| Admission perfusion CT: prognostic value in patients with severe head trauma. | |
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MedLine Citation:
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PMID: 15220504 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To assess the prognostic value of admission perfusion computed tomography (CT) in patients with severe head trauma. MATERIALS AND METHODS: This prospective study included 130 patients with severe trauma, aged 19-86 years, admitted with a Glasgow Coma Scale score of 8 or less. They underwent perfusion CT as part of their admission CT survey. Clinical data, unenhanced cerebral CT findings, and perfusion CT scans were evaluated with respect to the Glasgow Outcome Scale (GOS) score at 3 months. Perfusion CT features were evaluated in patients with intracranial hypertension, cerebral contusions, and juxtadural hematomas. Ordered logistic regression was used to determine risk factors for an unfavorable GOS score at 3 months. RESULTS: Perfusion CT was more sensitive than conventional unenhanced CT in the detection of cerebral contusions. Perfusion CT featured specific patterns with respect to patient outcome, with normal brain perfusion or hyperemia in patients with favorable outcome, and oligemia in patients with unfavorable outcome. The number of arterial territories with low regional cerebral blood volume at perfusion CT was an independent prognostic factor (P =.008), as were mean arterial pressure at the scene of accident (P =.083), base excess at admission (P =.002), presence of skull fractures (P =.041), and signs of herniation (P =.013) at admission unenhanced cerebral CT. Perfusion CT also showed a range of brain perfusion alterations in patients with juxtadural collections, cerebral edema, or intracranial hypertension. CONCLUSION: Perfusion CT in patients with severe head trauma provides independent prognostic information regarding functional outcome. |
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Authors:
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Max Wintermark; Guy van Melle; Pierre Schnyder; Jean-Pierre Revelly; François Porchet; Luca Regli; Reto Meuli; Philippe Maeder; René Chioléro |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Radiology Volume: 232 ISSN: 0033-8419 ISO Abbreviation: Radiology Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-06-28 Completed Date: 2004-07-29 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0401260 Medline TA: Radiology Country: United States |
Other Details:
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Languages: eng Pagination: 211-20 Citation Subset: AIM; IM |
Copyright Information:
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Copyright RSNA, 2004 |
Affiliation:
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Department of Diagnostic and Interventional Radiology, Surgical Intensive Care Unit, University Hospital, 1011 Lausanne, Switzerland. max_wintermark@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Blood Volume Brain / radiography* Brain Edema / etiology Brain Injuries / complications, radiography* Cerebrovascular Circulation* Contrast Media Emergency Service, Hospital Encephalocele / etiology Female Glasgow Coma Scale Hematoma, Epidural, Cranial / etiology, radiography Humans Intracranial Hypertension / etiology Iohexol / diagnostic use Logistic Models Male Middle Aged Prognosis Sensitivity and Specificity Skull Fractures / complications Tomography, X-Ray Computed* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 66108-95-0/Iohexol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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