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.
참고문헌 (20)
Adams H, Mitchell DE, Graham DI, Doyle D : Diffuse brain damage of immediate impact type. Its relationship to "primary brain stem damage" in head injury. Brain 100 : 489-502, 1977
Adams JH, Graham DI, Murray LS, Scott G : Diffuse axonal injury due to nonmissile head injury in humans : an analysis of 45 cases. Ann Neurol 12 : 557-563, 1982
Alberico AM, Ward JD, Choi SC, Marmarou A, Young HF : Outcome after severe head injury : relationship to mass lesions, diffuse injury, and ICP course in pediatric and adult patients. J Neurosurg 67 : 648-656, 1987
Eisenberg HM, Gary HE Jr, Aldrich EF, Saydjari C, Turner B, Foulkes MA et al. : Initial CT findings in 753 patients with severe head injury. A report from the NIH Traumatic Coma Data Bank. J Neurosurg 73 : 688-698, 1990
Eum SW, Lim DJ, Kim BR, Cho TH, Park JY, Suh JK, et al. : Prognostic factors in patients with diffuse axonal injury. J Korean Neurosurg Soc 27 : 1668-1674, 1998
Gennarelli TA, Spielman GM, Langfitt TW, Gildenberg PL, Harrington T, Jane JA, et al. : Influence of the type of intracranial lesion on outcome from severe head injury. J Neurosurg 56 : 26-32, 1982
Gennarelli TA, Thibault LE, Adams JH, Graham DI, Thompson CJ, Marcincin RP : Diffuse axonal injury and traumatic coma in the primate. Ann Neurol 12 : 564-574, 1982
Kim CH, Lee HK, Koh YC, Hwang DY : Clinical analysis of diffuse axonal injury (DAI) diagnosed with magnetic resonance image (MRI). J Korean Neurosurg Soc 26 : 241-248, 1997
Kim HJ, Park IS, Kim JH, Kim KJ, Hwang SH, Kim ES, et al. : Clinical analysis of the prognosis of the patients with cerebral diffuse axonal injuries, based on gradient-echo MR imaging. J Korean Neurosurg Soc 30 : 168-172, 2001
Lee HS, Lee KS, Bae HG, Yun IG, Lee IS : Systemic insults in the early death after head injury. J Korean Neurosurg Soc 19 : 1101-1106, 1990
Levati A, Farina ML, Vecchi G, Rossanda M, Marrubini MB : Prognosis of severe head injuries. J Neurosurg 57 : 779-783, 1982
Miller JD, Butterworth JF, Gudeman SK, Faulkner JE, Choi SC, Selhorst JB, et al. : Further experience in the management of severe head injury. J Neurosurg 54 : 289-299, 1981
Oh KS, Ha SI, Suh BS, Lee HS, Lee JS : The correlation of MRI findings to outcome in diffuse axonal injury patients. J Korean Neurosurg Soc (Suppl I) 30 : S20-S24, 2001
Park SW, Park K, Kim YB, Min BK, Hwang SN, Suk JS, et al. : Prognostic factors in diffuse axonal injuries of brain. J Korean Neurosurg Soc 20 : 983-990,1991
Strich SJ : Diffuse degeneration of the cerebral white matter in severe dementia following head injury. J Neurol Neurosurg Psychiatry 19 : 163-185, 1956
Williams JM, Gomes F, Drudge OW, Kessler M : Predicting outcome from closed head injury by early assessment of trauma severity. J Neurosurg 61 : 581-585, 1984
Zimmerman RA, Bilaniuk LT, Hackney DB, Goldberg HI, Grossman RI : Head injury : early results of comparing CT and high-field MR. AJR Am Roentgenol 147 : 1215-1222, 1986
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