Initial Evaluation of Patients with Head Injury using CT Brain Perfusion Imaging in the Emergency Room: Two Cases

ABSTRACT

Acute subdural hematoma (SDH) is a neurological trauma that can lead to death or life-long disability of the patient. It is usually diagnosed by examination of the patient's brain computed tomography (CT) images. While macroscopic change in the posttraumatic brain can be identified using this mode of diagnosis, visualization of abnormal change in cerebral blood flow and the resulting brain damage following a head injury is often difficult. The two patients studied in this case report were similar in terms of thickness and volume of subdural hematoma and severity of midline shift. However, their perfusion parameters were markedly different and so were their outcomes. According to findings of our study, with its perfusion parameters, CT brain perfusion imaging is a practical tool for use in initial evaluation of patients with traumatic brain injury and for prediction of the clinical prognosis. Subsequently, we may use the information for help in planning of treatment and in preparation for post-operative complication based on the severity of brain damage.