Post-traumatic defects in computed tomography

Abstract

Long term CT-investigations of nearly 6000 brain-traumatized patients undergoing rehabilitative measures in the past ten years, showed pathologic findings in 85-90%: 40% showed abnormalities of the ventricular system; 60% traumatic tissue lesions; and 15% abnormalities of the brain surface. Kind and frequency of occurrence of the ventricular changes found by CT were in similar to those found by pneumencephalography. Traumatic inner-hydrocephalus permagnus, which occurred in about 0.25% of our patients, is considered with regard to its rehabilitative meaning. Most traumatic defects were found in the frontal lobe (36%) or in the temporal lobe (46%). Presence and etiology of traumatic infarctions were shown in CT images in 3.5% of all traumatic cases. 25% of these were situated in the posterior area: 25% in the basal ganglia; 15% in the midcerebral artery region, and 30% were typical borderline area infarctions. Because of the frequent differences between CT-findings and neurologic or neuropsychologic symptoms, CT-findings are to be judged only in conjunction with the clinical picture. They should never serve as the only guide for the exaluation of traumatic brain defects, prescribing therapy or predicting outcome.

Traumatic Brain Edema in the Pathogenesis of Post-traumatic Hydrocephalus

“…Throughout the period of study the CSF resorption resistance (R) remained within the normal range «lOmmHg/ml per min). At 1 month after injury intracranial pressure Pedersen 1979;Foroglou 1976;Koo and LaRoge 1977;French and Dublin 1977;Gudeman et al 1981;Busch 1989;Croswasser et al 1988). In contrast, in hydrocephalic patients the incidence of head injury in anamnesis varies from 2% to 50% of cases (Salmon 1972;Wieser and Probst 1975;Laws and Mokri 1977;Symon and Hinzpeter 1977;Jensen and Jensen 1979).…”