Prognostic computed tomography Scores in traumatic brain injury

Traumatic brain injuries represent a significant cause of morbidity and mortality worldwide and road traffic crashes account for a significant proportion of these injuries. It is one of the leading causes of death, especially among young adults, and, according to the World Health Organization, this will surpass many diseases as the major cause of death and disability by the year 2020 and lifelong disability is common in those who survive. It is also known as the silent epidemic. Many CT scan scoring systems for brain injury have been developed but none of them are validated. These scores are based on structural findings of CT scan to predict the prognosis. Marshall and Rotterdam are the two most widely used scoring systems.

This was an observational study with prospectively collected data. 903 consecutive patients with TBI. This study aimed to compare the Helsinki CT scoring system with the Rotterdam scoring system to find out the better score for the prognostic purpose by using the Glasgow outcome score.

Helsinki CT scoring system was found to be the most accurate score among the others in predicting the outcome of the patient based on morphological findings in CT scan. These scores also guided us regarding the treatment plan and patients with the good prognostic outcome are usually treated aggressively. Also these scores guide clinicians whether to opt for a conservative approach or any intervention.

In this study we compared, Rotterdam vs. Helsinki CT Scoring System. We observed that the Helsinki score was a better outcome predictor for TBI than the Rotterdam score and can be used as a single validated score in predicting outcome and guiding the treatment.