scholarly journals ROLE OF COMPUTED TOMOGRAPHY IN PATIENT WITH MINOR HEAD INJURY IN TERTIARY CARE HOSPITAL

Author(s):  
Sanjay Narayangiri Gosavi ◽  
Sambhav Lodha ◽  
Apoorva Poonia

Aim: Approximately 2 million people sustain traumatic brain injury (TBI) annually in India. A CT scan of the head is the initial choice of radiological investigation to evaluate patients with suspected head injury. The need for neurosurgical intervention is based on the clinical status of the patient and the radiological finding on head CT. Material and Methods: This was a prospective observational study done over a period of 6 months. A total of 201 patients were included in the study. Patients of traumatic brain injury above 15 years of age who were subjected to two or more CT scans of the brain. Patients were followed for a maximum of up to 5 scans. The decision of repeat scan was taken by the treating neurosurgeon. Patients who were taken up for surgery based upon the findings of the first CT scan. Patients who were discharged or who expired after the first CT scan. Results: A total of 201 consequent head injury patients with 2 or more CT scans were studied. 192 were male. The mean age was 38.6 years (Range: 16e80). Road traffic accidents was the most common cause of trauma (134, 67%) followed by fall from height (47, 24%) and assault (17, 10%). Progression of lesion was seen more frequently in mixed lesions (21.8%), followed by SDH (12.5%) and EDH (6.2%). Conclusions: Repeat CT scans were found to be of value in detecting new lesions or enlargement of existing lesions resulting in change of management in a significant proportion of patients. Keywords: Computed Tomography, Minor Head Injury, Tertiary Care Hospital, Traumatic Brain Injury (TBI), Lesions.

2020 ◽  
Vol 27 (01) ◽  
pp. 94-99
Author(s):  
Qazi Muhammad Zeeshan ◽  
Ramesh Kumar ◽  
Asim Rehmani ◽  
Muhammad Imran ◽  
Atiq Ahmed Khan ◽  
...  

Objectives: Our study aims to determine the frequency of progressive hemorrhagic injury as observed on the CT scan from the initial scan performed at the time of presentation to a subsequent one in the 12 hours after the initial scan. Study Design: The type of study is a prospective observational case series. Setting: At Tertiary Care Hospital in Karachi, Pakistan. Period: 3 months from June 2018 to August 2018. Materials & Methods: All patients over 18 years of age who presented to the Accident and Emergency Department of the hospital with traumatic brain injury and had a CT scan performed within four hours of the injury were included in the study. A predesigned proforma was used to note down patient findings. CT scan findings were classified as subdural hematoma (SDH), intraparenchymal contusion (IPC) extradural hematoma (EDH) and subarachnoid hemorrhage (SAH). A repeat CT scan was performed twelve hours after the initial CT scan. Data were analyzed using IBM SPSS version 20.0, mean and frequencies were calculated for continuous variables while frequencies and percentages were calculated for categorical variables. Results: Of the n= 110 patients in our study 79 were males and 31 were female, the mean age of the patients was 34.25 years. The Glasgow Coma Scale scores at the time of arrival were between thirteen and fifteen for n= 33 (30%) of the patients, between nine and twelve for n= 54 (49.09%) of the patients, less than and equal to eight for n= 23 (20.90%) of the patients. Subarachnoid hemorrhage was present in n= 32 (29.09%) patients, intraparenchymal hematoma was present in n= 42 (38.18%) of the patients, while subdural hematoma and epidural hematoma was present in n= 14 (12.72%) and n= 22 (20%) of the patients respectively. Progressive hemorrhagic injury was found in n= 66 (60%) of the patients, while in n= 11 (10%) of the patients there was resolution of the lesion and n= 33 (33%) of the patients showed no observable changes in the repeat CT scan. Finally, our results indicate that of the 110 patients in our study PHI was seen in n= 17 (53.12%) patients with SAH, n= 18 (81.81%) patients of EDH, n= 5 (35.71%) patients of SDH and n= 26 (61.90%) patients of IPC respectively. Conclusion: According to the results of our study PHI is observed in 60% of the patients with a traumatic brain injury observed within the initial 12 hours after injury, and epidural hematoma and intraparenchymal contusions had the highest incidences of PHI among all the different types of traumatic brain injuries.


2019 ◽  
pp. 1-2
Author(s):  
Meghna Kinjalk ◽  
Dilraj Kadlas* ◽  
Pooja Agarwal

The morbidity and quality of life after head injury is long and devastating.The symptoms may persist for lifetime and if not, then can be long enough to affect a person's health/the working conditions and definitely the monetary factor for coping up with this comes into a larger picture.It is also one of the leading causes of lifelong disability or death worldwide.The presentation may vary between a conscious patient on arrival to the emergency room to a person with seizures,ear bleed or drowsiness.The various types of presentation go hand in hand with different types of head injury, its management,prognosis and long-term impact on a person's life.Despite various studies and appropriate guidelines, the morbidity after head injury remains high.This study has a purpose to correlate various presentations of head injury, the epidemiology of head injury,types of head injury and its management options in a tertiary acre hospital. OBJECTIVES: a. To study the demographic profile and gender distribution of patients presenting to emergency room in a tertiary care hospital in western India. b. To study the mode and type of head injury,Imaging finding and its management. METHODOLOGY: It was a prospective study of consecutive 200 patients presenting to a tertiary care hospital: Mahatma Gandhi Mission's Medical college and hospital,Kamothe,Navi Mumbai.Institute Ethical committee approval was obtained before the start of study. All the age group was included. There were no exclusion criteria. Result was tabulated and analysed at the end of the study. RESULT:This study enrolled 200 patients in which male were more common than female,young adults more commonly affected.Majority of patients were treated conservatively and improved. CONCLUSION: The most common cause of traumatic brain injury is road traffic accident and relating it with the most common age group ,brings us to the conclusion of importance of safety measures on road amongst young adults.Hence , preventing the wrath of morbidity associated with the debilitating head injury.This also helps in improving the quality of life of the patient and the care giver


Neurosurgery ◽  
2018 ◽  
Vol 84 (1) ◽  
pp. 95-103 ◽  
Author(s):  
Silvia D Vaca ◽  
Benjamin J Kuo ◽  
Joao Ricardo Nickenig Vissoci ◽  
Catherine A Staton ◽  
Linda W Xu ◽  
...  

