Choice of Management and Study about C.T. Finding in Traumatic Brain Injury of Temporal Lobe

Background: The indication for surgical treatment of traumatic parenchymal lesions in the temporal lobe remains controversial.Objective: To review the tomographic parameters that might be useful in making surgical decisions.Method: The tomographic findings of 70 patients were analyzed considering: (1) The effects of the lesion (determined by 4 variables: Midline shift, status of the cisterns, status of the ventricles, and status of the peripheral sulci); and (2) The characteristics of the lesion: Anterior, posterior or anteroposterior location (as defined by a coronal plane tangent to the cerebral peduncles) and its mediolateral diameter.Results: When none or only one of effect of the lesion variables was found to be altered, conservative treatment was instituted (23 out of 38 lesions). In three cases, all four variables were altered, and surgery was performed in all. Anterior, anteroposterior and posterior lesions measuring 21, 23 and 28mm in diameter, respectively, had a 50% chance of surgical removal.Conclusion: Amongst the patients who underwent surgical intervention, the more anterior the location of the temporal lobe lesion, the smaller the diameter.