Correlation of CT Scan Findings with the Level of Consciousness in Acute Head Trauma

Background/ Objective: The purpose of this study was to determine CT scan findings in acute craniocerebral trauma and the relation between these findings and the level of consciousness. Patients and Methods: In this retrospective study, 800 pati ents with acute (less than 24 hours) craniocerebral trauma were studied over a period of three years. The patients’ level of consciousness (GCS) were determined and a brain CT scan without contrast agent was performed. A third generation General Electrics ( GE) CT scanner was utilized and 10-mm and 5-mm sections were obtained for the supratento rial and infratentorial parts, respectively. Results: From 800 patients studied, 641 (80.1%) were males and 159 (19.9%) were females. The peak age was 25 and the mean age was 26.80 ±18.30. The most common mechanism of head trauma was motor vehicle accidents (60.1%).80. M ild head injury was seen in 75% of patients, while 14% and 5.25% had moderate and severe head injuries, respectively. In 14.1%, the CT scan was normal. The most common lesions were as follows: epidural hematoma (EDH) 27.1%, subdural hematoma (SDH) 13.3%, subarachnoid hemorrhage (SAH) 11.4%, contusion 32.9% and pneumocephalus 12.1%. Intracranial hemorrhage, IVH and subdural hygroma were seen in less than 10 percent of patients. The presence of mixed lesions and midline shift regardless of the background lesions were related to statistically significant decreases in GCS. Conclusion: As one of the leading causes of mortality in Iran, craniocerebral trauma needs more considration, This is true especially for road accidents, which are the main cause of multiple traumas. In lower levels of consciousness, one should consider more complicated lesions and probable surgical inter vention. The presence of mixed lesions and midline shift regardless of the underlying le sion on CT scan were accompan ied by lower GCS, which may be due to major energy transmission and diff use brain tissue damage and compression of the brain stem.