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KMID : 1150320200160020071
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Journal of Korean Society of Geriatric Neurosurgery
2020 Volume.16 No. 2 p.71 ~ p.77
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Clinical outcomes of diffuse axonal injury after traumatic brain injury according to magnetic resonance grading
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Lee In-Su
Park Kawng-Woo
Jeong Tae-Seok
Kim Woo-Seok
Kim Woo-Kyung
Rhee Do-Yeon
Park Cheol-Wan
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Abstract
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Objective: Diffuse axonal injury (DAI) is a severe form of traumatic brain injury (TBI) caused by shearing damage to the axons of long connecting fibers. In this study, we evaluated the clinical features according to DAI grading and identified prognostic factors.
Methods: The study involved patients diagnosed with DAI using magnetic resonance imaging within 2 weeks of being hospitalized for TBI from January 2019 to December 2019. Patients who received surgical treatments, such as craniectomy or craniotomy for hematoma evacuation or an external ventricular drain, were excluded. To determine prognostic factors, we retrospectively reviewed the demographic, clinical, and radiological characteristics of 41 patients. Patients’ outcomes were analyzed using the Glasgow Outcome Scale within 6 months of the traumatic injury.
Results: Using a multivariate logistic regression model, unfavorable outcomes were significantly associated with lower Glasgow Coma Scale score (P=0.03), DAI grade III (P=0.03), DAI located at the stem (P=0.04), and the presence of 7 or more DAIs (P=0.03). However, DAI grade II was not a significant prognostic factor (P=0.76). Furthermore, the rates of hospital-acquired infection (P=0.04) and tracheostomy (P=0.03) significantly increased according to DAI grade.
Conclusion: Our results provide valuable information on prognostic predictors in patients with TBI.
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KEYWORD
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Diffuse axonal injury, Traumatic brain injury, Brain magnetic resonance imaging, Prognosis
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