Ouedraogo ◽  
Kélan Bertille Ki ◽  
Salah Seif Idriss Traore ◽  
Ibrahim Alain Traore ◽  
...  

PLoS ONE ◽  
2020 ◽  
Vol 15 (10) ◽  
pp. e0240528
Author(s):  
Armand Zimmerman ◽  
Samara Fox ◽  
Randi Griffin ◽  
Taylor Nelp ◽  
Erika Bárbara Abreu Fonseca Thomaz ◽  
...  

Author(s):  
Dr. Dileep Kumar Jha ◽  
Dr. Rajnikant Narsinhbhai Chauhan

Introduction: In human body there are many causes of the injuries. Among all the injuries head injury is also one of the most important injuries which may cause morbidity and mortality. Craniocerebral injuries or Traumatic brain injury (TBI) is defined as any structural skull traumatic injury with alterations of cerebral physiology as a result of an external force either in the form of chemical energy, mechanical energy, electrical energy or thermal heating. Globally craniocerebral injuries or Traumatic brain injury (TBI)is cause of disability in young patients, especially those  <40 years of age. TBI is classified as mild, with most showing adequate and quick recovery. Nevertheless there are some kinds of TBI which showed persistent disabling symptoms that interrupt with their normal daily routine activities. Brain imaging is very important for the patients who suffer traumatic brain injury. In the emergency services Computed tomography (CT) is recommended as first assessment that provides initial information and diagnosis to identify the need of surgery. It also helps in the following of the patient and the evolution of pathology. Many studies suggest that CT can be used to predict patient outcomes. Computed tomography (CT) is an imaging technique which uses as dynamics of injected contrast material, allows rapid quantitative and qualitative evaluation of cerebral perfusion by generating cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) maps providing clinically important information with stroke subarachnoid hemorrhage (SAH)and head injury. Aim: The main aim of this study is to evaluate the computed tomography findings sustaining head injury and role of computed tomography scan in head injury. Material and Methods: During the study total 90 patients with head injury were included with different age group from 20 to 70 years old. Glasgow coma score (GCS) range 4–15 (mild head injury: GCS >14; moderate head injury: GCS = 9–13; severe head injury GCS <8) were also included in this study. For all the patients with head injury Computed tomography (CT) image were performed with siemen's somatom spirit dual slice spiral CT machine and a protocol of contiguous axial 5-mm sections through the posterior fossa and a contiguous 10 mm axial sequential scans for the rest of the brain and thinner cuts were also taken whenever required. For visualize any fractures of the skull bone algorithms with wide window settings were studied. After initial resuscitation, severity of the cranio-cerebral trauma was graded with the help of Glasgow Coma Scale (GCS) into mild head injury (GCS13- 15), moderate head injury (GCS 9-12) and severe head injury (GCS 3-8). Result: Among total patients sixty five (72.2%) patients were male and twenty five (27.8 %) were female with age range from 20 to 70 years old. In the age group 31-50 year group showed highest frequency of head trauma. The most common causes of head injury were RTA (65.6%) followed by fall injuries (20%) and physical assaults (14.4%). Among patients with head injuries Loss of consciousness and vomiting were the commonest clinical features brought to emergency. Out of 90 cases 59 (65.5%) cases showed mild head injury followed by 14(15.6%) cases sustained moderate head injury and 17(18.9%) had severe head injury. In all types of severity of head injury RTA was the prime etiological factor. Out of total cases 31(34.4%) had normal CT findings and 59(65.6%) had abnormal CT findings. Abnormal CT findings were seen in 59(65.6%) sustaining mild head injury and in all the patients with moderate and severe head injury. Out of 90 cases 13 cases with severe head injury had mortality. The most common mode of injury to cause the mortality was RTA. Five patients with severe head injury also had cervical spine injury Conclusion: This study concludes that use of CT in head trauma can finds high prevalence of head trauma related to CT. Therefore CT should be done when clinically necessary that helps to reduce cost and avoids unnecessary exposure to radiation. Keywords: Head injury, Traumatic brain injury (TBI), computed tomography (CT), Glasgow coma scale (GCS)


Sign in / Sign up

Export Citation Format

Share Document