scholarly journals Clinical application of magnetic resonance in acute traumatic brain injury

2008 ◽  
Vol 66 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Dionei F. Morais ◽  
Antonio R. Spotti ◽  
Waldir A. Tognola ◽  
Felipe F.P. Gaia ◽  
Almir F. Andrade
Keyword(s):  
Traumatic Brain Injury ◽  
Subarachnoid Hemorrhage ◽  
Brain Injury ◽  
Magnetic Resonance ◽  
Subdural Hematoma ◽  
Diffuse Axonal Injury ◽  
Correlation Method ◽  
Acute Subdural Hematoma ◽  
Acute Traumatic Brain Injury ◽  
Magnetic Resonance Imaging Mri

PURPOSE: To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. METHOD: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8%) males and 21 (38.2%) females, with acute (0 to 5 days) and closed TBI. RESULTS: Statistical significant differences (McNemar test): ocurred fractures were detected by CT in 29.1% and by MRI in 3.6% of the patients; subdural hematoma by CT in 10.9% and MRI in 36.4 %; diffuse axonal injury (DAI) by CT in 1.8% and MRI in 50.9%; cortical contusions by CT in 9.1% and MRI in 41.8%; subarachnoid hemorrhage by CT in 18.2% and MRI in 41.8%. CONCLUSION: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI.

HYPEREMIA BENEATH EVACUATED ACUTE SUBDURAL HEMATOMA IS FREQUENT AND PROLONGED IN PATIENTS WITH AN UNFAVORABLE OUTCOME

Neurosurgery ◽  
2009 ◽  
Vol 64 (4) ◽  
pp. 705-718 ◽  
Author(s):  
Arturo Chieregato ◽  
Alberto Noto ◽  
Alessandra Tanfani ◽  
Giovanni Bini ◽  
Costanza Martino ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Subdural Hematoma ◽  
Time Course ◽  
Unfavorable Outcome ◽  
Acute Subdural Hematoma ◽  
Control Group ◽  
Computed Tomographic ◽  
The Mean

Abstract OBJECTIVE To verify the values and the time course of regional cerebral blood flow (rCBF) in the cortex located beneath an evacuated acute subdural hematoma (SDH) and their relationship with neurological outcome. METHODS rCBF levels were measured in multiple regions of interest, by means of a Xe-computed tomographic technique, in the cortex underlying an evacuated SDH and contralaterally in 20 patients with moderate or severe traumatic brain injury and an evacuated acute SDH. Twenty-three patients with moderate or severe traumatic brain injury and an evacuated extradural hematoma or diffuse injury served as the control group. Outcome was evaluated by means of the Glasgow Outcome Scale at 12 months. RESULTS Values for the maximum (rCBFmax) and the mean of all rCBF levels in the cortex beneath the evacuated SDH were more frequently consistent with hyperemia. The side-to-side differences in the mean of all rCBF and rCBFmax levels between lesioned and nonlesioned hemispheres were greater in patients with evacuated SDH than in controls (P = 0.0013 and P = 0.0018, respectively). The side-to-side difference in the maximum rCBF value was higher in SDH patients with unfavorable outcomes than in controls at 24 to 96 hours and at 4 to 7 days and higher than in patients with favorable outcomes at 4 to 7 days. The widest side-to-side difference in rCBFmax value was more elevated in patients with an evacuated SDH with unfavorable outcome than in patients with a favorable outcome (P = 0.047), whereas no differences were found in controls. The SDH thickness and the associated midline shift were greater in patients with unfavorable outcomes than in those with favorable outcomes. CONCLUSION On average, hyperemic long-lasting rCBF values frequently occur in the cortex located beneath an evacuated SDH and seem to be associated with unfavorable outcome.

scholarly journals Acute Subdural Hematoma after Isolated Traumatic Brain Injury: Risk Factors and Prediction of Mortality

2015 ◽  
Vol 25 (2) ◽  
pp. 36-40
Author(s):  
Dalia Adukauskienė ◽  
Asta Mačiulienė ◽  
Aušra Čiginskienė ◽  
Agnė Adukauskaitė ◽  
Justina Čyžiūtė
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Blood Cell ◽  
Cell Count ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Blood Cell Count ◽  
Lethal Outcome ◽  
Pupil Reaction

The aim of this study was to determine mortality and it‘s risk factors also prediction of lethal outcome in case of acute subdural hematoma after isolated traumatic brain injury (ITBI). Methods. A retrospective study of 162 patients after ITBI was carried out in Neurosurgical Intensive Care Unit (NITS) of Lithuanian University of Health Sciences Hospital (LUHSH) Kaunas Clinics (KC). Demographic (gender, age), clinical (pupil reaction to light, Glasgow Coma Scale (GCS) score, APACHE II scale score) and laboratory (white blood cell count, glycemia) data analysis on the first day after the injury was made. Conclusions. The mortality rate of acute subdural hematoma after isolated traumatic brain injury was 41 pct. Risk factors of mortality were estimated to be patient age ≥ 65 yrs, absence of pupil reaction to light, GCS 3-8, APACHE II score ≥ 16 points, white blood cell count ≥10,1 x 109/l and glycemia ≥5,6mmol/l. It was estimated the evident relation between predicted lethal outcome and real mortality when the risk of lethal outcome was higher than 25 pct.

