Varela HA, Tamakloe K, Paucar CIJ, Silva AS, Medrano GR

Language: Spanish
References: 17
Page: 531-543
PDF size: 185.27 Kb.

ABSTRACT

Background: the carrying out of the structural imaging study of the brain through a sequential computerized tomography of brain is an established practice although it is conducted in a heterogeneous way in different contexts since there does not exist all the evidence necessary to set the standards.
Objective: to determine the predictive factors of significant tomographic change in patients with cranioencephalic traumatism.
Method: a quasiexperimental study was conducted with all the cranialinjured patients who had been studied at least twice during the same hospitalization period through a computerized tomography of brain. The systematization of the orders of the sequential tomography, its application, and afterwards the evaluation of the behavior of the variables through an exploratory statistic, the X2 test, ANOVA, and logistic regression, were made.
Results: eightyfour patients were studied and the 16.7 % of the sample showed significant tomographic changes in the sequential studies. The patients group that presented persistent symptoms with initial Marshall III or IV was more related to these changes. The main variables involved in the prognosis were the highspeed mechanisms in the appearance of the traumatism, the persistent symptoms, and the initial Rotterdam score.
Conclusions: when applying the protocol for the carrying out of the sequential computerized tomography of brain in these patients it is really important to take into consideration the persistence of the symptoms of the patients, the increase of the Rotterdam score in the initial tomography, and if the mechanism of appearance was a highspeed one or not.

REFERENCES

1. Lee H, Wintermark M, Gean DA, Ghajar J, Manley TG, Mukherjee P. Focal Lesions in Acute Mild Traumatic Brain Injury and Neurocognitive Outcome: CT versus 3T MRI. J Neurotrauma. 2008;25(9):104956.

2. Holli KK, Harrison L, Dastidar P, Waljas M, Liimatainen S, Luukkaala T, et al. Texture analysis of MR images of Patients with Mild Traumatic Brain Injury. BMC Med Imaging. 2010;10:817.

3. Govinal V, Gold S, Kaliannan K, Saigal G, Falcone S, Arheart L K, et al. WholeBrain Proton MR Spectroscopic Imaging of MildtoModerated Traumatic Brain Injury and Correlation with Neuropsichological Deficits. J Neurotrauma. 2010;27(3):48396.

4. Haacke ME, Duhaime ChA, Gean DA, Riedy G, Wintermark M, Mukherjee P, et al. Common Data Elements in Radiologic Imaging of Traumatic Brain Injury. J Magn Reson Imaging. 2010;32(3):52143.

5. Manolakaki D, Velmahos GC, Spaniolas K, de Moya M, Alam HB. Early Magnetic Resonance Imaging is Unnecessary in Patients with Traumatic Brain Injury. J Trauma. 2009;66(4):10124.

6. Robertson C, RangelCostilla L. Critical Care Management of Traumatic Brain Management. En: Winn H R, editor. Youmans Neurological Surgery. Philadelphia: Saunders; 2012. p. 3397423.

7. Yadav Y, Basoor A, Jain G, Nelson A. Expanding traumatic intracerebral contusions/hematomas. Neurology India. 2006;54(4):37781.

8. Le HT, Gean DA. Imaging of Traumatic Brain Injury. En: Winn HR, editor. Youmans Neurological Surgery. Philadelphia: Saunders; 2012. p. 334261.

9. Saatman EK, Duhaime ChA, Bullock R, Maas IRA, Valadka A, Monley TG. Classification of Traumatic Brain injury for Targeted Therapies. J Neurotrauma. 2008;25(7):71938.

10. Kim JJ, Gean DA. Imaging for the Diagnosis and Management of Traumatic Brain Injury. Neurotherapeutics. 2011;8(1):3953.

11. Ohaegbulam CS, Mezue CW, Ndubuisi AC, Erechkwu AU, Ani OC. Cranial Computed Tomographic Findings in Head Trauma Patients in Enugu, Nigeria. Sur Neurol Int. 2011;2:18292.

12. VarelaHernández A, PaucarCalderón JI, Tamakloe K, SilvaAdán S, MedranoGarcía R. Evolución tomográfica de los pacientes con trumatismos craneoencefálicos. Rev Cubana Neurol Neurocir. 2013;3(1):4450.

13. Velmahos CG, Gervasini A, Petrovick L, Dorer JD, Doran EM, Spaniolas K, et al. Rutine repite CT for minimal head injury is unnecessary. J Trauma. 2006;60(3):494501.

14. Compagnone C, de Avella D, Servadei F, Angileri FF, Brambilla G, Conti C, et al. Patients with moderate head injury: A prospective multicenter study of 315 patients. Neurosurg. 2009;64(4):69097.

15. Oertel M, Kelly F D, McArthur D, Boscardin J W, Glenn C T, Lee H J, et al. Progressive Hemorrhage after Head Trauma: Predictors and consequences of the evolving injury. J Neurosurg. 2002;96(1):10916.

16. Lobato DR, Alen FJ, PérezNúñez A, Alday R, Gómez AP, Pascual B, et al. Utilidad de la TAC secuencial y la monitorización de la presión intracraneal para detectar nuevo efecto de masa intracraneal en pacientes con traumatismo craneal grave y lesión inicial tipo III. Neurocirugía. 2005;16(3):21734.

17. Maas AIR, Hukkelhoven Ch WPM, Marshall LF, Steyerberg EW. Prediction of Outcome in Traumatic Brain Injury with Computed Tomographic Characteristics: A Comparison between the Computed Tomographic Classification and Combinations of Computed Tomographic Predictors. Neurosurg. 2005;57(6):117382.