gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Can MRI predict the clinical outcome after severe brain injuries?

Kann das MRT das Behandlungsergebnis nach schwerer Schädel-Hirnverletzung voraussagen?

Meeting Abstract

  • corresponding author D. Woischneck - Klinik für Neurochirurgie, Universität Ulm
  • M. Ly - Klinik für Neurochirurgie, Universität Ulm
  • B. Schmitz - Klinik für diagnostische und interventionelle Radiologie, Universität Ulm
  • E. Rickels - Klinik für Neurochirurgie, Universität Ulm

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocFR.07.04

The electronic version of this article is the complete one and can be found online at:

Published: April 11, 2007

© 2007 Woischneck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Recent studies promise new horizons in the prediction of outcome after severe brain injuries (BI) by Magnetic Resonanace Imaging (MRI) data. Nevertheless, their realiability is not verified yet. In this prospective study the predictive value of MRI in BI is analyzed and the findings are compared with those in the original papers.

Methods: From Jan 2005 – May 2006, 29 patients, all comatose after BI more than 24 hours, were recruited. MRI was performed within 8 days after BI according to the recommendations of the original protocol. The Glasgow Outcome Score (GOS) was measured 6 months after injury. Statistics were performed by use of SPSS 13.0 for Windows NP. Significance was assumed for p<0,01.

Results: 34% of the patients revealed supratentorial lesions only, 28 unilateral brain stem lesions, 17 bilateral or midline lesions of the mesencephalon and 21% bilateral lesions of the pons. 23 out of 25 patients without a bilateral lesion of the pons awoke from coma; 2 patients with supratentorial lesions remained comatose till death due to secondary supratentorial infarctions. 3 out of 4 patients with a bilateral lesion of the pons remained comatose. 1 patient with such a pontine damage (dorsal of the reticular formatio) awoke from coma and survived severely disabled. Mortality was significantly correlated with lesions of the pons and medulla oblongata. Persistent vegetative states occurred only in case of mesencephalic lesions. A favourable outcome was significantly correlated with grade I and II lesions.


MRI data predict favourable and unfavourable outcome with a significant certainty of 79%.
MRI is most powerful in predicting death and a persistent vegetative state.
Bipontine lesions are often fatal, but some patients survive and even awake from coma.
Unexpected outcome is due to lesions outside the formatio reticularis or due to neurological deterioration after MRI examination.