CORRELATION OF COMPUTERISED TOMOGRAPHY SCAN FINDINGS WITH THE LEVEL OF CONSCIOUSNESS IN ACUTE HEAD TRAUMA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 6
Abstract
BACKGROUND Trauma is one of the most common causes of death and lifelong disability in early decades of life, of which majority of cases are neurological trauma. TBI is becoming the most common and devastating problem due to exponential growth in population and increased vehicle use. Head injuries due to road traffic accidents (RTA) are the second most common cause of death, only next to cancer. The present study was observational, prospective study undertaken to evaluate the correlation between CT scan findings and level of consciousness in patients following acute craniocerebral trauma. The aim of this study is to correlate the CT scan findings and level of consciousness and to observe the outcome of the patient with single and multiple lesions. MATERIALS AND METHODS The study was conducted in Department of Neurosurgery, Krishna Medical College and Hospital. All the patients presenting to the hospital with history of head injury and admitted to Department of Neurosurgery were included as study population. Of all patients admitted with head injury and polytrauma, a careful history was collected from the patient and/or attendants to reveal the mechanism of injury and the severity of trauma. The patients were then assessed clinically to evaluate their general condition and the local injury. Glasgow coma scale, Glasgow outcome score and CT findings were evaluated. Statistical analysis- The statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21 for Windows. RESULTS It was observed that majority of patients were in the age group of 21 - 40 years (55.65%) followed by 41 - 60 years (20%). The majority of patients were males (71.43%) and females were 28.57%. Patients had higher RTA incidences (72.40%) followed by fall (22.22%) and assault (5.38%). In the clinical findings, majority of patients presented with vomiting (67.20%) followed by loss of consciousness (38.74%). The other clinical presentation includes ENT bleeding (24.46%) and convulsion (18.34%). The history of alcohol consumed was given by 23.48% of patients. It was observed that majority of patients were having abnormal CT findings (80.74%) and only 19.26% patients had normal CT findings. The most common brain lesion among patients was cerebral contusion (46.74%) followed by subdural haematoma (22.11%), inter-parenchymal haematoma (12.34%), subarachnoid haemorrhage (14.17%), skull fractures (8.06%) and midline shift (30.28%). It was observed that majority of patients had mild injury (73.72%) followed by severe type (16.34%) and moderate injury among 174 (9.94%) patients. According to outcome of brain injury, the majority of patients had good recovery (73.89%). The death was observed among 198 (11.31%) patients. It was observed that epidural haematoma, subdural haematoma, inter-parenchymal haematoma, SAH and IVH showed statistically significant relation with level of consciousness, (p < 0.05). It was observed that pneumocephaly and midline shift showed statistically significant relation with level of consciousness (p < 0.05); while cerebral contusion, skull fractures and cerebral oedema showed no statistically significant relation with level of consciousness (p > 0.05). CONCLUSION Falls were considered the most common external cause of TBI in both the youngest and the elderly. The proportion of the transport accidents was highest in young men. The majority of hospitalised patients have mild TBI. A majority of the patients had good recovery. The correlation of CT findings and level of consciousness showed statistically significant relation with the level of consciousness. CT scanning is the primary modality of choice in the diagnostic workup of patients with acute traumatic brain injury for identification of various intracranial consequences, especially within 48 hours which helps in the initial assessment, treatment planning and follow-up and long-term management of patients.
Authors and Affiliations
Vinayak Raje, Devdutta Patil, Trishant Chotai, Rahul Kumar, Shubhada Nalawade
Keywords
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- EP ID EP399030
- DOI 10.14260/jemds/2018/179
- Views 78
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