Prognostic Factors after Acute Subdural Hematoma

2021 ◽  
Vol 15 (11) ◽  
pp. 2979-2981
Author(s):  
Ali Akbar ◽  
Safdar Hussain Arain ◽  
Mumtaz Ali Narejo ◽  
Najmus Saqib Ansari
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Midline Shift ◽  
College Hospital ◽  
Medical College ◽  
Significant Difference ◽  
The Mean ◽  
Computed Topography

Background: Acute subdural hematoma is a lesion caused by traumatic brain injury. Computed topography, hematoma thickness and midline shift analysis are important factors in evaluating its prognosis. Aim: To evaluate the factors involved in prognosis of acute subdural hematoma. Study design: Retrospective study Place and duration of study: Department of Neurosurgery, Chandka Medical College Hospital, Larkana from 1st October 2020 to 30the June 2021. Methodology: One hundred patients from both genders and between age 18-55 years were enrolled. Clinical examination and radiological complete examination was done in each patient. Zumkeller Index (ZI) was calculated and Glasgow scoring was performed. Results: The mean age were 44.1±15.8 years with 87% males having major reasoning of head injury as a motor cycle accident. Traumatic brain injury was recorded as >3mm ZI in 10 cases. The mean midline shift was 12.4±6.06 mm with a significant difference between three categories. Conclusion: Midline shift and hematoma thickness are useful predictors of prognosis related to acute subdural hematoma. Keywords: Prognostic factor, Acute subdural hematoma, Computed tomography (CT)

EFFECTIVENESS OF TREATMENT OF ELDERLY PATIENTS WITH TRAUMATIC BRAIN INJURY COMPLICATED BY SUBDURAL HEMATOMA

2021 ◽  
pp. 461-465
Author(s):  
А.А. Баландин ◽  
И.А. Баландина ◽  
М.К. Панкратов
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Elderly Patients ◽  
Subdural Hematoma ◽  
Young Patients ◽  
Acute Subdural Hematoma ◽  
Severe Condition ◽  
Neurosurgical Patients ◽  
Personalized Approach ◽  
Outpatient Practice

Работа основана на результатах ретроспективного анализа медицинской документации 56 пациентов с черепно-мозговой травмой, осложненной острой субдуральной гематомой объемом 60-100 см3. Пациенты были разделены на две группы по возрасту: 1-я 29 пациентов 22-29 лет; 2-я 27 пациентов 61-69 лет. Степень нарушения сознания у пострадавших при поступлении в клинику оценивали по шкале Глазго, эффективность проводимого лечения при выписке пациентов из стационара проводили по шкале Рэнкина, оценивая степень независимости и инвалидизации. У пациентов пожилого возраста выявлено более тяжелое состояние при поступлении в клинику. При выписке из стационара оценка степени независимости и инвалидизации по шкале Рэнкина выявила статистически значимое преобладание баллов в группе пациентов пожилого возраста (p<0,01), что говорит о менее эффективном их лечении в сравнении с пострадавшими молодого возраста. Результаты данного исследования могут послужить основой для разработки дополнительных рекомендаций в амбулаторной практике для ухода и попечения пациентов старшей возрастной группы и персонифицированному подходу к пострадавшим нейрохирургического профиля с учетом их возраста. The work is based on the results of a retrospective analysis of the medical records of 56 patients with traumatic brain injury complicated by acute subdural hematoma with a volume of 60-100 cm3. The patients were divided into 2 groups according to their age: the 1st group included 29 patients aged 22-29 years, the 2nd group consisted of 27 patients aged 61-69 years. The degree of impaired consciousness in the victims at admission to the clinic was evaluated on the Glasgow scale, the effectiveness of the treatment at discharge from the hospital was performed on the Rankin scale, assessing the degree of independence and disability. Elderly patients were found to have a more severe condition upon admission to the clinic. Upon discharge from the hospital, the assessment of the degree of independence and disability on the Rankin scale revealed a statistically significant predominance of scores in the group of elderly patients ( p <0,01), which indicates less effective treatment in comparison with young patients. The results of this study can serve as a basis for the development of additional recommendations in outpatient practice for the care and care of patients in the older age group and a personalized approach to neurosurgical patients taking into account their age.

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