Park, Sung-Jun
(Department of Neurosurgery, Cheongju Saint Mary's Hospital)
,
Hur, Jin-Woo
(Department of Neurosurgery, Cheongju Saint Mary's Hospital)
,
Kwon, Ki-Young
(Department of Neurosurgery, Cheongju Saint Mary's Hospital)
,
Rhee, Jong-Joo
(Department of Neurosurgery, Cheongju Saint Mary's Hospital)
,
Lee, Jong-Won
(Department of Neurosurgery, Cheongju Saint Mary's Hospital)
,
Lee, Hyun-Koo
(Department of Neurosurgery, Cheongju Saint Mary's Hospital)
Objective : This study was conducted to investigate the correlation between the degrees of injury on brain magnetic resonance imaging (MRI) and the time interval to recovery of consciousness in patients with diffuse axonal injury. Methods : From January 2004 to December 2008, 25 patients with diffus...
Objective : This study was conducted to investigate the correlation between the degrees of injury on brain magnetic resonance imaging (MRI) and the time interval to recovery of consciousness in patients with diffuse axonal injury. Methods : From January 2004 to December 2008, 25 patients with diffuse axonal injury were treated at our hospital. We retrospectively investigated the patients' medical records and radiological findings. We divided the patients into three groups according to the grade of MRI finding : grade I, small scattered lesions on the white matter of the cerebral hemisphere; grade II, focal lesions on the corpus callosum; and grade III, additional focal lesions on the brain stem. Result : Seven patients belonged to the grade I group; 10 to the grade II group; and 8 to the grade III group. The mean Glasgow Coma Scale (GCS) score of all patients at the time of admission was 7.28. Recovery of consciousness was observed in 23 of the 25 patients; the remaining two patients never regained consciousness. The time interval to recovery of consciousness (awake status) ranged from 1 day to 125 days (mean 22.1 days) : grade I group patients, within approximately 1 week (mean 3.7 days); grade II group patients, within approximately 2 weeks (mean 12.5 days); and grade III group patients, within approximately 2 months (mean 59.5 days). Conclusion : Our study results suggest a correlation between the mean time interval to recovery of consciousness in patients with diffuse axonal injuries and the degrees of brain injuries seen on MRI. Patients with grade I and II diffuse axonal injuries recovered consciousness within 2 weeks, while patients with grade III injuries required approximately 2 months.
Objective : This study was conducted to investigate the correlation between the degrees of injury on brain magnetic resonance imaging (MRI) and the time interval to recovery of consciousness in patients with diffuse axonal injury. Methods : From January 2004 to December 2008, 25 patients with diffuse axonal injury were treated at our hospital. We retrospectively investigated the patients' medical records and radiological findings. We divided the patients into three groups according to the grade of MRI finding : grade I, small scattered lesions on the white matter of the cerebral hemisphere; grade II, focal lesions on the corpus callosum; and grade III, additional focal lesions on the brain stem. Result : Seven patients belonged to the grade I group; 10 to the grade II group; and 8 to the grade III group. The mean Glasgow Coma Scale (GCS) score of all patients at the time of admission was 7.28. Recovery of consciousness was observed in 23 of the 25 patients; the remaining two patients never regained consciousness. The time interval to recovery of consciousness (awake status) ranged from 1 day to 125 days (mean 22.1 days) : grade I group patients, within approximately 1 week (mean 3.7 days); grade II group patients, within approximately 2 weeks (mean 12.5 days); and grade III group patients, within approximately 2 months (mean 59.5 days). Conclusion : Our study results suggest a correlation between the mean time interval to recovery of consciousness in patients with diffuse axonal injuries and the degrees of brain injuries seen on MRI. Patients with grade I and II diffuse axonal injuries recovered consciousness within 2 weeks, while patients with grade III injuries required approximately 2 months.
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문제 정의
injury. This study aimed to investigate the correlation between the degrees of injuries based on MRI findings and the mean time intervals to recovery of consciousness in patients with diffuse axonal injuries.
제안 방법
Patients' GCS scores in the grade I and II groupsbegan to improve soon after admission; those in the grade Ⅲ group did not improve until 1 month after injury. Statistical analysis was performed for comparison of the mean time interval to awake status of each grade (Table 2). The mean time interval to awake status between the grade I and II groups did not show significant difference; however, there were statistically significant differences between the grade I and Ⅲ groups (/> = 0.
32 years. The patients had several coincidental injuries such as rib fracture, long bone fracture, and scanty amount of intracranial hemorrhage (subdural hematoma, contusion, subarachnoid hemorrhage, and intraventricular hemorrhage). But, the scanty amount of intracranial hemorrhage did not require decompressive cranial operation.
This study shows a correlation between the time interval to recovery of consciousness in patients with difRise axonal injury and the degrees of brain injuries seen on MRI, despite the limitation of a small study population. Patients with diffuse axonal injuries with small hemorrhagic lesions on the hemispheric white matter or corpus callosum recovered consciousness within 2 weeks.
대상 데이터
Twenty-five patients who had been diagnosed with diffuse axonal injury and underwent MRI at our hospital from January 2004 to December 2008 were included in this study. We had excluded patients with secondary hypoxic brain damage on admission or who had undergone cranial operation during treatment from this study All the medical records and radiographic findings were reviewed retrospectively; Patients were divided into three groups according to the location of lesions on MRI finding (grade I, Ⅱ, and Ⅲ) as classified by Gennarelli et al.
데이터처리
, Chicago, IL, USA). The correlation between the MRI grade and the mean time interval to recovery of consciousness was evaluated by oneway analysis of variance (ANOVA). Statistical significance was defined as/>< 0.
성능/효과
28 months. By using the GOS to classify outcomes, 13 patients (52%) were assessed as GR, 7 patients (28%) were assessed as MD, 3 patients (12%) were assessed as SD, and 2 patients (8%) were assessed as PVS. None of the patients died.
In our study; initial GCS scores of each MRI grade were similar, but sequential changes in GCS scores looked different: the mean GCS scores of the grade I and II groups tended to improve within 5 days, but GCS score improvement was not seen in the grade Ⅲ group until after 1 month (Fig. 2). We investigated the mean time interval to awake status according to the MRI grade.
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