Dynamics of focal traumatic parenchymal injuries of brain in acute period of mild traumatic brain injury

Abstract

Objective. To analyze the variation of clinical features and computer-tomographic dynamics of focal traumatic parenchymal brain lesions (TPBL) in the acute period of mild traumatic brain injury (TBI). Material and method. We observed 78 patients suffered from initially clinically mild TBI (GCS 13-15) and focal parenchymal brain lesions identified by CT at admission. We analyzed the clinical course of the TBI within the first 72 hours after injury in relation to the dynamics of the lesion by CT data. The examination included the repeated brain CTs at admission and within the next 3 days. Results. The worsening of patients’ condition with initially, clinically mild TBI occurred in 21 observations (27%), which was associated with the various manifestations of the TPBL progression. The deepest (up to 7 points on GCS) and fastest, within 8-12 hours after admission, fall in the level of consciousness had observed in six patients who suffered from development of delayed intracerebral hematomas. The dissociation between volumetric changes and clinical features of parenchymal lesions was observed in 24 cases (30,8%),. Conclusion. The critical assessment of “early” CTs at brain injuries with a repeated CT control is required. The small traumatic lesions or even invisible damages on primary CTs can progress and achieve the “surgical” level in a few hours with the sharp clinical deterioration.