scholarly journals Comparison between FOUR score and GCS in assessing patients with traumatic head injury: a tertiary centre study

2017 ◽  
Vol 4 (2) ◽  
pp. 656 ◽  
Author(s):  
Sharath S. Nair ◽  
Anilkumar Surendran ◽  
Rajmohan B. Prabhakar ◽  
Meer M. Chisthi
Keyword(s):  
Head Injury ◽  
Glasgow Coma Scale ◽  
Head Injuries ◽  
Neurological Status ◽  
Initial Assessment ◽  
Traumatic Head Injury ◽  
Mortality And Morbidity ◽  
Coma Scale ◽  
Tertiary Centre ◽  
Traumatic Head

Background: Head injuries are a major cause of mortality and morbidity across the world. Effective initial assessment and early intervention is of importance in patients with traumatic brain injury, so as to ensure the maximum favorable outcome. Glasgow Coma Scale is the widely accepted scale to assess severity in head injury patients, albeit with many inadequacies. The objective of this study was to test the validity of full outline of unresponsiveness score, an alternate tool, in assessing severity in patients with traumatic brain injury.Methods: This was a descriptive study, conducted on 69 patients admitted to the general surgical and neuro-surgical wards of Government Medical College, Trivandrum, India with traumatic head injury. For all these patients, full outline of unresponsiveness score and Glasgow Coma Scale were calculated at the time of presentation and serially thereafter. The predictive value of full outline of unresponsiveness score as well as its correlation with Glasgow Coma Scale was studied.Results: A statistically significant correlation was found between full outline of unresponsiveness score and Glasgow Coma Scale in estimating the severity of head injury. Also Full Outline of unresponsiveness score was able to furnish better details about the neurological status of trauma patients.Conclusions: As per the results, it can be concluded that the full outline of unresponsiveness score can be applied as an ideal tool to evaluate consciousness levels and patients’ status in patients with traumatic head injury. It can be used as the ideal replacement for Glasgow Coma Scale.

scholarly journals Assessing the effectiveness of the full outline of unresponsiveness scale and the Glasgow coma scale in patients of traumatic head injury

2021 ◽  
Vol 8 (12) ◽  
pp. 3583
Author(s):  
Fahad Ansari ◽  
Arvind Rai
Keyword(s):  
Head Injury ◽  
Glasgow Coma Scale ◽  
Youden Index ◽  
Traumatic Head Injury ◽  
Coma Scale ◽  
Medical College ◽  
Traumatic Head ◽  
Four Score ◽  
Gandhi Medical College ◽  
Gcs Score

Background: The Glasgow coma scale (GCS) is the most commonly used scale while the full outline of unresponsiveness (FOUR) score is a new validated coma scale in the evaluation of the level of consciousness in head injury patients. The aim of the study was to compare and assess the effectiveness of the FOUR score and the GCS in patients of traumatic head injury.Methods: This was a prospective observational study conducted in the department of surgery, Gandhi medical college, Bhopal during a 2 year period in which 100 patients of traumatic head injury were evaluated. The FOUR score and GCS score of these patients were assessed on admission and outcome followed for 2 weeks.Results: The mean age group of 100 patients was 25-45 years with 79% male and 21% female patients. The FOUR scale was found to have a marginally higher sensitivity of 65.6% while the GCS had a sensitivity of 64.2%. The FOUR scale however had a higher specificity of 71.5% compared to 66.4% of GCS. The Youden index showed that FOUR scale (46%) has a better prediction for death than GCS (35%). FOUR had a higher accuracy of 75% than GCS with an accuracy of 65%.Conclusions: Both FOUR score and GCS are valuable scales in assessment of traumatic head injury. The FOUR scale however is more accurate than the GCS in predicting outcome of head injury patients. 

scholarly journals Full Outline of Unresponsiveness Score versus Glasgow Coma Scale in Assessing Patients with Isolated Traumatic Head Injury

2021 ◽  
Vol 8 (16) ◽  
pp. 1047-1052
Author(s):  
Ashok Kumar Nayak ◽  
Srikanta Das ◽  
Prafullachandra Hoogar
Keyword(s):  
Head Injury ◽  
Interobserver Reliability ◽  
Pearson Correlation ◽  
Characteristic Curve ◽  
Initial Assessment ◽  
Traumatic Head Injury ◽  
Coma Scale ◽  
Traumatic Head ◽  
Four Score ◽  
Time Of Admission

