CT mozga u dijagnostici neurotraume

Namjena ovog rada je analiza i usporedba kliničkih i neuroradioloških parametara u pacijenata nakon traumatske ozljede mozga. U rad su uključeni inicijalni CT nalazi koji u dimenziji vremena korespondiraju ranim traumatskim ozljedama mozga. CT nalazi su prikazani kroz kategorije Marshallove klasifikacije. Od kliničkih parametra smo uključili Glasgowsku ljestvicu kome prikupljenu za vrijeme prijama u bolnicu, eventualne pupilarne defekte i ekstakranijalne komplikacije evidentirane monitoringom tijekom intezivističkog lječenja. UtvrĎujemo da preteţno muški spol podlijeţe traumatskoj ozljedi mozga, u našoj seriji čak 80.2%. Obzirom na dobnu raspodijelu, nema dobne skupine koja ne biljeţi traumatsku ozljedu mozga. Iz kliničkih podataka rekonstruira se mehanizam traume i korelira s dobi. Prema mehanizmu neurotraume najčešći uzrok bio je pad (67.8%), zatim udarac u glavu, pješaci oboreni autom, vozači motocikla i osobnih automobila. Kategorija pada i pješaka oborenih autom sačinjavaju po dobnoj strukturi starije osobe, dok vozači motocikla i osobnih automobila sačinjavaju mlaĎe osobe. Od 111 pacijenata, 68% je imalo traumatsku frakturu, dok je pojavnost intrakranijalnog krvarenja bila 77.47%, od kojih su samo 14.4% imali hernijacije. Prema Marshallovoj klasifikaciji u naših ispitanika najčešća je bila difuzna ozljeda I (77.4%), a slijedi je evakuirana hemoragija s 14.4%. Laka ozljeda mozga moţe ići s pridruţenim mass lezijama na inicijalnom CT nalazu, no do detorioracije Glasogowske ljestvice kome će doći tek u vremenu koji sljedi. Prikazali smo da pupilarni defekti (anizokorične, bilateralno punktiformne ili široke zjelice) u 100 % slučajeva prate intrakranijalnu hemoragiju. Statističkom analizom Marshallove klasifikacije s χ² testom utvrdili smo da nije nezavisna u odnosu na Glasogowsku ljestvicu kome.The aim of this study is to analyze and compare clinical and neuroradiological parameters in patients who sustained cranial trauma. We include the initial CT findings that were presented in the categories of Marshall's classification. Clinical findings consist of Glasgow Coma Score (GCS) collected during hospital admission, pupillary defects and extracranial complications recorded during the intensive care monitoring. Demographic characteristics of patients show male predomination in traumatic brain injury (80.2. According to the mechanism of trauma most people fell down (67.8%), others had mechanical cranial impact, were pedestrians knocked down by a car, or were injured as drivers of motorcycles and cars. Falls and pedestrians (victims of car accidents) affected older people, while high speeds and traffic accidents tend to affect young people. Of the 111 patients up to 68% has traumatic fracture, 77.5% had intracranial bleeding, while herniation was present in 14.4% of patients. According to Marshall's classification in our series the most common is diffuse injury I in 77.4%, followed by surgical evaluated hemorrhage in 14.4% patients. Minor brain injury can go with the associated mass lesions on the initial CT findings, but the deterioration of the GCS will come in time that follows. Minor brain injury can have a mass lesion. We demonstrated that pupillary defect (anisocory, bilateral punctiform or dilated pupils) in 100% of cases had intracranial hemorrhage. Statistic analyzes of the CT findings to the classification criteria of Marshall and GSC score the χ² test determines that variables are not independent