外伤性脑损伤放射挫伤进展的预测因素。

IF 1.4 Q3 EMERGENCY MEDICINE
Mehdi Shafiei, Masih Sabouri, Hossein Abdollahi Veshnavei, Donya Sheibani Tehrani
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引用次数: 0

摘要

背景:外伤性脑损伤是一种严重的疾病,主要由意外跌倒和机动车事故引起,包括从轴突到出血性损伤的一系列病理特征。其中,脑挫伤是导致受伤后死亡和残疾的重要原因,发生率高达35%。本研究旨在探讨外伤性脑损伤放射挫伤进展的预测因素。方法:对2021年3月21日至2022年3月20日发生脑挫伤的轻度外伤性脑损伤患者的档案进行回顾性横断面研究。脑损伤的严重程度由格拉斯哥昏迷评分确定。此外,与第一次相比,我们在第二次CT扫描(长达72小时)中使用挫伤大小增加30%的临界值来确定挫伤的显著进展。对于多发挫伤的患者,我们测量最大挫伤。结果:共发现705例外伤性脑损伤患者,其中轻度损伤498例,脑挫伤218例。131例(60.1%)患者在交通事故中受伤。111例(50.9%)有明显的挫伤进展。大多数患者采用保守治疗,但其中21例(10%)需要延迟手术干预。结论:我们发现硬膜下血肿、蛛网膜下腔出血和硬膜外血肿的存在是放射学挫伤进展的预测因素,硬膜下血肿和硬膜外血肿的患者更有可能接受手术治疗。除了提供预后信息外,预测挫伤进展的危险因素对于确定可能受益于手术和重症监护治疗的患者至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of radiological contusion progression in traumatic brain injury.

Background: Traumatic brain injury, mainly caused by the unintentional falls and motor vehicle accidents, is a serious condition encompassing a spectrum of pathological features from axonal to hemorrhagic injuries. Among these, cerebral contusions significantly contribute to death and disability following the injury and occur in up to 35% of cases. This study aimed to investigate the predictors of radiological contusion progression in traumatic brain injury.

Methods: We performed a retrospective cross-sectional study using the files of the patients with mild traumatic brain injury who had cerebral contusions from 21 March 2021 to 20 March 2022. The severity of brain injury was determined using the Glasgow Coma Score. Furthermore, we used a cut-off value of a 30% increase in contusion size in the secondary CT scans (up to 72 hours) compared to the first one to define the significant progression of the contusions. For the patients with multiple contusions, we measured the biggest contusion.

Results: 705 patients with traumatic brain injury were found, the severity of the injury was mild in 498 of them, and 218 had cerebral contusions. 131 (60.1%) patients were injured in vehicle accidents. 111 (50.9%) had significant contusion progression. Most patients were conservatively managed, but 21 out of them (10%) required delayed surgical intervention.

Conclusion: We found that the presence of subdural hematoma, subarachnoid hemorrhage, and epidural hematoma were predictors of radiological contusion progression, and the patients with a subdural hematoma and epidural hematoma were more likely to undergo surgery. In addition to providing prognostic information, predicting risk factors for the progression of the contusions is crucial for identifying patients who might benefit from surgical and critical care therapies.

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