Computer tomography in management and prognosis of patients with severe brain injury

The purpose of this study is to investigate the influence of computer tomography on the management and prognosis of patients with severe traumatic brain damage. To this end a consecutive series of patients with severe brain damage was investigated by means of serial computer tomography. The first part of this study deals with the influence of computer tomography on diagnosis and treatment. The emphasis here is placed on questions arising in practice, such as: - 1. What is the distribution of computer-tomographic fmdings at the various times when the patients were examined? 2. To what extent is a diagnosis based on the computer tomograms confirmed by operation or autopsy? 3. When should patients with severe brain damage be examined by computer tomography? 4. Which patients with brain damage should be examined by means of computer tomography? 5. What is the influence of computer tomography on the frequency with which other diagnostic techniques are used and on the treatment of patients with severe brain damage? In the second part of the study, the prognostic significance of computer tomography of comatose patients will be considered. To this end, the clinical course in 121 consecutive comatose patients was recorded, according to a protocol, at predetermined intervals after the accident. An attempt was made to produce computer tomograms at these same intervals. The outcome of each patient after one year was subsequently recorded according to the Glasgow Outcome Scale.