Neuropsychological outcome in relation to the traumatic coma data bank classification of computed tomography imaging.

Abstract

The Traumatic Coma Data Bank (TCDB) classification of CT (computed tomography) scan hasbeen related to the general outcome and intracranial pressure evolution. Our aim was to analysethe relationship of thisclassification with neuropsychological outcome and late indices of ventriculardilatation. Fifty-seven patientswith a moderate or severe head injury (mean admission GlasgowComa Scale Score, 7.7) were studied from 122 consecutive cases. There were 49 males and 8 females(mean age, 27.7 years). Subjects were classified into TCDB categories on the basis of their most seriousacute CT scan finding. From the last control CT scan image, performed at a mean of 6.12months postinjury, several measures of ventricular dilatation were calculated. Neuropsychologicalassessment at 6-month included tests of verbal and visual memory, visuoconstructive functions, finemotor speed, and frontal lobe functions. Patients with diffuse injury type I showed better neuropsychologicaloutcome than patients with more severe diffuse injuries and those with mass lesions.Within the diffuse injury groups, the degree of diffuse damage was related to measures of verbalmemory and attention and cognitive flexibility. Ventricular enlargement was more evident in patientswith mass lesions and it decreased in the remaining groups as the severity of diffuse injury diminished.