BACKGROUND Traumatic head injury is one of the most common causes of mortality all over the world. Substantial initial assessment of head injury and its intensity in these patients is the primary goal for medical treatment. Hence, there is a necessity for a score better than GCS for the assessment of head injury patients. FOUR score, a new coma scale was published by Wijdicks in 2005. It included 4 components, motor response, eye response, brainstem reflex, and respiration. It precisely assesses the neurological activity as it includes the brain stem reflexes and eliminates the verbal component and identifies locked-in syndromes, temporal lobe herniations and third nerve dysfunctions which GCS fails to do so. We wanted to evaluate the correlation between FOUR score and GCS in evaluating the level of consciousness in patients with head injuries and evaluate the interobserver reliability of both the above-mentioned scores. METHODS This is an observational prospective study conducted on 92 patients with isolated traumatic head injury admitted to Department of General Surgery, VIMSAR, Burla, from November 2018 to October 2020. The parameters that were evaluated were clinical examination at the time of admission, were blood pressure (BP), temperature, pulse, and respiratory rate at the time of admission. Assessment of GCS and FOUR score at the time of admission, at 6 th hour, 24th hour and daily assessment till discharge. RESULTS A total of 92 isolated traumatic head injury patients were included in the study. Number of females (19.5 %) were significantly less when compared to males. The Pearson correlation coefficient between FOUR score and GCS was calculated to be 0.945, 0.962 and 0.951 respectively at the time of presentation, after 6 hours and isolated traumatic head injury. After 24 hours in patients with isolated traumatic head injury, Cohen’s weighted Kappa of GCS and FOUR score inter reliability was 0.956 and 0.985 respectively. Area under receiver operating characteristic curve (ROC) for GCS and FOUR score with Modified Rankins Score was 0.951 and 0.951. Area under ROC for mortality for GCS and FOUR score was 0.974 and 0.997 respectively. CONCLUSIONS As per our results, there is an excellent correlation between GCS and FOUR score in head injury patients. The FOUR score aims to overcome these shortcomings with a scale that is both simple to use and comprehensive in its overall neurologic assessment of the isolated traumatic head injury patients. FOUR score might prove to be a better tool to evaluate the consciousness of head injury patients and help in detection and stratification of these patients and in monitoring the efficiency of ongoing treatment. KEYWORDS Four Score, GCS, Head Injury

scholarly journals A STUDY ON CORRELATION OF DEGREE OF MIDLINE SHIFT ON CT SCAN AND GLASGOW COMA SCALE IN PATIENTS OF ACUTE TRAUMATIC HEAD INJURY

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Sandeep Kumar ◽  
Narendra Kumar Kardam ◽  
Kushal babu Gahlot ◽  
Manphhol Singh Maharia
Keyword(s):  
Head Injury ◽  
Glasgow Coma Scale ◽  
Ct Scan ◽  
Subdural Hematoma ◽  
Midline Shift ◽  
Extradural Hematoma ◽  
Traumatic Head Injury ◽  
Coma Scale ◽  
Depressed Fracture ◽  
Traumatic Head

Background: The larger the amount of the midline shift on CT scan the poorer will be the outcome of traumatic head injury. Other variables such as Glasgow coma scale have been subsequently introduced to build more complex and accurate prognostic model. Methods: A study was conducted on patients with acute traumatic head injury. Most common and important complication of traumatic head injury is the development of an increased intracranial pressure resulting in midline shift. The larger the amount of the midline shift on CT scan the poorer will be the outcome of traumatic head injury. Results: External injury of scalpel is seen in 92% of cases, blackening of eye in 50% & vomiting in 50%. Cerebral contusion (50%) was the most common CT scan finding followed by depressed fracture (32%), subdural hematoma (22%) than extradural hematoma (6%). Hemorrhagic contusion was the most common CT scan finding irrespective of GCS score. In patients with GCS 3-5 other outcome findings are extradural hematoma, subdural hematoma, & depressed fracture. In patients with GCS 6-8 other common findings are extradural hematoma, depressed fracture & hemorrhagic contusion. In patients with GCS 9-12 other common findings were hemorrhagic contusion, depressed fracture & intra cerebral hematoma. In patients with GCS 13-15 other common findings were depressed fracture, hemorrhagic contusion. Conclusions: The increased degree of midline shift in patients with head injuries by CT scan was related to the severity of head injury (GCS= 3-12) and was significantly related to poor final clinical outcome. Keywords: CT scan, Glasgow coma scale, acute traumatic head injury.

scholarly journals Glasgow Coma Scale and Outcomes after Structural Traumatic Head Injury in Early Childhood

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
pp. e82245 ◽  
Author(s):  
Natasha L. Heather ◽  
José G. B. Derraik ◽  
John Beca ◽  
Paul L. Hofman ◽  
Rangi Dansey ◽  
...  
Keyword(s):  
Early Childhood ◽  
Head Injury ◽  
Glasgow Coma Scale ◽  
Traumatic Head Injury ◽  
Coma Scale ◽  
Traumatic Head

scholarly journals Famous head injuries of the first aerial war: deaths of the “Knights of the Air”

2015 ◽  
Vol 39 (1) ◽  
pp. E5
Author(s):  
Prateeka Koul ◽  
Christine Mau ◽  
Victor M. Sabourin ◽  
Chirag D. Gandhi ◽  
Charles J. Prestigiacomo
Keyword(s):  
Head Injury ◽  
World War I ◽  
Head Injuries ◽  
World War ◽  
Traumatic Head Injury ◽  
The Public ◽  
Time Period ◽  
Traumatic Head ◽  
The Media

