Predictors of Outcome in Patients with Post-Traumatic Brain Contusion | ||||
Zagazig University Medical Journal | ||||
Article 24, Volume 28, Issue 4, July 2022, Page 805-814 PDF (611 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/zumj.2021.79026.2249 | ||||
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Authors | ||||
Ashraf El Desouky zaghloul ![]() | ||||
1Neurosurgery Department , Benha Faculty of Medicine, Benha University ,Egypt | ||||
2Department of Neurosurgery , Benha faculty of Medicine, Benha uUniversity , Benha city , Egypt | ||||
3Department of General Surgery, Benha faculty of Medicine, benha university, Benha City, Egypt | ||||
4Department of neurosurgery, Benha faculty of medicine, Benha University , Benha city , Egypt | ||||
Abstract | ||||
ABSTRACT Background: Traumatic brain injury is the leading cause of mortality, morbidity and disabilities in children and young adults. Aim is to evaluate the factors that may predict outcome of post-traumatic brain contusion. Patients and Methods: A prospective study, where 50 patients with traumatic brain contusion categorized into 2 groups. Group A treated conservatively and Group B treated surgically. on admission GCS recorded then initial CT brain done. In group A, CT brain again redone after 24 hours and when indicated. In group B we did post-operative CT before discharge. patients followed up for 3 months. Glasgow outcome scale (GOS) used to assess functional outcome. Results: 46 patients included, group A (n=21) and group B (n=25). In group A, mean initial GCS score was 12.95 ± 2.18. Average midline shift in initial CT was 0.19 ± 0.51 mm. In group B, mean initial GCS score was 10.24 ± 2.18. Average initial midline shift was 3.96±1.62 mm while after 2nd CT was 6.40±1.35 mm. At 3 months follow up, average GOS was 4.2 ± 1.1 for group A, and 4.19 ± 1.12 for Group B. Conclusion: in those patients, initial GCS, radiological findings (initial and follow up midline shifts, initial and follow up brain contusion volumes) and mechanism of trauma are the most important predictors of functional outcome and duration of hospital stay. A combination of clinical deterioration with increased midline shift and/or increased volume of brain contusion are the most reasonable indications for surgical intervention in such patients. | ||||
Keywords | ||||
Traumatic brain contusion; Glasgow coma scale; Glasgow outcome scale | ||||
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