Role of Computerized Tomography as Prime Imaging Modality in the Evaluation of Traumatic Brain Injury

2017 ◽  
Vol 2 (1) ◽  
pp. 17-23
Author(s):  
Sagar Tyagi ◽  
Atul Mehrotra ◽  
Pradeep Parakh ◽  
Parveen Hans
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Computerized Tomography ◽  
Multidetector Ct ◽  
Imaging Modality ◽  
Craniocerebral Trauma ◽  
Traumatic Head Injury

ABSTRACT Introduction Trauma is the most common worldwide cause of death and disability in young adults. Neurotrauma is one of the most frequent indications for emergent neuroimaging because imaging plays such a key role in patient triage and management. Aims and objectives (1) To assess the role of computed tomography (CT) in patients with traumatic head injury. (2) To localize trauma to a particular extraaxial and intraaxial compartment and to delineate various spectrum of hemorrhages that occur in craniocerebral trauma with the aid of CT. (3) To evaluate the value of early CT imaging with patient prognosis. Materials and methods This is a prospective study carried out in 100 patients with traumatic brain injury, referred to the Department of Radiodiagnosis, Rohilkhand Medical College & Hospital, Bareilly, Uttar Pradesh, India, for CT scan during a period of 1 year. The patients were scanned using GE Bright Speed 16-Slice multidetector CT. Conclusion Computed tomography is the single-most informative diagnostic modality in the evaluation of a patient with a head injury and should be considered the first imaging of choice in acute head injury as it forms the cornerstone for rapid and effective diagnosis. How to cite this article Hans P, Mehrotra A, Kumar P, Agarwal M, Kumar L, Parakh P, Tyagi S. Role of Computerized Tomography as Prime Imaging Modality in the Evaluation of Traumatic Brain Injury. Int J Adv Integ Med Sci 2017;2(1):17-23.

scholarly journals DIAGNOSIS AND MANAGEMENT OF COMPUTED TOMOGRAPHY IN HEAD INJURY

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Dr. Dileep Kumar Jha ◽  
Dr. Rajnikant Narsinhbhai Chauhan
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Head Trauma ◽  
Severe Head Injury ◽  
Mild Head Injury ◽  
Age Group ◽  
Ct Findings ◽  
Craniocerebral Injuries

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)

Complications of head injury

2019 ◽  
pp. 521-530
Author(s):  
Fardad T. Afshari ◽  
Antonio Belli ◽  
Peter C Whitfield
Keyword(s):  
Traumatic Brain Injury ◽  
Young Adults ◽  
Brain Injury ◽  
Head Injury ◽  
Older People ◽  
Late Phase ◽  
Late Complications ◽  
Neuronal Tissue

Traumatic brain injury is a potentially devastating condition that affects many young adults and is increasingly seen in older people. In addition to initial insult to the neuronal tissue at the time injury, patients with traumatic brain injury may suffer from many physical and psychological complications. These complications further protract the path of recovery and pose challenges in treatment of this group of patients. In this chapter we aim to discuss early and late phase complications following traumatic brain injury and summarize the role of neurorehabilitation in the care of patients with head injury, with the understanding that classification by timing is an inexact science and there is considerable overlap between early and late complications.

Neutrophil to lymphocyte ratio as a predictive biomarker for computed tomography scan use in mild traumatic brain injury

2020 ◽  
Vol 14 (12) ◽  
pp. 1085-1090
Author(s):  
George A Alexiou ◽  
Georgios D Lianos ◽  
Aggeliki Tzima ◽  
Athanasios Sotiropoulos ◽  
Anastasios Nasios ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Characteristic Curve ◽  
Predictive Biomarker ◽  
Health Concern ◽  
Mild Tbi ◽  
Ct Findings ◽  
The Mean

Aim: Traumatic brain injury (TBI) is a serious health concern. We set out to investigate the role of neutrophil-to-lymphocytes ratio (NLR) at admission for predicting the need for computed tomography (CT) in mild-TBI. Materials & methods: A retrospective study of adult patients who presented with mild-TBI Results: One hundred and thirty patients met the inclusion criteria. Seventy-four patients had positive CT-findings. The mean NLR-levels at presentations were 5.6 ± 4.8. Patients with positive CT-findings had significant higher NLR-levels. Receiver operating characteristic curve analysis was conducted and the threshold of NLR-levels for detecting the cases with positive CT-findings was 2.5, with 78.1% sensitivity and 63% specificity Conclusion: To the best of our knowledge no previous study has assessed the value of NLR-levels for predicting the need for CT in mild-TBI.

