"Pure" traumatic cerebral lacerations. A review of 129 cases with long-term follow-up

The authors present a series of 129 patients with "pure" traumatic cerebral lacerations, i.e. not associated with other intracranial lesions (especially haematomas) which by their presence alone can play a primary role in affecting clinical course and prognosis. Twenty per cent of the patients presented a lucid interval, thus confirming the nature of the laceration as a true expanding lesion, increasing in size in the post-traumatic period. Age, GCS score and neuroradiological findings were investigated in view of the eventual outcome. Follow-up examination confirmed that age and level of coma on admission, together with the degree of ventricular shift and presence of bilateral skull fractures, were all factors of statistical significance in affecting prognosis. Lacerations in the temporal area were associated with the poorest prognosis, and highest incidence of neurological focal deficits and residual parenchymal damage on CT control.