After a moderate to severe traumatic brain injury, a CT scan is the most common diagnostic tool used to predict injury severity and potential outcome. This prediction is a critical tool not only for clinical planning, but also to provide any information for anxious family members. However, prediction of outcome based on the CT scan can be challenging.
Several small studies have looked at specific characteristics of the CT scan that can help predict outcome after traumatic brain injury, but with mixed results. A recent large study looking at the CT scans of moderate to severe traumatic brain injuries and the 6-month outcome found that there were three CT characteristics that most accurately predicted outcome. These were the:
1. Aspect of ambient cisterns
2. Presence of intraventricular or subarachnoid hemorrhage
3. Type of dominant lesion
Clinicians can focus on these three aspects of a CT scan to more accurately predict outcome after traumatic brain injury.
Jacobs B, Beems T, ven der Vliet TM, et al. Outcome prediction in moderate and severe traumatic brain injury: A focus on computed tomography variables. Neurocritical Care. (November 2012).