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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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The correlation of early neurological findings with early MRI findings and late outcome in comatose patients after head injury

Meeting Abstract

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  • Raimund Firsching - Klinik fuer Neurochirurgie, Otto-von-Guericke-Universitaet Magdeburg
  • Andreas Parreidt - Klinik fuer Neurochirurgie, Otto-von-Guericke-Universitaet Magdeburg
  • Alexander Langejürgen - Klinik fuer Neurochirurgie, Otto-von-Guericke-Universitaet Magdeburg
  • Benjamin Voellger - Klinik fuer Neurochirurgie, Otto-von-Guericke-Universitaet Magdeburg

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMO.18.02

doi: 10.3205/13dgnc156, urn:nbn:de:0183-13dgnc1562

Published: May 21, 2013

© 2013 Firsching et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: The predictive value of neurological findings and coma scales in comatose patients in the first 12 hours after the injury is controversial. The correlation with underlying brain lesions is unclear.

Method: In a prospective study, 178 patients with a minimum 12 hours of coma (i.e., a Glasgow Coma Scale sum score of 7 or less) received an early 1.5 Tesla MRI within 10 days after the injury (median: 2 days). Clinical findings as singular features included the GCS sum score, and unilateral or bilateral loss of pupil reactivity, hemiparesis or posturing as signs of acute brainstem dysfunction within 12 hours after the injury. MRI findings were classified into 4 grades. Outcome was assessed using the Glasgow Outcome Score (GOS) at 1 year after the injury. The relation of the GCS sum score and signs of brain stem dysfunction within 12 hours after the injury with MRI findings and outcome was investigated. Statistical analysis included crosstables, Chi square and Fisher's exact test.

Results: The signs of brain stem dysfunction, MRI findings and outcome at one year were highly statistically correlated with each other. The GCS sum score was neither related with outcome at one year nor with the highly predictive MRI findings.

Conclusions: As the signs of brain stem dysfunction are significantly correlated with MRI findings and outcome, they should be monitored in the early phase of head injury.