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686 Study of predictors of prognosis of mild head injury
  1. Latifa Arfaoui,
  2. Chokri Hamouda,
  3. Nèbiha Borsali Falfoul
  1. Emergency Department Rabta

Abstract

Background The mild head injury is a mild traumatic pathology in most cases and the role of emergencies often comes down to an early lesion assessment, analgesic treatment and practice of a brain scan. The follow up is assured by the neurology departments and no feedback is communicated to emergencies and thus no relationship between the original picture and the prognosis can be established. The aim of our study is to evaluate the prognosis of mild head injury after one month based on initial data.

Methods Descriptive prospective study of the clinical and evolutionary characteristics of mTBI isolated over a three months period (October-December 2009).

Results We collected 200 cases of mTBI. The average age of patients was 38.9 years with a sex ratio of 1.78. The initial loss of consciousness was reported in 95 patients (47.5%) and was predictive of the presence of intracranial lesions (p = 0.02). Follow up has been done in 84.5% of cases. CT scan was performed in 50.5% and allowed to reveal traumatic defects in 16.8% of cases. The existence of an epistaxis, agitation or periorbital hematoma was correlated with the existence of traumatic injuries to the scanner (p < 0.05). 169 patients were evaluated at one month by the Glasgow Outcome Scale (GOS). 50% of patients kept variable somatic complaints (headache, irritability, insomnia …). GCS, agitation, CCEP, CT score, initial loss of consciousness, Masters score and the ISS score are prognostic indicators.

Conclusions The initial loss of consciousness, the initial GCS, evaluating the severity of the accident and the patient’s condition are predictors of the existence of intracranial lesions indicating brain scan. These factors with brain damage, Masters Score and ISS are prognostic factors which are correlated with the appearance of post concussion syndrome. Early psychological treatment is necessary.

  • Mild traumatic brain injury
  • CT scan
  • prognosis

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