Background: Traumatic brain injury is important public health problem and the leading cause of mortality, morbidity and disabilities in children and young adults.
This study is to evaluate the factors that may predict outcome in patients with post-traumatic brain contusion.
Patients and Methods: A prospective study conducted from April 2020 to April 2021. 50 patients with traumatic brain contusion categorized into 2 groups. Group A (25 patients) treated conservatively and Group B (25 patients) treated surgically. After management of possible associated injury, neurological ex. and GCS recorded and initial CT brain done. In group A, CT brain was done 24 hours after the initial and when indicated. In group B we did post-operative CT before discharge. patients followed up for 3 months. To assess functional outcome, we used Glasgow outcome scale (GOS).
Results: 46 patients included, group A (n=21) and group B (n=25). In group A, patients aged from 9 to 60 years. Mean of initial GCS score was 12.95 ± 2.18. Average of midline shift in initial CT was 0.19 ± 0.51 mm. In group B, patients aged from 7 to 65 years. Mean of initial GCS score was 10.24 ± 2.18. Average of initial midline shift was 3.96±1.62 mm while after 2nd CT was 6.40±1.35 mm. At 3 months follow up, average GOS was 4.2 ± 1.1 for group A, and was 4.19 ± 1.12 for Group B.
Conclusion: in patients with post-traumatic brain contusion, initial GCS, radiological findings (initial and follow up midline shifts, initial and follow up brain contusion volumes) and mechanism of trauma are the most important predictors of functional outcome and also the duration of hospital stay. A combination of clinical deterioration with increased midline shift and/or increased volume of brain contusion are the most reasonable indications for surgical intervention in such patients.
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