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Related Concept Videos

Computed Tomography01:10

Computed Tomography

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Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
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Early computed tomography for acute post-traumatic diffuse axonal injury: a systematic review.

Giovana Figueira Rodrigues Vieira1, José Fernando Guedes Correa2

  • 1Department of Neurosurgery, Gaffrée e Guinle University Hospital, School of Medicine, Federal University of Rio de Janeiro State, 775 Mariz e Barros Street, Rio de Janeiro, RJ, Brazil. giovana_frvieira@hotmail.com.

Neuroradiology
|March 5, 2020
PubMed
Summary

Computed tomography (CT) signs in the first 24 hours after traumatic brain injury (TBI) can help predict prognosis in diffuse axonal injury (DAI). The presence and severity of intraventricular hemorrhage (IVH) on CT scans are key indicators of DAI severity and patient outcomes.

Keywords:
Computed tomographyDiffuse axonal injuryPost-traumatic comaTraumatic brain injury

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Area of Science:

  • Neurology
  • Radiology
  • Trauma Surgery

Background:

  • Diffuse axonal injury (DAI) is a common and severe consequence of traumatic brain injury (TBI), resulting from acceleration-deceleration forces.
  • Computed tomography (CT) is the initial imaging modality for TBI but has limited sensitivity for detecting DAI, a microscopic injury.
  • Identifying early CT predictors of DAI severity is crucial for patient management and prognosis.

Purpose of the Study:

  • To systematically review the literature for CT signs within 24 hours of TBI that differentiate patients with better versus worse prognoses.
  • To identify potential imaging biomarkers for DAI severity on early CT scans.

Main Methods:

  • A systematic literature search was conducted in the PubMed database for primary scientific articles published in English since January 1, 2000.
  • Five relevant articles were selected for review and analysis.

Main Results:

  • Traffic accidents were the cause in 70% of DAI cases, with 79% of patients being male and a mean age of 41 years.
  • Significant associations were found between DAI and intraventricular hemorrhage (IVH) and traumatic subarachnoid hemorrhage (tSAH).
  • The grade of IVH correlated with the number of corpus callosum lesions, and blood in the interpeduncular cisterns (IPC) was associated with brainstem lesions.

Conclusions:

  • The absence of traumatic subarachnoid hemorrhage (tSAH) suggests severe DAI is unlikely.
  • The absence of intraventricular hemorrhage (IVH) makes any DAI unlikely.
  • The presence and extent of IVH on CT scans are strong indicators of DAI severity and a poorer patient prognosis, with more affected ventricles correlating with worse outcomes.