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 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 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 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 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 Significance of time from injury to surgery in the functional recovery of individuals with traumatic acute subdural hematoma

2019 ◽  
Author(s):  
Shih-Han Chen ◽  
Jui-Ming Sun ◽  
Wen-Kuei Fang
Keyword(s):  
Ct Scan ◽  
Scale Score ◽  
Functional Recovery ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Midline Shift ◽  
Coma Scale ◽  
Poor Recovery ◽  
Recovery Group ◽  
Time From Injury

Abstract Background: The time from injury to surgery (TIS) is critical in the functional recovery of individuals with traumatic acute subdural hematoma (TASDH). However, only few studies have confirmed such notion.Methods: The data of TASDH patients who were surgically treated in Chia-Yi Christian Hospital between January 2008 and December 2015 were collected. The significance of variables, including age, sex, traumatic mechanism, coma scale, midline shift on brain computed tomography (CT) scan, and TIS, in functional recovery was assessed using the student’s t -test, chi-square test, univariate and multivariate models, and receiver operating characteristic (ROC) curve.Results: A total of 37 patients achieved functional recovery (outcome scale score of 4 or 5) and 33 patients had poor recovery (outcome scale score of 1–3) after at least 1 year of follow-up. No significant difference was observed in terms of age, sex, coma scale score, traumatic mechanism, or midline shift on brain CT scan between the functional and poor recovery groups. TIS was found to be significantly shorter in the functional recovery group than in the poor recovery group (145.5±27.0 vs. 181.9±54.5, P-value=0.001). TIS and midline shift ≥10 mm were significant factors for functional outcomes in the multivariate regression models. The analysis of TIS with the ROC curve between these two groups showed that the threshold time for functional recovery in comatose patients and those with TASDH who were surgically treated was 2 hours and 57.5 minutes.Conclusions: TIS is crucial for the functional recovery of TASDH patients who underwent surgery.

scholarly journals Correlation of Computed Tomography findings with Glasgow Coma Scale in patients with acute traumatic brain injury

2015 ◽  
Vol 10 (2) ◽  
pp. 4-9
Author(s):  
SK Sah ◽  
ND Subedi ◽  
K Poudel ◽  
M Mallik
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Ct Scan ◽  
Midline Shift ◽  
Female Ratio ◽  
Coma Scale ◽  
Acute Traumatic Brain Injury ◽  
Gcs Score

OBJECTIVE To correlate Computed Tomography (CT) findings with Glasgow Coma Scale (GCS) in patients with acute traumatic brain injury attending in Chitwan Medical College teaching hospital Chitwan, Nepal.MATERIALS AND METHODS A cross-sectional study was performed among 50 patients of acute (less than24 hours) cases of craniocerebral trauma over a period of four months. The patient’s level of consciousness (GCS) was determined and a brain CT scan without contrast media was performed. A sixth generation General Electric (GE) CT scan was utilized and 5mm and 10mm sections were obtained for infratentorial and supratentorial parts respectively.RESULT The age range of the patients was 1 to 75 years (mean age 35.6± 21.516 years) and male: female ratio was 3.1:1. The most common causes of head injury were road traffic accident (RTA) (60%), fall injury (20%), physical assault (12%) and pedestrian injuries (8%). The distribution of patients in accordance with consciousness level was found to be 54% with mild TBI (GCS score 12 to 14), 28% with moderate TBI (GCS score 11 to 8) and 18% with severe TBI (GCS score less than 7). The presence of mixed lesions and midline shift regardless of the underlying lesion on CT scan was accompanied by lower GCS.CONCLUSION The presence of mixed lesions and midline shift regardless of the underlying lesion on CT scan were accompanied with lower GCS. Patients having single lesion had more GCS level than mixed level and mid line shift type of injury.Journal of College of Medical Sciences-Nepal, 2014, Vol.10(2); 4-9

scholarly journals Application of PECARN rules would significantly decrease CT rates in a Dutch cohort of children with minor traumatic head injuries

2020 ◽  
Vol 179 (10) ◽  
pp. 1597-1602
Author(s):  
Nicky Niele ◽  
Marlies van Houten ◽  
Ellen Tromp ◽  
J.B. van Goudoever ◽  
Frans B. Plötz
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Clinical Decision ◽  
Research Network ◽  
Ct Scans ◽  
Lower Percentage ◽  
National Guidelines ◽  
Traumatic Head Injury ◽  
Traumatic Head ◽  
Dutch Cohort

Abstract The aim of this study was to determine the potential impact of the Pediatric Emergency Care Applied Research Network (PECARN) rules on the CT rate in a large paediatric minor traumatic head injury (MTHI) cohort and compare this with current national Dutch guidelines. This was a planned sub-study of a prospective multicentre observational study that enrolled 1006 children younger than 18 years with MTHI. We calculated the number of recommended CT scans and described trauma-related CT scan abnormalities. The PECARN rules recommended a significantly lower percentage of CT scans in all age categories, namely 101/357 (28.3%) versus 164/357 (45.9%) (p < 0.001) in patients under 2 years of age and 148/623 (23.8%) versus 394/623 (63.2%) (p < 0,001) versus in patients 2 years and older. Conclusion: The projected CT rate can significantly be reduced if the PECARN rules are applied. We therefore advocate that the PECARN guidelines are also implemented in The Netherlands. What is Known:• To guide clinicians whether to perform a CT scan in children with a minor traumatic head injury (MTHI) clinical decision rules has been developed.• The overall CT scan rate in adherence with the Dutch MTHI guidelines is 44%. What is New:• The projected CT rate can significantly be reduced in a Dutch cohort of MTHI if the PECARN rules are applied.• The Dutch national guidelines for MTHI can safely be replaced by the PECARN rules.

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