Life prognosis in diffuse brain injury.

Abstract

The clinical symptoms and CT findings in 38 cases of diffuse brain injury in the acute stage were evaluated in relation to life prognosis. Diffuse brain injury was defined as disturbance of consciousness of 8 points or less on the Glasgow coma scale (GCS) for more than 24 hours after injury, and the specific findings of diffuse brain injury were noted on CT examination. Cases complicated with focal abnormality in CT were also included in this study. Among patients with diffuse brain injury, poor life prognosis was noted in those older than 60 years, scoring 4 points or less on the GCS and showing brainstem disfunction in the early stage after injury. Life prognosis was poor in those in whom CT showed diffuse brain swelling and disappearance of perimesencephalic cisterns. Primary brainstem injury and diffuse brain swelling were considered to indicate poor life prognosis in diffuse brain injury, and the study therefore concentrated on these two points.