Neurological deteriorations in mild brain injuries: the strategy of evaluation and management

Shou Chi Chien, Po Hsun Tu, Zhuo Hao Liu, Ching Chang Chen, Chien Hung Liao, Chi Hsun Hsieh, Chih Yuan Fu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

3 Scopus citations

Abstract

Purpose: Most mild traumatic brain injuries (TBIs) can be treated conservatively. However, some patients deteriorate during observation. Therefore, we tried to evaluate the characteristics of deterioration and requirement for further management in mild TBI patients. Methods: From 1/1/2017 to 12/31/2017, patients with mild TBI and positive results on CT scans of the brain were retrospectively studied. Patients with and without neurological deteriorations were compared. The characteristics of mild TBI patients with further neurological deterioration or the requirement for interventions were delineated. Results: One hundred ninety-two patients were enrolled. Twenty-three (12.0%) had neurological deteriorations. The proportions of deterioration occurring within 24 h, 48 h and 72 h were 23.5, 41.2 and 58%, respectively. Deteriorated patients were significantly older than those without neurological deteriorations (69.7 vs. 60.2; p = 0.020). More associated extracranial injuries were observed in deteriorated patients [injury severity score (ISS): 20.2 vs. 15.9; p = 0.005). Significantly higher proportions of intraventricular hemorrhage (8.7 vs. 1.2%; p = 0.018) and multiple lesions (78.3 vs. 53.8%; p = 0.027) were observed on the CT scans of patients with neurological deteriorations. Subset analysis showed that deteriorated patients who required neurosurgical interventions (N = 7) had significantly more initial GCS defects (13 or 14) (71.4 vs. 12.5%; p = 0.005) and more initial decreased muscle power of extremities (85.7 vs. 18.8%; p = 0.002). Conclusion: More attention should be given to mild TBI patients with older age, GCS defects, decreased muscle power of the extremities, multiple lesions on CT scans and other systemic injuries (high ISS). Most deteriorations occur within 72 h after trauma.

Original languageEnglish
Pages (from-to)2173-2181
Number of pages9
JournalEuropean Journal of Trauma and Emergency Surgery
Volume48
Issue number3
DOIs
StatePublished - 06 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021, Springer-Verlag GmbH Germany, part of Springer Nature.

Keywords

  • Computed tomography scan
  • Deterioration
  • Mild head injury
  • Muscular weakness

Fingerprint

Dive into the research topics of 'Neurological deteriorations in mild brain injuries: the strategy of evaluation and management'. Together they form a unique fingerprint.

Cite this