Formulation Of A Three Tier Cisternal Grade As A Predictor Of In Hospital Outcome From A Prospective Study Of Patients With Traumatic Intracranial Hematoma

• Published in: World neurosurgery Vol. 104; pp. 848 - 855
• Main Authors: Raghunath, avanali, MCh in Neurosurgery, Bhadran, Biju, M.Ch in Neurosurgery, Panchal, Sunil, MS in Surgery, Krishna Kumar, P., M.Ch in Neurosurgery, Abhishek, V., M.Ch in Neurosurgery, Musthafa, Aneeze.M., M.Ch in Neurosurgery, Harison, G., M.Ch in Neurosurgery
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2017
• Subjects: Adolescent; Adult; Basal cisterns; Cerebral Ventricles - diagnostic imaging; Cohort Studies; Female; Glasgow Outcome Scale; Hospital Mortality; Humans; India; Intracranial Hemorrhage, Traumatic - classification; Intracranial Hemorrhage, Traumatic - diagnostic imaging; Intracranial Hemorrhage, Traumatic - mortality; Intracranial Hemorrhage, Traumatic - surgery; Male; Middle Aged; Neurosurgery; Patient Outcome Assessment; Prediction scores in TBI; Prognosis; Prospective Studies; Subarachnoid Space - diagnostic imaging; Survival Analysis; Tomography, X-Ray Computed; Traumatic intracerebral hematoma; Young Adult; Prediction scores in TBI; Traumatic intra cerebral hematoma; Basal cisterns; CT; GCS; ROC; Traumatic intracerebral hematoma; GOS; TBI; SAH
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2017.05.054

Abstract Objective Outcome prediction is of paramount importance in traumatic brain injury. Our objective of conducting this prospective study was to identify the predictors needed to formulate a prognostic score. Methods Clinical and radiological characteristics of hundred patients with traumatic intra cranial hematoma were analyzed. Key measurements were taken in midbrain and pontine regions and status of each of the nine basal cisterns were noted, by giving a score of 1 if they were visible and 0 if not. All the predictors were analyzed for outcome. Results Total cisternal score was found to be an independent predictor of outcome. A Grade was formulated by dividing the score in to three levels. Conclusions The model based on cisternal status described in the study is technically simple and conveys the information regarding the outcome to the treating neurosurgeon. Since the score obtained seems to have very low inter observer variation, we believe that it can be a useful tool not only in recording data in case files and inter physician communication but also in traumatic brain injury research.