Findings seen on Computed Tomography in patients with traumatic coma can be used to classify the patients and to assess the prognosis.
Findings found clinically important:
(1) presence of mass lesions
(2) cerebral edema and associated midline shift
(3) obliteration of the mesencephalic cisterns
(4) presence of subarachnoid blood
|
Definition |
Category |
|
no visible intracranial pathology seen on CT scan |
Diffuse Injury I |
|
(1) cisterns are present with midline shift 0-5 mm and/or lesion densities present (2) no high-density or mixed density lesion > 25 cc (3) may include bone fragments and foreign bodies |
Diffuse Injury II |
|
(1) cisterns compressed or absent, with shift 0-5 mm (2) no high-density or mixed density lesion > 25 cc |
Diffuse Injury III (swelling) |
|
(1) shift > 5 mm (2) no high-density or mixed density lesion > 25 cc |
Diffuse Injury IV (shift) |
|
any surgically evacuated lesion (epidural hematoma, subdural hematoma, intracerebral hematoma) |
Evacuated Mass Lesion |
|
high-density or mixed-density lesion > 25 cc, not surgically evacuated |
Nonevacuated Mass Lesion |
Outcome for Each Category
|
Category |
good recovery or moderate disability |
vegetative state or dead |
|
Diffuse Injury I |
61.6% |
19.2% |
|
Diffuse Injury II |
32.5% |
24.8% |
|
Diffuse Injury III |
16.4% |
55.9% |
|
Diffuse Injury IV |
6.2% |
75% |
|
Evacuated lesion NOS |
22.8% |
51.1% |
|
Evacuated lesion - epidural hematoma |
46.6% |
21.1% |
|
Evacuated lesion - subdural hematoma |
13.8% |
60.4% |
|
Evacuated lesion - intracerebral hematoma |
26.7% |
43.7% |
|
Nonevacuated mass lesion |
11.1% |
69.5% |
Purpose: To assess patients with traumatic coma based on findings on computed tomography.
Specialty: Sports Medicine & Rehabilitation, Neurology
Objective: severity, prognosis, stage
ICD-10: R40.2,
