الفهرس 
Introduction & aim of the workOnly 14 pages are availabe for public view
 |  | from | 22 |  |  |
| | | from | 22 | | |
Abstract
The present study included 100 patients with head trauma, 73% of the patients (73 cases) were male and only 27% (27 cases) of them were female. Their ages ranged between 1 day and 18 years. The aim of this work is to study the correlation between initial GCS and the imaging finding of CT brain and MRI brain if needed. All the patients of this study were evaluated clinically to detect their initial GCS and examined by CT “Siemens Somatom spirit dual MDCT” and some patients (10cases) were further examined by MRI because there were discrepancy between their initial GCS and their admission CT brain findings. Patients with multisystem injury were excluded from the study.
Among the studied patients, 79% had positive CT findings, with 91.1% of them presenting with subgaleal hematoma, 55.6% with craniofacial fractures, 18.9% with brain contusion ,17.7% with diffuse cerebral edema, and 50.6% with extra-axial blood collection (10.1% epidural hematoma, 20.2% subdural hematoma, 15.1% subarachnoid hemorrhage and 5.2% intraventricular hemorrhage). One or more imaging findings were observed in 67.1% of the patients. All the patients with negative CT finding (21% of study group) were classified as mild TBI at the time of admission.
In this study the most common imaging finding in mild TBI cases (GCS≥ 13) is subgaleal hematoma followed by skull fractures and brain contusions. While the most common imaging finding in moderate TBI cases (GCS 9-12) is subgaleal hematoma followed by fractures; subdural hematoma were the most common
Summary and conclusion
extra-axial finding and brain contusions were the most intra-axial finding in cases of moderate TBI.
While in severe TBI cases (GCS 3-8) the most common extra-axial finding was subdural hematoma which found in about 36.8% of cases followed by subarachnoid hemorrhage which found in 26.3% of cases and epidural hematoma was found in 18.4% of cases and at the last intraventricular hemorrhage was found in 7.9% of cases. And the most common intra-axial finding was brain edema which found in about 31.6% of severe TBI cases followed by brain contusions which found in 26.3% of cases while intracerebral hemorrhage was found in 21.1% of cases and DAI was found in 13.1% of cases with severe TBI.
In the present study there was a relation between GCS and brain imaging finding, the lower the GCS score, the more severe were the TBI and imaging findings. CT is the modality of choice in the evaluation of acute head injury because it is fast, widely available, highly sensitive to acute blood and can more easily accommodate life-support and monitoring equipment. MRI is indicated for patients with acute TBI when the neurological findings are unexplained by CT and don’t correlate with GCS. MR has traditionally been less desirable than CT in the acute setting because of the longer examination time, difficulty in managing life support and other monitoring equipment, and inferior demonstration of bone detail. MRI however has been shown to be superior to CT in the detection of acute epidural and subdural hematomas, non-hemorrhagic brain injury and cases of diffuse axonal injury. MRI is also more sensitive to brainstem injury especially with FLAIR sequence.