Early Prognostic Evaluation with C-T Scan in Cerebral Contusion

ABSTRACT

The cerebral contusion(necrotic brain tissue infiltrated with blood) is common post-traumatic lesion, In 851 consecutive C-T scan performed by 48 hours from injury, the contusion were present in 193(22.%) of the case. Comparing the midline shift, area, number, size of the lesions and their etiopathogenesis with the clinical course(assessed by Glasgow coma scale), it is possible to evaluate the early prognosis. The patient who showed 1) midline shift over 15mm, 2) the contusional lesion in basal ganglia, brain stem or corpus callosum, 3) multiple or large sized lesion took poor prognosis. Cortical contusion especially in the frontal region had relatively good prognosis. The pathogenetic mechanisms(angular acceleration of the brain) is the same in basal ganglia, brain stem and corpus callosum, but a direct impact of the In conclusion, the etiopathogenetic mechanism and consequent site of the cerebral contusion are the most important factors on the evaluation of the severity of the brain damage and their prognosis.