POSITIVE CT BRAIN DURING EARLY POSTOPERATIVE PERIOD IN HEAD INJURY PATIENTS: IMPACT ON CLINICAL COURSE AND OUTCOME

Abstract

Objectives: To assess the impact of positive postoperative CT head during the
initial 72 hours on overall clinical course and outcome.
Methodology: 157 patients of head trauma who underwent cranial surgery
were prospectively included. All patients underwent a repeat head CT during
the initial 72 hours or as was indicated by neurological status of the patient.
Data was collected about patient demographics, initial CT diagnosis, repeat CT
findings, re-operation if performed, GCS at discharge, mortality and outcome in
terms of GOS. Data was analysed for impact of positive finding in postoperative
CT head and its impact on clinical course and outcome.
Results: The overall mean age was 34.25 ±11.59 years with a mean arrival
GCS of 9.2 ±2.32. The mean time to first postoperative CT was 21.45 ±9.83
hours. The postoperative CT scan was positive in 29 (18.5%) patients in which
16 (10.2%) cases required re-intervention. Overall mortality was 19 (12.1%), of
which 9 (44.1%) had a positive post-operative CT scan and 4 (21.1%) of them
underwent a repeat intervention. 2.3% of patients with negative CT were re-operated
while 44.8% were re-operated in the positive CT (p <0.0001). Similarly,
mortality was 7.8% in the negative CT group while it was 31.0% in the positive
CT group (p <0.0001).
Conclusions: Positive follow-up CT scan during early post-operative period can
affect significantly the clinical course and neurological outcome of patients.