EARLY CT FINDINGS TO PREDICT EARLY DEATH IN PATIENTS WITH TRAUMATIC BRAIN INJURY: MARSHALL AND ROTTERDAM CT SCORING SYSTEMS COMPARED IN THE MAJOR TERTIARY CARE HOSPITAL IN NEPAL

Abstract

In clinical practice, the severity of traumatic brain injury (TBI) is generally classified as mild, moderate and severe according to the level of consciousness as assumed using the Glasgow Coma Scale (GCS). The increased use of early sedation, intubation and ventilation in more severely injured patients has decreased the accuracy of GCS for the purposes of TBI classification, as patients need to be conscious to be able to respond verbally. An alternative to this is the classification of TBI according to morphological criteria based on computed tomography (CT) scan. Although TBI can also be classified using magnetic resonance imaging (MRI), which is more sensitive for detecting small white matter lesions in later phases, CT examination remains the investigation of choice to rapidly identify the presence and extent of structural damage in the acute phase.