The Significance of Type of Intracranial Lesion on Outcome from Coup and Contre-coup Contusional Brain Injuries: Computerized Tomographic Scanning Study.

Hong, Soon Ki; Kim, Hun Joo; Pyen, Jin Soo; Ju, Chul; Kim, Soo Il; Han, Yong Pyo

Original Article

Journal of Korean Neurosurgical Society 1987;16(1): 5-12.

Soon Ki Hong, Hun Joo Kim, Jin Soo Pyen, Chul Ju, Soo Il Kim, Yong Pyo Han

Department of Neurosurgery, Yonsei University, Wonju College of Medicine, Wonju, Korea.

ABSTRACT

Serial computed tomography(CT) was done on 168 patients suffering from craniocerebral trauma. The type of initial intracranial lesion in response to primary impact site was evaluated with special reference to the initial Glasgow Coma Scale(GCS), the number of specific CT findings on GCS outcome, and the skull fracture on resultant pathological findings. The development of delayed intracranial lesion, both intra - and extra - dural, was examined by comparing the intial scan with follow-up studies. The conclusions are as follows : 1) The initial GCS has a close relationship to outcome. 2) Initial CT findings(intraventricular hemorrhage, subdural hematoma, cerebral swelling, and subarachnoid hemorrhage) appear to be closely associated with poor outcome. 3) The more the number of intial pathological findings, the poorer the outcome. 4) The CT findings with skull fracture cause much more pathology than those without skull fracture. 5) The frontal lobe is shown to be the most vulnerable contusional site. 6) Delayed traumatic intracerebral hematoma, cerebral edema and cerebral inforction as new lesions encountered on subsequent CT scan have a bad outcome. We conclude that initial and follow-up scan help predict the outcome of patient with craniocerebral trauma, and may be very important in their examination and management.

Key Words: Craniocerebral trauma; Follow-up computed tomography; Glasgow coma scale; Glasgow coma scale outcome