World War I advanced the development of aviation from the concept of flight to the use of aircraft on the battlefield. Fighter planes advanced technologically as the war progressed. Fighter pilot aces Francesco Baracca and Manfred von Richthofen (the Red Baron) were two of the most famous pilots of this time period. These courageous fighter aces skillfully maneuvered their SPAD and Albatros planes, respectively, while battling enemies and scoring aerial victories that contributed to the course of the war. The media thrilled the public with their depictions of the heroic feats of fighter pilots such as Baracca and the Red Baron. Despite their aerial prowess, both pilots would eventually be shot down in combat. Although the accounts of their deaths are debated, it is undeniable that both were victims of traumatic head injury.

scholarly journals A study of correlation of degree of midline shift on computed tomography scan and Glasgow coma scale in patients of acute traumatic head injury

2021 ◽  
Vol 8 (10) ◽  
pp. 3075
Author(s):  
A. K. Chaurasia ◽  
Lalit Dhurve ◽  
Rajneesh Gour ◽  
Rajpal Kori ◽  
Avias K. Ahmad
Keyword(s):  
Computed Tomography ◽  
Head Injury ◽  
Glasgow Coma Scale ◽  
Severe Head Injury ◽  
Road Traffic ◽  
Midline Shift ◽  
Traumatic Head Injury ◽  
Cross Sectional ◽  
Common Cause ◽  
Coma Scale

Background: Traumatic brain injury is one of most common cause of death in road traffic accident. Most of these classified as mild injury, with approximately 20% classified as moderate to severe. Approximate 50% of the 150,000 trauma deaths every year are caused by head injury.Methods: A prospective cross-sectional study was conducted on 150 patients with a head injury admitted in the Hamidia hospital, Bhopal. The assessment of the severity of head injury using Glasgow coma scale (GCS) at the time of admission, follow up on 5 days and 15 days respectively. The collected data were transformed into variables, coded and entered in Microsoft excel. Data were analyzed and statistically evaluated using statistical package for the social sciences (SPSS)-PC-21 version.Results: Out of 150, a total of 115 patients had no midline shift while 35 patients were having midline shift. Severe head injury patients (GCS 3-8) were having more morbidity and mortality. Moderate head injury (GCS 9-13) was associated with good prognosis and low mortality. A greater degree of midline shift of (more than 5 mm) is indicated severe head injury and is significantly associated with morbid outcome and higher mortality.Conclusions: In our study, road traffic accidents is the most common cause of head injury, with males being affected more than females. The degree of midline shift on computed tomography (CT) scan head in patients with head injuries was found to be significantly associated with high mortality and morbidity.

scholarly journals Relationship of The Degree of Head Injury Based on Glasgow Coma Scale (GCS) with the Arrival of Acute Post Concussion Syndrome (PCS) Onset in Post-Head Injury Patients in General Hospital Dr.M.Djamil Padang

2021 ◽  
Vol 7 (1) ◽  
pp. 153-169
Author(s):  
Muhammad Reza Azriyantha ◽  
Syaiful Saanin ◽  
Hesty Lidya Ningsih
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Glasgow Coma Scale ◽  
Cause Of Death ◽  
Head Injuries ◽  
Acute Onset ◽  
P Value ◽  
Coma Scale ◽  
Post Concussion Syndrome

A B S T R A C TBackground: Traumatic brain injury is the main cause of death in the populationunder the age of 45 years, and the fourth leading cause of death in the entire ofpopulation. Based on the degree of traumatic brain injury, it is commonly categorizedbased on the Glasgow Coma Scale (GCS). Post-Concussion Syndrome (PCS) is theset of somatic, emotional / behavioral and cognitive symptoms that occur after atraumatic brain injury. The aim of this study was to find out the prevalence andcorrelation of the degree of traumatic brain injury based on the Glasgow Coma Scale(GCS) and the emersion of Post-Concussion Syndrome (PCS) acute onset in patientswith head injuries Method: This study was a cross-sectional analytic study ofpatients who experienced Post-Concussion Syndrome (PCS) after traumatic braininjury at DR. M. Djamil Hospital Padang in 2020 from June to November 2020. Datawere collected by filling in a questionnaire (The Rivermead Post ConcussionSymptoms Questionnaire) and medical record data of neurosurgical patients thatmet the inclusion and exclusion criteria. Result: : It indicated that 70 patients wereincluded in the inclusion criteria of this study. A total of 38 (54.3) respondents didnot undergo the acute onset of PCS, meanwhile respondents who experienced acuteonset of PCS were 32 (45.7) respondents. The results showed that 25 (67.6%)respondents with mild traumatic brain injury had PCS acute onset, while 4 (17.4%)respondents with moderate degree of traumatic brain injury had PCS acute onset,and 4 (17.4%) respondents had PCS acute onset PCS 3 (30%) respondentsexperienced severe traumatic brain injury with acute onset PCS and statistically thedifference in the proportion of data from each of these variables was significant witha p-value of 0.0001. The results of statistical tests showed that p value> 0.05 on thecorrelation between PCS and GCS, thus, it can be concluded that there was nocorrelation between the direction of the relationship between PCS and GCS.Conclusion There was no correlation between the degree of traumatic brain injurybased on GCS and the incidence of PCS acute onset, either it was unidirectional orvice versa in patients with head injuries at RSUP M. Djamil Padang.

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