The prognosis analysis of CT image with early stage diffuse axonal injury

Abstract

Objective To analyse and evaluate the value of the relationship between early period cerebral special CT image and prognosis of patients with cerebral diffuse axonal injury (DAI) combining clinical characteristic.Methods The clinical data of 110 cases of patients with DAI,aged 16-60 years,from the department of neurosurgery,Ningxia medical university general hospital from 2010.10 to 2012.3 were analysed retrospectively through case-control study.To analyze the CT findings of brain for 110 cerebral stroke patients in the acute stage (after the onset within 24 hours).They were divided into four groups:interpeduncular cistern(IPC) blood group,midline brain areas hemorrhage group,both IPC blood and midline brain areas hemorrhage group,and control group (both IPC blood and midline brain areas hemorrhage negative)according to CT scan if there is the following image,IPC blood,and midline brain areas hemorrhage,and then,comparing the differences of Glasgow coma score (GCS),the persistent time of primary coma,Glasgow outcome score (GOS),between the groups above.Results These differences of parameters between the four groups above were as follows:GCS(score) 6(5-7) 、7(6-8) 、5(4-6) 、9(9 -10) ; the persistent time of primary coma(day) 10.2 ± 3.3、5.9 ± 2.0、13.4 ± 4.2、1.8 ± 1.1 ; the poor rate of long-term prognosis 84.2％ 、61.9％ 、95.2％ 、23.3％.IPC blood and brainstem injury is closely related:The evidence of IPC blood on CT scan as an indicator of brainstem injury had a Kappa coefficient:0.8(95％ CI:0.6,1),P ＜ 0.0001,a sensitivity of 96.2％,and a specificity of 86.0％.Conclusions Our data suggest that CT scan early after trauma in patients with DAI is significant in determining the severity of the disease and the prognosis.the finding of IPC blood and traumatic hemorrhage in midline brain areas on CT scan early after trauma in patients with DAI shows the severe condition and poor prognosis.The finding of IPC blood on CT scan early after trauma in DAI patients is a good marker for brainstem injury. Key words: Diffuse axonal injury ; Tomography, spiral computed ; Prognosis; Interpeduncular cistern