Prognostic Value of Cerebral CT and MRI in Comatose Patients after Severe Traumatic Brain Injury / 中国康复理论与实践

ABSTRACT

@#Objective To evaluate the value of cerebral CT and MRI in prediction of the recovery of comatose patients after severe traumatic brain injury.Methods Cerebral CT and MRI were performed in 98 comatose patients after severe traumatic brain injury. CT and MRI were reviewed by three neuroradiologists for the number, sizes, and location of brain lesions. Three neurologists assessed the patients at admission and 1 month after injury. The correlation among the neuroimaging finding, clinical examination index and the prognosis of the patients was analyzed.Results Clinical characteristics, such as initial score on the Glasgow Coma Scale, age, and pupillary abnormalities failed to predict recovery. Cerebral CT did not predict future recovery from post-traumatic coma. The patients in persistent vegetative state(PVS) revealed a significantly higher frequency of corpus callosum, corona radiate, and dorsolateral brainstem injuries than did patients who recovered within 1 month.Conclusion Cerebral CT findings in the acute stage after head injury can not predict the outcome of the post-traumatic PVS. There is a significant association between MRI findings and PVS patients in coma with lesions in the corpus callosum, corona radiata or dorsolateral brainstem.