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 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

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

BACKGROUND: Traumatic acute subdural hematoma remains one of the most lethal of all head injuries. It has been strongly held that the critical factor in the overall outcome from acute subdural hematoma is the timing of operative intervention for clot removal; those operated on within 4 hours of injury may have a marked decrease in mortality and morbidity. METHODS: Data were reviewed for 79 patients with a traumatic acute subdural hematoma during 2 years between January 1997 and December 1998. Treatment protocol included rapid operative intervention and aggressive postoperative control of intracranial pressure. RESULTS: The overall mortality rate was 63.3%, and 21.5% had functional recovery. The following variables statistically correlated(pmortality between patients operated on within 4 hours of injury and those undergoing surgery 4 hours or longer after the injury. CONCLUSION: Earlier surgical removal of the hematoma has a better prognosis, but the operative timing-within the first 4 hours-may not be critical to the outcome.
Clinical Protocols ; Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural, Acute* ; Humans ; Intracranial Pressure ; Linear Models ; Mortality ; Prognosis* ; Pupil

One hundreds eighty cases of traumatic intracerebral hematoma(TICH) among 1,633 head injury patients diagnosed with computerized tomography in neurosurgical department from Jan. 1990 to Jun. 1996. were classified into two TICH groups; TICH group associated with other traumatic intracranial lesions and TICH group without other traumatic intracranial lesions. The incidence of TICH was 11.0% and percentage of TICH with other traumatic intracranial lesions among 180 cases of TICH was 66.7%. TICH group with other traumatic intracranial lesions showed worse initial level of consciousness, more likely to have abnormal pupillary reflex, higher incidence of delayed traumatic intracerebral hematomas(DTICH), greater amount of hematoma, increased chance of surgery and worse outcome. In TICH group with other traumatic intracranial lesions, the factors affecting prognosis were initial Glasgow coma scale(GCS) score, pupillary reflex, amount of hematoma and treatment modality. In TICH only group, the factors affecting prognosis were initial GCS score, pupillary reflex, amount of hematoma and DTICH. The patients with 12-15 of GCS score, normal pupillary reflex, absence of DTICH, and amount of hematoma below 10cc, the presence of other traumatic intracranial lesions were found to be important prognostic factor. The overall mortality was 27.7% but in TICH group with other traumatic intracranial lesions, the mortality was 35.0% compared to 13.3% in TICH only group. It is concluded from this study that in the case with other traumatic intracranial lesions, TICH showed worse initial neurological status and prognosis compared to those without other lesions. Thus, these patients, although in conditions of good general clinical index at admission, should be considered to provide intensive care and treatment because these associated lesions will play as a bad prognostic factor.
Coma ; Consciousness ; Craniocerebral Trauma ; Hematoma* ; Humans ; Incidence ; Critical Care ; Mortality ; Prognosis ; Reflex, Pupillary