This report is made to investigate clinical outcome in 144 patients with severe head injuries. The result was as follows: 18% made a good recovery, 25% were moderately disabled, 11% were left vegetative, and 44% died. The outcome from severe head injuries seemed to become worse with advancing age. It was observed that the prognosis for head injury in general worsens in the group older than 30 years and the apparent increased morbidity and mortality with a surgical hematoma relate more to age than to the presence of the hematoma.
Craniocerebral Trauma* ; Head* ; Hematoma ; Humans ; Mortality ; Prognosis

A series of 24 cases of gun shot and explosive injuried patients of the brain is analyzed according to causes, types, operability, the relation between Glasgow coma scale(GCS) and operative mortality, associated injuries, complications and sequelae. The authors notice that gun shot and explosive injury of the brain are more worse than blunt head trauma because of injury mechanism by itself.
Brain* ; Coma ; Craniocerebral Trauma ; Humans ; Mortality

This study includes 48 patients with severe head injury and with Neurosurgical Coma Scale(N.C.S.) scores of < or =8, who were admitted during last 1 1/2 years in our neurosurgical department. One week interval Serial C.A.T. scan was performed for 3 times and reviewed with patient's outcome and coma score comparing with consequences of serial C.A.T. Scan. Mortality rate was 33% who's coma score of < or =5 and 14% of > or =6. C.A.T. scans are correlated with the level of consciousness and coma score. The most common abnormalities were small ventricle ad area of mixed density interpreted as diffuse contusion. Two cases are new formed post-traumatic intracerebral hematoma. The patients, who's coma score of < or =5 had severe clinical and C.A.T. abnormality.
Coma ; Consciousness ; Contusions ; Craniocerebral Trauma* ; Head* ; Hematoma ; Humans ; Mortality

The present study is made to evaluate prognostic factors in 67 patients with severe head injuries collected from entire 617 head-injured patients who were admitted to the Department of Neurosurgery, Won Kwang University Hospital from January, 1984 to December, 1985. The results were as follows : 1) The mortality rate in the different age group was as follows : 37.8% for patients aged 40 years and less, and 72.7% for those over 40 years old. The difference in mortality was significant. 2) The mortality rate increased steadily as the GCS score on admission decreased. 3) The mortality rate increased steadily in sequence of the motor response of localizing, withdrawal, abnormal flexion, abnormal extension, and flaccidity. The difference in mortality was significant only between abnormal flexion and abnormal extension. 4) The mortality rate was significantly higher in patients without pupillary light reflex than those with reflex. 5) The mortality rate observed in patients operated on for a intracranial mass lesion was 57.1% and the mortality rate in patients not undergoing surgery was 40.6%. The difference was not statistically significant. 6) In the overall outcome of 67 patients, 7.5% made a good recovery, 23.9% were moderately disabled, 11.9% were left severly disabled, 7.4% were vegetative, and 49.3% of the patients died.
Adult ; Craniocerebral Trauma* ; Head* ; Humans ; Mortality ; Neurosurgery ; Reflex

The authors analysed 140 cases of subdural hygroma developed after head injury and various neurosurgical operations and was treated at Hanyang university hospital from 1983 to 1989. The results were analysed and summarized as follows. 1) The peak incidence was the age over 50 and under 10. 2) 104 cases(74.4%) were bilateral frontotemporoparietal lesions. 3) Causes were head injury(121 cases), operation for intracranial aneurysms(5 cases), ventriculoperitoneal shunt(5 cases), traumatic(2 cases), external ventricular drainage(1 case). 4) Change in mental status without focal sign of brain damage was presenting symptom. 5) Operation was underwent if 63 cases and the reaccumulation rate was high (26.8%) after trephination but outcome was favorable. 6) Mortality rate in traumatic subdural hygroma was low(5.8%) because brain CT could detect subdural hygroma easily in early stage.
Brain ; Craniocerebral Trauma ; Head ; Incidence ; Mortality ; Subdural Effusion* ; Trephining

