Document Detail


Computed tomographic brain density measurement as a predictor of elevated intracranial pressure in blunt head trauma.
MedLine Citation:
PMID:  17983073     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There are no independent computed tomography (CT) findings predictive of elevated intracranial pressure (ICP). The purpose of this study was to evaluate brain density measurement on CT as a predictor of elevated ICP or decreased cerebral perfusion pressure (CPP). A prospectively collected database of patients with acute traumatic brain injury was used to identify patients who had a brain CT followed within 2 hours by ICP measurement. Blinded reviewers measured mean density in Hounsfield Units (HU) within a 100-mm2 elliptical region at four standardized positions. Brain density measurement was compared for patients with an ICP of 20 or greater versus less than 20 mm Hg and CPP of 70 or greater versus less than 70 mm Hg. During a 2-year period, 47 patients had ICP monitoring after brain CT. Average age was 40 +/- 18 years old; 93.6 per cent were male; mean Injury Severity Score was 25 +/- 10; and Glasgow Coma Scale was 6 +/- 4. There was no difference in brain density measurement for observer 1, ICP less than 20 (26.3 HU) versus ICP 20 or greater (27.4 HU, P = 0.545) or for CPP less than 70 (27.1 HU) versus CPP 70 or greater (26.2, P = 0.624). Similarly, there was no difference for observer 2, ICP less than 20 (26.8 HU) versus ICP 20 or greater (27.4, P = 0.753) and CPP less than 70 (27.6 HU) versus CPP 70 or greater (26.2, P = 0.436). CT-measured brain density does not correlate with elevated ICP or depressed CPP and cannot predict patients with traumatic brain injury who would benefit from invasive ICP monitoring.
Authors:
Kenji Inaba; Pedro G R Teixeira; Jean-Stephane David; Carlos Brown; Ali Salim; Peter Rhee; Timothy Browder; Joseph Dubose; Demetrios Demetriades
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  73     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-11-06     Completed Date:  2007-11-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1023-6     Citation Subset:  IM    
Affiliation:
Division of Trauma Surgery and Surgical Critical Care, University of Southern California, Los Angeles, California 90033, USA. KInaba@surgery.usc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain / physiopathology*,  radiography*
Female
Glasgow Coma Scale
Head Injuries, Closed / physiopathology*
Humans
Injury Severity Score
Intracranial Hypertension / physiopathology*
Male
Middle Aged
Oxygen / analysis
Retrospective Studies
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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