Antero posterior elongation of midbrain in traumatic brain injury- significant sign yet a mistaken entity

Avanali, Raghunath; Bhadran, Biju; Panchal, Sunil J.; P, Krishna Kumar; Abhishek, Vaidya; Gulhane, Kshitij; G, Harison

doi:10.1080/02688697.2018.1432748

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…[13] Another important factor which all of us have been noticing in patients with traumatic brain injury, but was never studied in detail, is mentioned in study by Raghunath et al Elongated brainstem appearance, presence of this entity significantly affects the outcome of patients. [14] Higher the midline shift, lesser number of cisterns open, distorted brainstem appearance are indicators of mass effect, the degree of brain compression by intracranial mass. Mass effect is usually a better predictor of outcome than the size of the mass.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Clinico-Radiological Factors and Their Effectiveness in Prognostication of Traumatic Brain Injury- A Prospective Study Conducted at a Tertiary Care Hospital

Panchal¹,

Krishnakumar²,

G³

et al. 2018

jemds

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Section: Discussionmentioning

confidence: 99%

Analysis of Clinico-Radiological Factors and Their Effectiveness in Prognostication of Traumatic Brain Injury- A Prospective Study Conducted at a Tertiary Care Hospital

Panchal¹,

Krishnakumar²,

G³

et al. 2018

jemds

Self Cite

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Midbrain volume in brain herniation: A volumetric analysis in operative traumatic brain injury

Lara-Reyna,

Karabacak,

Wedderburn

et al. 2024

Surgical Neurology International

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Background: This study primarily aimed to assess the volumetric attributes of the midbrain and perimesencephalic structures preoperatively and following surgical interventions in patients diagnosed with brain herniation secondary to traumatic brain injury (TBI). Methods: We evaluated patients based on radiological findings and clinical symptoms indicative of brain herniation. We performed semi-automated segmentation of the intracranial structures most relevant to trauma and of interest for the current study, such as hematoma, ventricles, midbrain, and perimesencephalic cisterns. Using preoperative and postoperative computed tomography scans, we measured and analyzed the volume of these structures. Patients were grouped based on their discharge Glasgow Coma Scale (GCS) scores: GCS 15 and non-GCS 15. Results: From May 2018 to February 2020, we included 20 patients in the study. Our volumetric analysis revealed that preoperative midbrain volume (5.84 cc vs. 4.37 cc, P = 0.034) was a significant differentiator between GCS 15 and non-GCS 15 groups. Preoperative midbrain volume remained significant in univariate (odds ratio [OR] = 2.280, 95% confidence interval (CI) = 1.126–5.929, P = 0.04) and multivariate logistic regression analysis (adjusted OR = 3.204, 95% CI = 1.228–12.438, P = 0.038) even after adjusting for age, sex, and admission GCS score. We identified a cut-off point of 4.86 ccs in preoperative midbrain volume, which demonstrated a discriminatory performance of 0.788 area under the receiver operating characteristic curve, 80.0% accuracy, 77.8% sensitivity, and 81.8% specificity between the two groups. Conclusion: Our findings suggest that patients presenting with lesser midbrain compression preoperatively tended to have improved clinical outcomes postsurgery. Thus, we propose that this preoperative midbrain volume cut-off point holds predictive value for clinical outcomes within our cohort.

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Antero posterior elongation of midbrain in traumatic brain injury- significant sign yet a mistaken entity

Cited by 2 publications

References 19 publications

Analysis of Clinico-Radiological Factors and Their Effectiveness in Prognostication of Traumatic Brain Injury- A Prospective Study Conducted at a Tertiary Care Hospital

Analysis of Clinico-Radiological Factors and Their Effectiveness in Prognostication of Traumatic Brain Injury- A Prospective Study Conducted at a Tertiary Care Hospital

Midbrain volume in brain herniation: A volumetric analysis in operative traumatic brain injury

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