Prognostic Parameters in Moderate or Severe Diffuse Axonal Injury.

Lee, Sang Kook; Park, Kwan; Kim, Young Baeg; Min, Byung Kook; Hwang, Sung Nam; Suk, Jong Sik; Choi, Duck Young

Original Article

Journal of Korean Neurosurgical Society 1990;19(8-9): 1123-1128.

Sang Kook Lee, Kwan Park, Young Baeg Kim, Byung Kook Min, Sung Nam Hwang, Jong Sik Suk, Duck Young Choi

Department of Neurosurgery, College of Medicine, Chung Ang University, Seoul, Korea.

ABSTRACT

A retrospective study 40 patients with moderate or severe diffuse axonal injury which is defined as posttraumatic coma for over 24 hours without mass lesions or ischemic insults was conducted in order to identify prognostic parameters. The sign of hypothalamic damage and motor reactivities of 40 patients were reviewed and compared to the outcome. The results were as follows ; 1) The ratio of male to female was about 3 to 1 and the peak incidence was at the first decade. 2) Of abnormal brain stem signs, fever of central origin was observed at the early posttraumatic phase and correlated with nonrecovery of consciousness(P<0.05). 3) Of abnormal brain stem signs, abnormal ADH secretion was significantly correlated with nonrecovery of consciousness(P<0.005). 4) Abnormal motor reactivity to pain was significantly correlated with nonrecovery of consciousness(P<0.005). 5) In the group of recovery of consciousness, initial Glasgow coma scale in 40 patients with moderate or severe DAI was significantly correlated with their outcome(P<0.005).

Key Words: Diffuse axonal injury; Prognostic parameters; Hypothalamic damage; Motor reactivities; Outcome