DOI: http://dx.doi.org/10.18203/2349-2902.isj20195118

Outcome of cerebral contusion in mild traumatic head injury patients

Jagadish B. Hedawoo, Maheshkumar S. Soni

Abstract


Background: Mild traumatic head injury is classified as one with Glasgow coma scale (GCS) score between 13 and 15. The aim of the study was to find underlying cause of deterioration of mild traumatic brain injury (TBI) and its association with other factors like bony injury.

Methods: A prospective observational study at a tertiary centre with patients admitted for mild TBI with GCS 13-15 were followed up in ward and reviewed after every 6 hours interval, those who deteriorated repeat computed tomography (CT) scan was done for further diagnosis and intervention.

Results: Determining the level of deterioration after 24 hours observation following mild TBI, 268 (63.4%) of the admitted patients were discharged home after 24 hours of observation, 89 (20.7%) needed more observation while 63 (14.8%) deteriorated and 3 (0.7%) died. As the GCS on admission was decreasing; deterioration increased i.e., 12.7%, 16.7% and 33.3% for GCS of 15, 14 and 13 respectively. Likewise, as the GCS increased, recovery improved. Subdural haematoma (39.7%) was the leading cause of deterioration while (13.8%) despite their deterioration, CT brain did not reveal any abnormality.

Conclusions: Patients presenting with mild TBI (i.e., GCS- 13-15) secondary to high velocity/energy trauma i.e., road traffic accidents have to be carefully observed for at least 24-48 hours post-trauma as the chances for neurological deterioration are significant especially in polytrauma patients. The most cause for deterioration is subdural haemorrhage among others, has to be investigated so appropriate management for the same can be instituted as soon as possible. 


Keywords


Traumatic brain injury, GCS, Polytrauma

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