Citation

Kim H, Jin ST, Kim YW, Kim SR, Park I, Jo KW. J. Neurotrauma 2015; 32(13): 950-955.

Affiliation

The Catholic University of Korea, Bucheon St. Mary's Hospital, Neurosurgery , Sosa-ro 327, Wonmi-gu , Bucheon, Korea, Republic of ; armada1997@naver.com.

Copyright

(Copyright © 2015, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2014.3697

PMID

25557755

Abstract

The purpose of this study was to identify the risk factors related to the hemorrhagic progression (HP) of brain contusion in patients after traumatic brain injury (TBI). Recently, many studies have reported abnormal lipid levels associated with hemorrhagic stroke. However, unlike hemorrhage stroke, the lipid profiles in TBI patients have not been examined. Therefore, we evaluated the risk factors of HP in TBI patients and focused on lipid profiles. Fifty-six TBI patients with mild to moderate injuries (Glasgow Coma Scale ≥9) who initially did not require surgical intervention were enrolled in this study. Patients underwent repeated computed tomographic (CT) scans at 4 hours and 24 hours after injury. Magnetic resonance imaging (MRI) was performed 7 days after the initial injury. In each noncontrast CT scan, the hemorrhage volume was quantified using the ABC/2 technique. Clinical features, pervious medical history, initial CT and microbleeding on follow up MRI were analyzed retrospectively. Thirty-one patients (55%) developed significant HP (volume>30%). Current smoking (p=0.034), higher initial systolic blood pressure (p=0.035), and lower triglyceride levels (p=0.039) were significantly associated with HP. Current smoking and a TG level <150 mg/dL were the only statistically significant predictors of HP in the multivariate analysis (p = 0.019, p = 0.021, respectively). HP with TBI is common in patients who currently smoke and have lower TG levels (150 mg/dL). These patients would be monitored closely, and surgery may be considered before deterioration occurs.

Language: en