Article
Early magnetic resonance imaging predicts long-term outcome in patients with severe head injury
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Published: | May 20, 2009 |
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Objective: The factors determining long-term outcome in patients with severe traumatic brain injury still remain largely unknown as there are no clinical or neuroradiologic parameters available yet which can reliably predict long-term outcome in these patients. The aim of the present study was the assessment of the value of early magnetic resonance imaging (MRI) in predicting duration of coma and long-term outcome in patients with severe traumatic brain injury.
Methods: Early MRI was performed in 162 patients within ten days following severe traumatic head injury. The MRI was analyzed by a neuroradiologist, who was blinded to the clinical findings in these patients. We investigated whether the location and extent of traumatic intracerebral lesions as revealed by early MRI correlates with the duration of coma and the clinical outcome as assessed by the Glasgow outcome score (GOS) one year after brain injury.
Results: Early MRI revealed a strong correlation between the location and extent of lesions of the brain stem and duration of coma as well as GOS one year after traumatic brain injury: 82% of the patients with a one year GOS ≤ 3 showed a traumatic brain stem lesion in the initial early MRI.
Conclusions: The above findings support the hypothesis that duration of coma und long-term outcome following severe head injury is mostly related to a lesion of the brain stem.