Research Reports - Factors predicting early deterioration in mild brain trauma

Brain Inj. 2013 Oct 2

Seddighi AS, Motiei-Langroudi R, Sadeghian H, Moudi M, Zali A, Asheghi E, Alereza-Amiri R, Seddighi A.

Abstract Primary objective: To evaluate risk factors for clinical deterioration
in mild traumatic brain injury. Research design: Prospective cross-sectional.
Methods and procedures: This study evaluated 203 patients with mild traumatic
brain injury. A brain computed tomography scan was performed in all patients and
they were observed for 6-48 hours. Main outcomes and results: Among these
patients, 2.5% had cerebral contusions and the most common sites for contusions
were frontal lobes; 94% of patients had no hematoma in the initial scan, while 3%
had subgaleal haematoma, 1.5% had subdural haematoma, 1% showed subarachnoid
haemorrhage, 0.5% intracerebral haemorrhage and 0.5% epidural haemorrhage. GCS
was 15 in 96.6% and 13-14 in 3.4%. GCS deteriorated in three (1.5%). Presence of
coagulopathy, anticoagulant drug use, GCS of 13-14 and increased age predicted
further deterioration. Among CT findings, those with midline shift, cerebral
contusion and diffuse cerebral oedema deteriorated more. Among different
haematoma types, only SDH predicted a worse outcome. Conclusions: Although
deterioration rarely occurs in patients with mild brain injury, those with
coagulopathy, anticoagulant drug use, GCS of 13-14, increased age, midline shift,
cerebral contusions, diffuse cerebral oedema and SDH were more prone to
deterioration.

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