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J Korean Soc Emerg Med > Volume 7(1); 1996 > Article
Journal of The Korean Society of Emergency Medicine 1996;7(1): 44-54.
INITIAL CT FINDINGS IN SEVERELY HEAD-INJURED PATIENTS
Kab Teug Kim, Joon Seok Park, Haw Sik Song
Department of Emergency medicine, College of medicine, Dankook university, Chunan, Korea
  Published online: March 31, 1996.
ABSTRACT
The authors have analyzed 60 patients with severe head injury who defined as post-traumatic coma for 24 hours with Glasgow Coma Scale(GCS) score of 8 or less and admitted to emergency room of Dankook university hospital from January to June 1995 to evaluate the factors affecting GCS and autcome with initial CT findings. The results are summerized as follows; 1. The status with low GCS score was observed from ① intracranial mass, especially acute subdural hematoma(SDH) ② midline shift ≥3 mm ③ completely compressed mesencephalic cistern 2. The mortality was high in intracranial mass, especially in acute SDH 3. The mortality for patients with miline shift ≥3mm was high regardless of a mass lesion, but there was no statistical significance. As the mesencephalic cistern was partially compressed, the midline shift ≥ 3mm did not affect the mortalith. The outcome was good in the group of midline shift <3mm with GCS 6-8. 4. If the mesencephalic cistern were compressed, especially in complete compression, the outcome was much more likely to be poor than cistern was normal. 5. The poor outcome was obtained from the patients with low GCS score and compression, the outcome was much more likely to be poor than cistern was normal. 5. The poor outcome was obtained from the patients with low GCS score and compressed mesencephalic cistern in initial CT findings.
Key words: Severe head injury, Midline shift, Mesencephalic cistern, Intracranial mass, Computerized tomography
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