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Score of Pace et al for Identifying a Patient with Raised Intracranial Pressure After Traumatic Brain Injury

Description

Pace et al developed a score for identifying a patient at risk for raised intracranial pressure (ICP) after traumatic brain injury. The authors are from Western University, London Health Sciences Centre Trauma Program and Schulich School of Medicine in London, Ontario.


Patient selection: traumatic brain injury

 

Criteria for the diagnosis of raised intracranial pressure: - one or both of the following

(1) changes on head CT (midline shift, compression of basal cisterns, sulcal effacement)

(2) ICP > 20 mm Hg within 1 hour of probe insertion

 

Parameters:

(1) age in years

(2) signs of significant head trauma (major scalp degloving, depressed skull fracture, basal skull fracture, CSF rhinorrhea)

(3) intubation

(4) pupils fixed

 

Parameter

Finding

Points

age in years

<= 55 years

0

 

> 55 years

1

signs of significant head trauma

absent

0

 

present

1

intubation

no

0

 

yes

2

pupils fixed

no

0

 

yes

3

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 7

• The higher the score the higher the probability of raised intracranial pressure (ICP).

 

Score

Percent Raised ICP

0

5%

1

9%

2

16%

3

26%

4

39%

5

54%

6

69%

7

80%

 


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