Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Traumatic brain injury (TBI) contribute to a significant mortality and substantial morbidity. CT is
essential for identifying lesions requiring urgent intervention & those that require observation and
non surgical management .
OBJECTIVE:
To assess the prevalence of CT findings with respect to the severity of TBI & to find out the
relation between the age of the patient & the severity of TBI.
PATIENTS AND METHODS:
100 patients with TBI evaluated by brain CT. All age groups with Glasgow coma scale (GCS) of
less than 15 were included.The abnormal CT findings were evaluated & recorded. The findings were
further correlated with the patient`s age & the GCS score
RESULTS:
Eighty percent of the cases had mild TBI, 6% had moderate TBI and 14% had severe TBI. Ninety
three percent had closed type of injury . Twenty four percent of the patients had normal CT scan ,
all of them had mild TBI . The most common CT findings in mild TBI cases were subgalial
haematoma(SGH) & calvarial skull fracture, with minority of cases had cerebral contusion , fracture
base of skull , diffuse cerebral oedema & intracranial haemorrhage . Two third of patients with
moderate TBI had subarachnoid haemorrhage(SAH) & cerebral contusion, 50% had diffuse
cerebral oedema, calvarial skull fracture,& 1/3 had Subdural haematoma & fracture base of skull.
More than half of patients with severe TBI had calvarial skull fracture, fracture base of skull,
cerebral contusion, SAH, with lower prevalence of diffuse cerebral oedema,and intracranial
haemorrhage.
CONCLUSION:
The lower the GCS score, the more significant CT findings,predominantly fracture base of skull,
subarachnoid haemorrhage and diffuse cerebral oedema.
KEY WORDS: traumatic brain injury, computed tomography, glasgow coma scale.