The authors analyze arbitrary 100 cases of skull fractures and compare with the incidence and character of the complication of head injuries associated with a skull fracture. Age, sex, cause of injury, skull fracture, intracranial hemorrhage, mortality rate and sequelae are discussed.
Craniocerebral Trauma ; Incidence ; Intracranial Hemorrhages ; Mortality ; Skull Fractures* ; Skull*

Posttraumatic cerebral infarction is a recognized complication of craniocerebral trauma, but, its frequency, cause, and influence on mortality are not well defined. During a two year period, 706 patients with head trauma were examined in our hospital with cranial CT studies. The CT findings which strongly suggested the herniation were seen in 46 patients. The posttraumatic cerebral infarction was diagnosed retrospectively in 18 of these patients. Detailed information, including CT findings were recorded from 1 to 10 days after admission. Posttraumatic cerebral infarctions were seen in the vascular territories of the middle cerebral artery(PCA) in 9 patients, posterior cerebral artery(PCA) in 4 patients, anterior cerebral artery(ACA) in 3 patients, and multiple in 2 patients. Outcomes of these 18 patients were severely disabled in 8 patients, moderate disabled in 6 patients, and death in 3 patients. Only one remaining patient was demonstrated a good recovery. These results suggest that cerebral infarction with severe head trauma might be associated with significantly bad influence on outcome of these patients when compared with those without cerebral infarction.
Cerebral Infarction ; Craniocerebral Trauma ; Humans ; Mortality ; Retrospective Studies

The authors analyzed 115 cases of head injury surgically treated in the Department of Neurosurgery, Yonsei University Medical College, in 1978. Among them, 18 patients had another significant combined injury in the body. Mortality of them was twice more than of the group without combined injury. Protection of brain from circulatory disturbance, hypoxia, fat embolism, etc. is chief point of early treatment of multiply injured patients. The most common cause of multiple injuries involving head injuries was traffic accident. Mortality of the group diagnosed with CT scan was lowest. Intervals between the injury and operation were within 24 hours in almost them.
Accidents, Traffic ; Anoxia ; Brain ; Craniocerebral Trauma ; Embolism, Fat ; Humans ; Intracranial Hemorrhage, Traumatic* ; Mortality ; Multiple Trauma ; Neurosurgery ; Tomography, X-Ray Computed

OBJECTIVE: The aim of this study is to determine the factors influencing the surgical outcome following craniotomy for head injury and to establish the criteria for surgical intervention in the age of 65 years or older. METHODS: We retrospectively investigated the mechanism of injury, types of computed tomography lesions, Glassgow coma scale(GCS) score at admission, pupillary reactivity, past medical history and surgical outcome following craniotomy in the elderly during 8 year period. RESULTS: There were 35 men and 21 women with a mean age of 70.7 years(range 65-87 years). The mortality rate at discharge was 58.9%. Good outcome was achieved only in 25 percent of the patients. The cause of injury did not affect on the surgical outcome. All of 19 patients with GCS of 5 or less at admission had poor outcome. Outcome was significantly worse in older patients(more than 75 years) compare to younger patients(less than 75 years). Ninety percent of the patients with pupillary abnormality had poor outcome, whereas 57.7 percent of the patients with bilateral reactive pupil had poor outcome. Past medical history did not affect on the surgical outcome following craniotomy. CONCLUSION: Surgical outcome is unexceptionally poor in the elderly head-injuried patients if the age is 75 years old or older, the GCS is 5 or less and the pupil is bilaterally dilated. Craniotomy under those circumstances is not desirable.
Aged* ; Coma ; Craniocerebral Trauma ; Craniotomy ; Female ; Humans ; Intracranial Hemorrhage, Traumatic* ; Male ; Mortality ; Pupil ; Retrospective Studies

We have experienced nine patients with acute optic never injury after blunt head trauma. In each patient the optic cannal was decompressed via an ipsilateral external ethmoidectomy or transcranial approach. Two Patients recieved treatment with steroid during the perioperative period. There patient improved mild visual acuity. There was no morbidity or mortality but the results were controversial.
Craniocerebral Trauma ; Decompression* ; Humans ; Mortality ; Optic Nerve Injuries* ; Perioperative Period ; Visual Acuity