The Value of Immediate Computerized Tomography Following Emergency Surgery for Traumatic Brain Injury: Experience in A Tertiary Center in Egypt

Ali, Maha A.; Aboul-Ela, Hashem M.; Mohamed, Ahmed; Salah, Ahmed

doi:10.21608/mjcu.2020.110944

Cited by 1 publication

(5 citation statements)

References 10 publications

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“…This result is similar to that reported in Paci et al [4] study, where the only variable statistically associated with unexpected findings was ASDH as an indication for re-operation (P < 0.01). Also, our result comes in agreement with that of Mohammed et al [21] who reported that both of ASDH and ICH was associated with a high rate of re-operation (P = 0.037 and 0.034, respectively), where out of the 9 patients who In our study, coagulopathy (high INR) was a significant predictor in TBI patients going for cranial surgery, where out of the 11 patients who had preoperative high INR, 9 cases (81.8%) developed remarkable postoperative findings (P < 0.001). Our result is in accordance with the result of Rehman et al [12] study where in patients who had a positive follow-up CT the mean INR was significantly higher than those with negative postoperative CT (P < 0.001).…”

Section: Remarkable Findings In the Early Postoperative Ctsupporting

confidence: 94%

“…On the other hand, Khaldi et al [24] reported that some postoperative changes might evolve over time and may influence patients' management and the early postoperative CT may fail to predict these changes. Also, in Mohammed et al [21] unexpected change in the NE was the single most influential factor in determining the need for re-surgery.…”

Section: Postoperative Ne and Early Follow-up Ctmentioning

confidence: 90%

“…In the study of Takeuchi S and associates [25], new findings were observed in postoperative CT scans of 26 patients (25.5%) out of 102 patients who underwent DC for TBI. In Mohammed FA and associates [21] study, 24 patients (16.6%) out of 145 patients had positive findings in the postoperative CT and 9 patients of them went to the OR again.…”

Section: Remarkable Findings In the Early Postoperative Ctmentioning

confidence: 92%

“…In Rehman et al [12] study, EDH and ASDH were the most common lesions (41.4% and 26.8%, respectively). Mohammed FA and associates [21] reported that EDH was the most frequent lesion (51.7%) followed by DSF (28.9%) and then ASDH (15.9%).…”

Section: Preoperative Datamentioning

confidence: 96%

“…In Paci et al [4] study, 6 patients developed unexpected findings in postoperative CT; recurrent SDH or EDH in two, new SDH or EDH in two and ICH in two. In Mohammed et al [21] study, positive findings in the immediate follow-up CT included re-bleeding, new cerebral contusion in the operation site, contralateral contusion with MLS, brain edema and significant hematoma recollection.…”

Section: Remarkable Findings In the Early Postoperative Ctmentioning

confidence: 97%

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Guiding lights in the early postoperative computed tomography following cranial surgery for traumatic brain injury patients

Elkholy,

Elnoamany,

Dorrah

2024

Egypt J Neurosurg

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Background Computed tomography (CT) can be a substantial source of guiding lights during the early postoperative hours in traumatic brain injury (TBI) patients. However, controversy still exists regarding: What is the appropriate time for the first postoperative CT? And what are the guiding lights that can be gained from an early follow-up CT? Therefore, our objective was to reach more clear answers for these questions and to design a simple algorithm for the follow-up of TBI patients during the first 24 h after cranial surgery. Methods This is a retrospective study included 164 TBI patients who were surgically treated for various traumatic cranial and/or intracranial lesions in our neurosurgery department from January 2022 to April 2023. Pre- and postoperative clinical and radiological data of these patients were collected and analyzed. Results The mean age was (23.46 ± 15.126) years. The mean glasgow coma scale (GCS) on presentation was (11.62 ± 3.004). 51.2% of patients had their first follow-up CT done within the first postoperative hour (0–1 h). Postoperative remarkable CT findings were detected in 39 patients (23.8%), with 13 cases (33.3%) of them required re-surgery. 69.2% of the postoperative remarkable findings were recognized in the first hour CT (P = 0.025). Acute subdural hematoma was the only significant primary lesion associated with the need for re-surgery (P = 0.015). Postoperative development of remarkable CT findings was significantly (P < 0.001) associated with increased possibility of re-surgery, high mortality rate, prolonged hospital stay and poor outcome. Conclusions Immediate (0–1 h) follow-up CT brain can be more lucrative in the early postoperative assessment for TBI patients. The first hour CT can provide distinct guiding lights of significant value for the subsequent postoperative management and prediction of patients' clinical course and discharge outcome.

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Section: Remarkable Findings In the Early Postoperative Ctsupporting

confidence: 94%

Section: Postoperative Ne and Early Follow-up Ctmentioning

confidence: 90%