2021 ◽  
Vol 10 (10) ◽  
pp. 711-714
Author(s):  
Khongbantabam Vyas ◽  
Khaidem Mani Singh

BACKGROUND Cranioplasty although a simple elective neurosurgical procedure is burdened by considerable morbidity. The timing of doing cranioplasty and a good outcome remains a topic of much debate. We wanted to compare the outcome of doing cranioplasty within (early) and beyond (late) 2 months after decompressive craniectomy for traumatic brain injury. METHODS The study was carried out in a tertiary care hospital. A 5-year retrospective study of patient records was analysed. Consecutive series of traumatic brain injury patients who underwent cranioplasty after decompressive craniectomy from a tertiary care hospital operated by a single neurosurgeon, were studied. Data was analysed using SPSS version 21, IBM. Associations of categorical variables were compared using chisquare test and of continuous variables by using unpaired 2-tailed Student t-test. RESULTS Altogether 90 patients were identified who had undergone cranioplasty after decompressive craniectomy for traumatic brain injury and were grouped into early (within 2 months; 44 patients) and late (beyond 2 months; 46 patients). Cranioplasty operative time was significantly shorter in the early (59.39 mins) than the late (77.28 mins) with a P value of 0.001. Infection rates were significantly higher in the early (4.55 %) than late (0 %), with P value 0.144. Other complication rates were postoperative haematoma (0 % early, 2.17 % late, P = 0.325), hydrocephalus (0 % early, 6.52 % late, P = 0.085), sunken brain (0 % early, 4.35 % late, P = 0.162), and bone graft resorption (0 % early, 2.17 % late, P = 0.325). These differences were not statistically significant though. CONCLUSIONS Early cranioplasty performed within 2 months of decompressive craniectomy has better outcome in the form of reduced hospital stay, decreased cost, and fewer complications. KEY WORDS Traumatic Brain Injury, Decompressive Craniectomy, Outcome, Cranioplasty


2021 ◽  
Vol 6 (1) ◽  
pp. 1352-1357
Author(s):  
Ajay Kumar Yadav ◽  
Binit Dev ◽  
Sushil Taparia ◽  
Parvez Kumar ◽  
Rakesh Mandal ◽  
...  

Introduction: Traumatic brain injury (TBI) in patients with head trauma is common cause for emergency visits to hospital affecting all age groups. It is one of important leading cause of death and disability worldwide besides leading to neurological disease burden. Noncontrast enhanced Multidetector computed tomography (MDCT) is imaging modality of choice for detection of various intracranial lesions. Objectives: This study was done to analyse various imaging findings on MDCT in traumatic head injury patients along with association of CT findings with clinical manifestation and mechanism of injury. Methodology: In this ethically approved prospective study, CT scan was done in 224 consecutive patients with head injury from November 2020 to February 2021. The various imaging findings seen in CT scan were documented in proforma. The data collected was analyzed with appropriate statistical test and statistical significance was calculated. Results: Total of 224 patients with diagnosis of head injury were included in the study. The male to female ratio was 2.86 and most common age group involved was between 20-40years (41.1%). The most common mode of injury was road traffic accidents (57.6%) and most of the patients presented with history of altered sensorium (35.7%). About 47.3% patients showed abnormal findings on CT scan with scalp lesion was most common findings (82%) followed by skull fractures (54.7%) and cerebral contusions (43.4%). Patients with history of RTA had more abnormal CT scan (62%) than fall injury and physical assault. Statistically significant association seen between CT scan findings with Glasgow Coma Scale and RTA (P<0.05). Conclusion: The present study showed well documented role of CT scan in diagnosis of TBI besides detection of spectrum of intracranial lesions in patients with head trauma. Road traffic accident is most common mode of head injury with most of the victims are young middle age active male. 


Author(s):  
Basudev Agrawal ◽  
Rupesh Verma

Background: This study was undertaken to correlate Glasgow Coma Scale (GCS) score with Non-Contrast Computed Tomography (NCCT) findings in patients with acute traumatic brain injury (TBI) attending tertiary care Shree Narayana Hospital, Raipur, Chhattisgarh, India.Methods: A cross-sectional study was performed among 100 patients of acute traumatic head injury (those presenting to hospital within 24 hours of injury) over a period of six months. The patient’s GCS score was determined and NCCT Brain scan was performed in each case immediately (within 30 minutes) after presenting to casualty of the hospital. A 16 slice siemens Somatom CT scan was utilized and 5mm and 10mm sections were obtained for infratentorial and supratentorial parts respectively.Results: The age range of the patients was 0 to 76 years and male: female ratio was 2.85:1. Younger age group was more commonly involved, with 61% of cases seen in 11-40 years of age group. The most common causes of head injury were road traffic accident (RTA) (65%) and fall from height (25%). The distribution of patients in accordance with GCS was found to be 55% with mild TBI (GCS 12 to 14), 25% with moderate TBI (GCS 11 to 8) and 20% with severe TBI (GCS 7 or less).Conclusions: The presence of multiple lesions and midline shift on CT scan were accompanied with lower GCS, whereas patients having single lesion had more GCS level. There was significant correlation between GCS and NCCT findings in immediate post TBI.


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