Neuropsychiatric Sequelae of Stroke and Traumatic Brain Injury: The Role of Psychostimulants

1995 ◽  
Vol 25 (1) ◽  
pp. 39-51 ◽  
Author(s):  
Marilyn F. Kraus
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Case Studies ◽  
Current Literature ◽  
Treatment Choice ◽  
Clinical Usefulness ◽  
Cognitive Symptoms ◽  
General Review

Objective: The primary purpose of this article is to review certain neuropsychiatric sequelae of stroke and traumatic brain injury (TBI), and the role of the psychostimulants methylphenidate (MPD) and dextroamphetamine (DAMP) in their treatment. Method: A general review of the topic is presented. Controlled and uncontrolled studies involving the use of the psychostimulants are discussed. These consist of 11 studies listed with Medline 2000 that deal specifically with stroke or head injury, with the oldest study reviewed dating back to 1984. Studies concerning the use of psychostimulants in the medically or neurologically ill are reviewed to the extent that they are pertinent. Results: The current literature consists primarily of uncontrolled case studies. However, these are reviewed and found to suggest a role for the use of the psychostimulants, which is discussed. Conclusions: In general, these drugs appear to be a reasonable treatment choice for certain types of mood, behavior, and cognitive symptoms following brain injury. However, it is noted that larger scale controlled studies are needed to adequately assess the clinical usefulness of these drugs.

Multidetector Computed Tomography (MDCT) Evaluation of Traumatic Brain Injury in Head Trauma Patients in Tertiary Hospital of Eastern Region of Nepal

2021 ◽  
Vol 6 (1) ◽  
pp. 1352-1357
Author(s):  
Ajay Kumar Yadav ◽  
Binit Dev ◽  
Sushil Taparia ◽  
Parvez Kumar ◽  
Rakesh Mandal ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Ct Scan ◽  
Head Trauma ◽  
Road Traffic ◽  
Imaging Findings ◽  
Intracranial Lesions ◽  
History Of

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. 

Pediatric Minor Head Injury and Concussion

2018 ◽  
Author(s):  
Chad Scarboro ◽  
Simone Lawson
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Mild Traumatic Brain Injury ◽  
Head Injuries ◽  
Normal Activity ◽  
Secondary Brain Injury ◽  
Wide Range ◽  
Serious Injuries

Head injury is one of the most common reasons children present to the emergency department (ED) and the leading cause of pediatric death and disability. Head injuries can range from having no neurologic deficits to death. Management in the ED centers on determining if there is a serious brain injury and preventing secondary brain injury. In most cases of mild traumatic brain injury, serious injuries can be ruled out based on the history of the injury, associated symptoms, and clinical assessment. Concussion is a common presentation of head injury and encompasses a wide range of symptoms. Computed tomography should be used judiciously, and extensive research has led to algorithms to aid in this decision. Prior to discharge from the ED, parents will often have questions about when their child may resume normal activity. This is a decision that most often will involve the patient’s primary care provider or a concussion specialist as the ED provider is unable to follow progression or resolution of symptoms. However, the ED provider should be able to provide anticipatory guidance.   Key words: computed tomography, concussion, head injury, mild traumatic brain injury, traumatic brain injury

scholarly journals Correlation of Glasgow Coma Scale with Non-Contrast Computed Tomography findings in immediate post traumatic brain injury

2019 ◽  
Vol 7 (4) ◽  
pp. 1059
Author(s):  
Basudev Agrawal ◽  
Rupesh Verma
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Glasgow Coma Scale ◽  
Ct Scan ◽  
Age Group ◽  
Female Ratio ◽  
Coma Scale ◽  
Gcs Score

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.

scholarly journals Application and Limitations of Hypothermia Therapy for Traumatic Brain Injury(Traumatic Head Injury Update)

2011 ◽  
Vol 20 (12) ◽  
pp. 873-879
Author(s):  
Eiichi Suehiro ◽  
Hirosuke Fujisawa ◽  
Hiroyasu Koizumi ◽  
Hiroshi Yoneda ◽  
Hideyuki Ishihara ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Special Issue ◽  
Traumatic Head Injury ◽  
Traumatic Head

scholarly journals TP9.1.2We must do better - An audit assessing local compliance with NICE Guidelines (2014) on giving patient discharge advice regarding driving following traumatic brain injury

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Tarak Chouari ◽  
Hamza Khan ◽  
Umar Wali ◽  
Arun Shanmuganandan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Patient Discharge ◽  
Complex Activity ◽  
Traumatic Head Injury ◽  
Safe Driving ◽  
Nice Guidelines ◽  
Local Compliance ◽  
Patient Advice

Abstract Introduction Driving is a complex activity involving the coordination of a number of cognitive and physical skills, which may be impaired after head injury. It is a legal requirement that patients’ inform the licensing authority when they have sustained a head injury. Failure to do so results in possible fines, invalid insurance and prosecution. NICE recommends printed patient advice about driving once discharged following a head injury. Methods A retrospective analysis of all traumatic brain injury admissions under the surgical team over a 6 months was performed. The aim was to identify current practice regarding assisting patients to return to safe driving after head injury. Information related to patient demographics, documented driving status and advice (verbal and written) related to driving, was sought. Descriptive statistics were used to portray the results. Results 56 patients were admitted following a traumatic head injury. The average age was 77 (range of 24 to 94) Patients spent on average 4 days in hospital. Only 2 patients had their driving status documented. These two patients also had a documented occupation dependent on driving. No patients received advice specific to DVLA guidelines. Conclusion This study demonstrates that there is poor compliance with NICE guidelines. Indeed, there is a need for change in our practice. We have a duty of care for our patients and in ensuring the safety of the general public. The main limitation of this study relates to the adequacy of documentation. We provide solutions in order to tackle the findings of this audit.

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