Marion Smits MD, Presenter: Nothing to Disclose

M. G. Myriam Hunink MD, PhD, Abstract Co-Author: Grant, W. L. Gore & Associates, Inc

Daphne van Rijssel, Abstract Co-Author: Nothing to Disclose

Heleen Dekker, Abstract Co-Author: Nothing to Disclose

Pieter E. Vos MD, PhD, Abstract Co-Author: Nothing to Disclose

Digna Rosemarijn Kool MD, Abstract Co-Author: Nothing to Disclose

Paul J. Nederkoorn MD, Abstract Co-Author: Nothing to Disclose

Paul A.M. Hofman MD, Abstract Co-Author: Nothing to Disclose

Albert Twijnstra MD, PhD, Abstract Co-Author: Nothing to Disclose

Herve L.J. Tanghe, Abstract Co-Author: Nothing to Disclose

Diederik Dippel, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To assess functional outcome and postconcussive symptoms in minor head injury patients with neurocranial traumatic findings on CT, and to evaluate whether specific CT findings are predictive of poor functional outcome.

All patients from the CT in Head Injury Patients (CHIP) study with neurocranial traumatic CT findings were included (n=312). The CHIP study is a prospective, multicentre study of consecutive patients, aged ≥16 years, presenting within 24h of blunt head injury, a Glasgow Coma Scale (GCS) score of 13-14 or a GCS score of 15 and a risk factor: loss of consciousness, anterograde amnesia, amnesia for the traumatic event, post-traumatic seizure, vomiting, headache, intoxication with alcohol/drugs, coagulopathy, supraclavicular injury or neurological deficit. Primary outcome was functional outcome according to the Glasgow Outcome Scale (GOS) as assessed by telephone interview or from patient records. Other outcome measures were the modified Rankin Scale (mRS), Barthel Index (BI), and number and severity of postconcussive symptoms (Rivermead questionnaire). The association between CT findings and outcome was assessed using univariable and multivariable regression analysis.

GOS was assessed in 237/312 patients (76%) at an average of 15 months (range 0-56 months) after injury. There was full recovery in 150 patients (63%), moderate disability in 70 (30%), severe disability in 7 (3.0%), and death in 10 (4.2%). Outcome according to the mRS and BI was also favourable in most patients. 71/87 (82%) of interviewed patients had postconcussive symptoms, that were, if present, more commonly severe. Evidence of parenchymal damage was the only independent predictor of poor functional outcome (odds ratio = 1.89; p=0.022).

Patients with neurocranial complications after minor head injury generally make a good functional recovery, but postconcussive symptoms persist in the majority of patients. Evidence of parenchymal damage on CT was predictive of poor functional outcome.

After minor head injury, evidence of parenchymal damage on CT is predictive of poor functional outcome. Postconcussion symptoms are very common, but not found to be related to specific CT findings.

Smits, M, Hunink, M, van Rijssel, D, Dekker, H, Vos, P, Kool, D, Nederkoorn, P, Hofman, P, Twijnstra, A, Tanghe, H, Dippel, D, et al, , et al, , Long-term Outcome after Complicated Minor Head Injury.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011287.html