Lobato et al classified lesions on head CT scans of patients with severe head injury. The severity of the changes is associated with outcome. The authors are from Universidad Complutense in Madrid.
Patient selection: CT scan following severe head injury
The majority of relevant CT changes develop within 48 hours after injury.
Parameters:
(1) status of cisterns
(2) midline shift in mm
(3) density lesion in mL
(4) bone fragments or foreign bodies
(5) surgical evacuation
Diagnosis
Category
Class
no visible intracranial pathology
diffuse I
I
midline shift <= 5 mm, cisterns present, fragments may be present
diffuse II
II
midline shift <= 5 mm, cisterns compressed or absent
diffuse III (sswelling)
III
midline shift > 5 mm
diffuse IV (shift)
IV
density > 25 mL, evacuated
evacuated mass
V
density > 25 mL, not surgically corrected
non-evacuated mass
VI
pathology present, none of the above
unknown
other
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